Information Letter No. 16-27 Transition of MDCP Long Term Services and Supports to Managed Care
Beginning November 1, 2016, children and young adults under the age of 21 who receive:
•Supplemental Security Income (SSI),
•disability-related Medicaid, or
•MDCP services will transition from traditional fee-for-service Medicaid or STAR+PLUS to the new STAR Kids managed care program to receive their Medicaid State Plan and waiver services.
Participation in managed care does not impact an individual’s ability to access or maintain a slot on the MDCP interest list or the interest lists of Community Living and Support Services (CLASS), Deaf Blind with Multiple Disabilities (DBMD), Home and Community-based Services (HCS), and Texas Home Living (TxHmL).
STAR Kids enrollment does not apply to:
•children in foster care who receive SSI or disability-related Medicaid;
•individuals receiving MDCP who are served through the STAR Health program; or
•individuals who turn 21 in November 2016, December 2016, or January 2017 (first 90 daysof implementation) who will remain in fee-for-service Medicaid and be enrolled inSTAR+PLUS if eligible.
Individuals eligible for Medicare and Medicaid will receive acute care services through their Medicare provider and receive MDCP and other long-term services and supports through a STAR Kids or STAR Health managed care organization (MCO). In addition, all assessments, reassessments, and ongoing case management for MDCP will be completed by the STAR Kids and STAR Health MCOs, rather than the Texas Department of Aging and Disability Services (DADS) case managers and nurses. MCOs will be responsible for individual service plan (ISP) development and ensuring their members’ continued eligibility for MDCP in accordance with the policies and procedures outlined in the STAR Kids Handbook and the STAR Health MDCP chapter of the Uniform Managed Care Manual (UMCM).
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