SKOPH Revisions
26-3, Miscellaneous Changes
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Revision Notice 26-3; Effective Aug. 14, 2026
The following sections were revised in the STAR Kids Program Support Unit Operational Procedures Handbook:
| Section | Title | Change |
|---|---|---|
| 1200 | MDCP Eligibility | Updates language. |
| 1210 | Medical Necessity Determination | Changes title to Age. Updates language. |
| 1210.1 | Reserved for Future Use | Deletes section. |
| 1210.2 | Medical Necessity Approval Time Frame for Initial Eligibility Determinations | Deletes section. |
| 1220 | Individual Cost Limit | Changes title to Texas Residency. Updates language. |
| 1230 | Unmet Need for at Least One Medically Dependent Children Program Service | Changes title to Medical Necessity Determination. Updates language. |
| 1230.1 | Medical Necessity Approval Time Frame for Initial Eligibility Determinations | Adds section. |
| 1240 | Age | Changes title to Unmet Need for at Least One MDCP Service. Updates language. |
| 1240.1 | Individual Service Plan Cost Limit | Adds section. |
| 1250 | Citizenship and Identity Verification | Changes title to Living Arrangement. Updates language. |
| 1260 | Living Arrangement and Texas Residency | Changes title to Financial Eligibility. Updates language. |
| 1260.1 | Individual with a Qualified Income Trust | Adds section. |
| 1260.2 | Copayment and Room and Board | Adds section. |
| 1260.3 | Copayment Changes | Adds section |
| 1270 | Financial Eligibility | Deletes section. |
| 1270.1 | Individual with Qualified Income Trust | Deletes section. |
| 1270.2 | Copayment and Room and Board | Deletes section. |
| 1270.3 | Copayment Changes | Deletes section. |
| 1610 | Confidential Nature of Medical Information - Health Insurance Portability and Accountability Act | Changes title to Confidential Nature of Medical Information – HIPAA. Updates language. |
| 1631 | Program Support Unit Communications with Managed Care Organizations | Changes title to Privacy Incidents. Updates language. |
| 1632 | PSU Posting Errors in the MCOHub | Adds section. |
| 2130 | Declining Medically Dependent Children Program Services | Deletes section. |
| 2230 | MDCP ILR: PSU Staff Coordination | Removes requirement to fax Form H1746-A to MEPD noting approved MDCP services for non-MAO applicants. |
| 6300.7 | Exceeding the ISP Cost Limit | Clarifies and updates language. |
| 7110 | PSU Staff Compliant Escalation Procedures | Changes title to Privacy Complaints. Updates language. |
| 7120 | PSU Staff Compliant Escalation Procedures | Adds section. |
| 7201 | Timely or Non-timely State Fair Hearing Request | Adds clarifying language. |
| 7510 | Sustained State Fair Hearing Decision | Updates language. |
| 7521 | Reversed Decision – Effective Date | Adds clarifying language. |
| Appendix XVIII | STAR Kids HEART Naming Conventions | Clarifies and updates language. |
| SKOPH Contact Us | Contact Us | Updates PES policy’s mailbox address. |
26-2, Miscellaneous Changes
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Revision Notice 26-2; Effective June 1, 2026
The following sections were revised in the STAR Kids Program Support Unit Operational Procedures Handbook:
| Section | Title | Change |
|---|---|---|
| 1270.2 | Copayment and Room and Board | Adds section. |
| 1270.3 | Copayment Changes | Adds section. |
| 1500 | PSU Online Database Resources | Adds section. |
| 1510 | Community Services Interest List | Adds section. |
| 1520 | Health and Human Services Commission Benefits Portal | Adds section. |
| 1530 | Health and Human Services (HHS) Enterprise Administrative Report and Tracking System | Adds section. |
| 1540 | Service Authorization System Online | Adds section. |
| 1550 | Texas Integrated Eligibility Redesign System | Adds section. |
| 1560 | Texas Medicaid & Healthcare Partnership Long Term Online Portal | Adds section. |
| 1570 | MCOHub | Adds section. |
