STAR+PLUS Provider Updates

Therapy Policy Changes FAQ -Effective September 1, 2017

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.
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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 https://hhs.texas.gov/. 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 . 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 FormM

Looking for past communications? Click here for Archive of Past Updates.