DADS has issued Information Letter 14-37 stating…
Effective September 1, 2014, acute care services (e.g., physician visits, prescriptions) for some residents of non-state operated intermediate care facilities for individuals with an intellectual disability or related conditions (ICF/IID) will change from fee for service to managed care. Individuals who enroll into the STAR+PLUS program will receive acute care services through STAR+PLUS, with two exceptions as described below.
Behavioral Health Services
ICF/IID residents who are STAR+PLUS members and living in Collin, Dallas, Ellis, Hunt, Kaufman, Navarro or Rockwall County will continue using the “Your Texas Benefits” Medicaid card for behavioral health services. Behavioral health services include psychiatry services, counseling for adults, inpatient mental health services, outpatient mental health services, and substance abuse treatment.
Dental Services
The expansion of acute care services to managed care will not affect dental services. Residents of non-state operated ICF/IID will continue receiving dental services through the “Your Texas Benefits” Medicaid card, including intravenous (IV) sedation as part of a dental procedure. However, STAR+PLUS will cover the IV sedation if the dental condition “jeopardizes the overall health of the individual.”
To help ensure continued access to needed services, the Department of Aging and Disability Services encourages ICF/IID providers to remind dental providers to scan the Your Texas Benefits card each visit in order to verify the individual’s eligibility for dental services.
If you have questions about this letter, please email pdo@dads.state.tx.us.
