Hidalgo Service Area STAR and STAR+PLUS Expansion

Notice: The Texas Health and Human Services Commission (HHSC) will conduct a Town Hall meeting in Brownsville on May 9, 2012. [More information on the May 9 meeting (DOC)]

Notice: The Texas Health and Human Services Commission (HHSC) will conduct Town Hall meetings in Edinburg on May 24, 2012.  [More information on the May 24 meeting (DOC)]

Notice:  On Feb. 17, 2012, HHSC issued an advisory to long-term services and supports (LTSS) providers related to authorization and billing issues under Section 8.2.1 of the STAR+PLUS Expansion Contract (Continuity of Care and Out-Of-Network Providers).  [View advisory (DOC)]

Provider meeting: Acute care providers are invited to attend a town hall meeting for information on the STAR and STAR+PLUS Medicaid managed care expansion. The meeting will take place Friday, February 10, from 10 a.m. to 3 p.m. at the Marine Military Academy Auditorium, 320 Iwo Jima Blvd., in Harlingen. 

The Texas Health and Human Services Commission and the Medicaid managed care organizations will be in attendance to provide information and answer questions about the STAR and STAR+PLUS Medicaid programs. The managed care organizations also will offer information about contract opportunities for interested providers. 

For additional information regarding this town hall meeting, please contact Mary Helen Barrera at 713-446-4366.  Pre-registration is not required to attend.

Claims testing: Claims testing opportunities are available for contracted STAR+PLUS Long-term Services and Supports providers in the Hidalgo, El Paso, and Lubbock service areas before the March 1 Medicaid managed care expansion.  More about claims testing.

Overview

Starting March 1, 2012, the STAR and STAR+PLUS programs will provide managed care health services for people who have Medicaid in these counties in the Hidalgo Service Area: Cameron, Duval, Hidalgo, Jim Hogg, Maverick, McMullen, Starr, Webb, Willacy, and Zapata.

About the STAR program

STAR provides health care for:

  • Children and families with low-income.
  • Pregnant women.
  • Families who have Temporary Assistance to Needy Families (TANF).

About the STAR+PLUS program

Medicaid clients must enroll in STAR+PLUS if they meet one or more of the following:

  • Have SSI and are age 21 or older.
  • Get Community Based Alternative (CBA) services.
  • Get Medicaid through Social Security exclusion programs.

Children age 20 and younger with Supplemental Security Income (SSI) may choose between STAR+PLUS and traditional Medicaid.

People who have both Medicaid and Medicare will:

  • Continue to get health care from their Medicare doctors.
  • Continue to get medications through Medicare.
  • Get long-term services and supports from STAR+PLUS.

The following will continue to get Medicaid services the same way they do now:

  • People who live in an institution—such as a nursing home, Intermediate
  • Care Facility for Persons with Mental Retardation (ICF-MR) or state school.
  • People who get home and community-based services through a
  • Medicaid waiver other than the CBA program.
  • Children in state foster care.

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