| (92) Significant traditional provider (STP)--A provider
identified by HHSC as having provided a significant level of care
to the target population, including a DSH.
(93) STAR--The State of Texas Access Reform (STAR)
managed care program that operates under a federal waiver and primarily
provides, arranges for, and coordinates preventive, primary, acute
care, and pharmacy services for low-income families, children, and
pregnant women.
(94) STAR Health--The managed care program that operates
under the Medicaid state plan and primarily serves:
(A) children and youth in DFPS conservatorship;
(B) young adults who voluntarily agree to continue
in a foster care placement (if the state as conservator elects to
place the child in managed care); and
(C) young adults who are eligible for Medicaid as a
result of their former foster care status through the month of their
21st birthday.
(95) STAR Kids--The program that operates under a federal
waiver and primarily provides, arranges, and coordinates preventative,
primary, acute care, and long-term services and supports to persons
with disabilities under the age of 21 who qualify for Medicaid.
(96) STAR+PLUS--The managed care program that operates
under a federal waiver and primarily provides, arranges, and coordinates
preventive, primary, acute care, and long-term services and supports
to persons with disabilities and elderly persons age 65 and over who
qualify for Medicaid by virtue of their SSI or MAO status.
(97) STAR+PLUS Home and Community-Based Services Program--The
program that provides person-centered care services that are delivered
in the home or in a community setting, as authorized through a federal
waiver under §1115 of the Social Security Act, to qualified Medicaid-eligible
clients who are age 21 or older, as cost-effective alternatives to
institutional care in nursing facilities.
(98) State plan--The agreement between the CMS and
HHSC regarding the operation of the Texas Medicaid program, in accordance
with the requirements of Title XIX of the Social Security Act.
(99) Supplemental Security Income (SSI)--The federal
cash assistance program of direct financial payments to people who
are 65 years of age or older, are blind, or have a disability administered
by the Social Security Administration (SSA) under Title XVI of the
Social Security Act. All persons who are certified as eligible for
SSI in Texas are eligible for Medicaid. Local SSA claims representatives
make SSI eligibility determinations. The transactions are forwarded
to the SSA in Baltimore, which then notifies the states through the
State Data Exchange (SDX).
(100) Texas Health Steps (THSteps)--The name adopted
by the State of Texas for the federally mandated Early and Periodic
Screening, Diagnosis, and Treatment (EPSDT) services, described at
42 U.S.C. §1396d(r) and 42 CFR §440.40 and §§441.40
- 441.62.
(101) Value-added service--A service provided by an
MCO that is not "medical assistance," as defined by §32.003 of
the Texas Human Resources Code.
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| Source Note: The provisions of this §353.2 adopted to be effective February 28, 1997, 22 TexReg 1799; amended to be effective August 10, 2005, 30 TexReg 4466; amended to be effective September 1, 2006, 31 TexReg 6629; amended to be effective July 1, 2007, 32 TexReg 2135; amended to be effective September 1, 2007, 32 TexReg 5333; amended to be effective March 1, 2012, 37 TexReg 1283; amended to be effective July 8, 2012, 37 TexReg 4851; amended to be effective September 1, 2014, 39 TexReg 5873; amended to be effective November 1, 2016, 41 TexReg 8265; amended to be effective September 1, 2017, 42 TexReg 4273; amended to be effective April 24, 2019, 44 TexReg 1980; amendedtobe effective August 12, 2021, 46 TexReg 4843; amended to be effective April 2, 2024, 49 TexReg 2061 |
