Face to face service coordination visits are suspended through May 31, 2021 for STAR Health, STAR Kids, STAR+PLUS MCOs, and Dual Demonstration Medicare-Medicaid Plans (MMPs).
Health plans may replace face to face visits with telephonic or telehealth outreach.
-Extended enrollment MDCP and STAR+PLUS HCBS
To ensure members do not experience a gap in services due to the temporary suspension of face to face service coordination visits for COVID-19, HHSC is extending enrollment for the Medically Dependent Children’s Program (MDCP) and STAR+PLUS Home and Community Based Services (HCBS) for members with individual service plans (ISPs) expiring in September 2020.
The extension applies to the member’s Screening and Assessment Instrument (SAI), STAR+PLUS HCBS Medical Necessity Level of Care (MNLOC) and corresponding ISPs.
However, health plans may process a change in condition via telehealth if a member’s service needs change. The member’s ISP may be adjusted but they will not lose eligibility.
-MDCP and STAR+PLUS HCBS reassessments
Health plans may not complete level of care reassessments via telehealth for members at this time.
-Nursing facility MDS authorization extensions
HHSC is extending nursing facility minimum data set (MDS) assessment authorizations.
This means nursing facility eligibility, Medical Necessity, and the current Resource Utilization Groups (RUG) level will be extended for 90 days for those residents who would otherwise have an eligibility lapse, or until the MDS is completed, whichever is sooner.
HHSC directed STAR, STAR Health, STAR Kids, and STAR+PLUS MCOs to allow FMSAs to suspend providing face-to-face orientations for CDS employers. Employer orientations scheduled through the end of October 2020 will be virtual or by telephone. Face-to-face will be required after the suspension.