An official State of Texas website.
Contracts
- STAR Kids Managed Care Contract (PDF)
- CHIP Rural Service Area Contract (PDF)
- Medicare-Medicaid Dual Demonstration (MMDD) Contract (PDF)
- Uniform Managed Care Contract (PDF)
STAR Health
- Full STAR Health Contract Operational 09/01/2023 (PDF)
- Amended STAR Health 1 (PDF) 03/01/2023 (Exhibits A, B, and P)
- Amended STAR Health 2 (PDF) 09/01/2023 (Exhibits A, B, D, F, and P)
- Amended STAR Health 3 (PDF) 03/01/2024 (Exhibits B, D, and P)
- Amended STAR Health 4 (PDF) 06/01/2024 (Exhibit P)
- Amended STAR Health 5 (PDF) 09/01/2024 (Exhibits A, B, D, and P)
- Amended STAR Health 6 (PDF) 12/01/2024 (Exhibit P)
STAR+PLUS
- Full STAR+PLUS Contract Operational 06/01/2024 (PDF)
- Amended STAR+PLUS Revised Operational 09/01/2024 (PDF)
- Amended STAR+PLUS 2 (PDF) 09/01/2024 (Exhibits A, B, D, H, and Q)
- Amended STAR+PLUS 3 (PDF) 12/01/2024 (Exhibit Q)
Dental Service
- Full Dental Services Contract Operational 09/01/2020 (PDF)
- Amended Dental Service 1 (PDF) 04/01/2020 (Attachments A and B)
- Amended Dental Service 2 (PDF) 09/01/2020 (Attachments A, B, and F)
- Amended Dental Service 3 (PDF) 12/15/2020 (Attachment B)
- Amended Dental Service 4 (PDF) 03/01/2021 (Attachments A and B)
- Amended Dental Service 5 (PDF) 06/01/2021 (Attachments A and B)
- Amended Dental Service 6 (PDF) 09/01/2021 (Attachments A, B, and G)
- Amended Dental Service 7 (PDF) 03/01/2022 (Attachments A and F)
- Amended Dental Service 8 (PDF) 09/01/2022 (Attachments A, B, and F)
- Amended Dental Service 9 (PDF) 03/01/2023 (Attachments A, B, and F)
- Amended Dental Service 10 (PDF) 09/01/2023 (Attachments A, B, and F)
- Amended Dental Service 11 (PDF) 03/01/2024 (Attachments B, F, and O)
- Amended Dental Service 12 (PDF) 06/01/2024 (Attachment O)
- Amended Dental Service 13 (PDF) 09/01/2024 (Attachment A, B, F, and O)
- Amended Dental Service 14 (PDF) 09/01/2024 (Attachment O)
Manuals and Handbooks
Reporting
- Exclusionary Screening Disclosures (Excel)
- Financial Statistical Reports
- Managed Care Incentives and Disincentives
- Managed Care Organization Sanctions
Medicaid and CHIP Financial Statistical Report Agreed Upon Procedures Results
Per Federal requirement, (42 CFR §438.602(e) and (g); May 6, 2016, Federal Register (81 FR 27497); OMB No. 0938-0920), HHSC is posting the result of each agreed upon procedures review of all Managed Care Organizations' and Dental Maintenance Organizations' Financial Statistical Reports by year.
The files below are in Excel format. All totals stated are based on current figures and subject to change.
- SFY 2020 FSR AUP Results Summary (Excel)
- SFY 2019 FSR AUP Result Summary (Excel)
- SFY 2018 FSR AUP Result Summary (Excel)
Managed Care Program Annual Report
The Center for Medicaid and Medicaid Services (CMS) regulations at 42 CFR 438.66(e) require HHSC to submit a Managed Care Program Annual Report (MCPAR) for each Medicaid managed care program administered by the state. Additionally, 42 CFR 438.66(e)(3)(i) requires HHSC to post the completed MCPARs each year.
Resources
- Electronic Code of Federal Regulations - Managed Care Section
- Texas Administrative Code
- Approved Medicare Advantage and Dual Eligible Health Plans (Excel)
Persons with disabilities that require an accessible version of any document should email Patricia Hastings.