STAR+PLUS HHSC Notifications
- Benefit Criteria to Change for Respiratory Equipment and Supplies Effective 1-13-2017
- Cardiorespiratory Monitor (CRM) Benefits to Change Effective 1-13-2017
- Continuous Positive Airway Pressure (CPAP) Effective 1-13-2017
- Humidifiers Heating Elements Compressors and Large Volume Nebulizers Benefit Criteria to Change Effective 1-13-2017
- Mechanical Ventilation Equipment Tracheostomy Tubes and Other Related Supplies Effective 1-13-2017
- New Respiratory Prior Authorization Forms Effective 1-13-2017
- Oxygen Therapy Benefits to Change for Texas Medicaid Effective 1-13-2017
- Pulse Oximeter Benefit Changes for All Ages Effective 1-13-2017
- Secretion and Mucus Clearing Devices Benefit Criteria to Change Effective March 1, 2017
- Small Volume and Ultrasonic Nebulizer Benefit Criteria to Change for Texas Medicaid Effective 1-13-2017
TMHP PROVIDER DIS-ENROLLMENT
Patient Protection and Affordable Care Act Deadline has Passed and Dis-enrollment from Texas Medicaid will occur January 31, 2017. Learn More
Enterprise Validation Tool In compliance with Centers for Medicare and Medicaid Services (CMS) and State regulations, Cigna-HealthSpring STAR+PLUS is implementing front-end HIPAA validation edits for all claims and encounter data submissions. The change is effective August 15, 2016.
On March 17, 2014, the Centers for Medicare and Medicaid Services (CMS) issued new regulations with additional requirements for Medicaid-funded home and community-based services, including Medicaid 1115 waiver programs providing such services. Providers must comply with the new rules by March 17, 2019. As part of the transition to the new rules, the Health and Human Services Commission (HHSC) and the Department of Aging and Disability Services (DADS) are assessing current services and practices. Part of that project is a self-assessment of residential service providers.
For STAR+PLUS, this specifically relates to providers of assisted living facility services or adult foster care services. A survey must be completed for every site at which assisted living facility services or adult foster care services is provided. The four-part survey tool and instructions can be found on the HHSC website at http://www.hhsc.state.tx.us/medicaid/hcbs/index.shtml. Providers have until July 29th to complete the survey. Please send any questions about the assessment to MCD_managed_care_quality@hhsc.state.tx.us with subject line "HCBS Settings ." Thank you for your assistance with this important initiative. Use of Electronic Visit Verification for Department of Aging and Disability Services Providers Transitioning to Managed Care - Read about it here.
UPDATE on Delay of Statewide Implementation of the Health and Human Services Commission Electronic Visit Verification (EVV) Initiative- Learn more/ EVV Vendor Selection Form