| 2010.2 | MCO Selection or Default | Incorporates the first position interest list option. |
| 2120 | Inability to Contact the Individual | Corrects link. |
| 2412 | Traditional Money Follows the Person Non-STAR Kids Nursing Facility Residents | Corrects language. |
| 2427 | Individual Approved for an MFP Limited NF Stay: PSU Procedures | Changes title to MFP Limited NF Stay: Individuals Enrolled in STAR Kids. Updates language. |
| 2427.1 | MFP Limited NF Stay: Individuals Enrolled in STAR Kids and STAR Health | Changes title to MFP Limited NF Stay: Individuals Enrolled in STAR Health. Updates language. |
| 2427.2 | MFP Limited NF Stay: Individuals Enrolled in STAR or Individuals Receiving Other Types of Medicaid | Updates language. |
| 2427.3 | MFP Limited NF Stay: Individuals Not Receiving Medicaid or Individuals Enrolled in CHIP | Updates language. |
| 2428.1 | MFP Limited NF Stay: PSU Staff Coordination | Updates language. |
| Appendix IX | STAR Kids MCOHub Naming Conventions | Updates language. |
| Appendix XXI | Creating an Appeal in TIERS | Updates language. |
| Appendix XXIV | MDCP Medical Necessity Denial Attachment - Member | Updates language. |
| Appendix XXV | Acronyms | Adds new acronyms. |
| Appendix XXVII | MDCP Medical Necessity Denial Attachment - Applicant | Updates language. |
| Appendix XXXIV | CSIL Closure Guide | Adds new appendix. |
26-1, Miscellaneous Changes
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Revision Notice 26-1; Effective March 16, 2026
The following sections were revised in the STAR Kids Program Support Unit Operational Procedures Handbook:
| Section | Title | Change |
|---|---|---|
| 2100 | Activities Following an MDCP Interest List Release | Incorporates the first position interest list option. |
| 2100.1 | Individuals Enrolled in STAR Kids | Changes title to MDCP ILR: Individuals Enrolled in STAR Kids. Incorporates the first position interest list option. |
| 2100.2 | Individuals Enrolled in STAR Health | Changes title to MDCP ILR: Individuals Enrolled in STAR Health. Incorporates the first position interest list option. |
| 2100.3 | Individuals Enrolled in STAR and Individuals Receiving Other Types of Medicaid | Changes title to MDCP ILR: Individuals Enrolled in STAR and Individuals Receiving Other Types of Medicaid. Incorporates the first position interest list option. |
| 2100.4 | Individuals Not Receiving Medicaid or Individuals Enrolled in CHIP | Changes title to MDCP ILR: Individuals Not Receiving Medicaid or Individuals Enrolled in CHIP. Incorporates the first position interest list option. |
| 2210 | Individuals Enrolled in STAR and Individuals Receiving Other Types of Medicaid | Incorporates the first position interest list option. |
| 2210.1 | Individuals Not Receiving Medicaid or Individuals Enrolled in CHIP | Incorporates the first position interest list option. |
| 5000 | SB 1207 Interest List Options | Adds new section. |
| 5100 | First Position | Adds new section. |
| 5200 | Advanced Placement | Adds new section. |
| 5300 | MDCP State Fair Hearing, First Position and Advanced Placement Request Scenarios | Adds new section. |
| 5400 | First Position and Advanced Placement Assignments: PSU Staff Procedures | Adds new section. |
| 5400.1 | Advanced Placement Assignments and First Position Assignments Without a State Fair Hearing | Adds new section. |
| 5400.2 | First Position and Advanced Placement Assignments Following a Sustained MN Denial | Adds new section. |
| 5400.3 | First Position and Advanced Placement Assignments Beyond 120 Days | Adds new section. |
| 6300.5 | Medical Necessity and Level of Care | Updates language to incorporate the MN denial call campaign and the first position and advancement placement options. |
| Medical Necessity Denial by Texas Medicaid & Healthcare Partnership | Changes title to Medical Necessity Denial by the Office of the Medical Director. Updates language. |
| Sustained State Fair Hearing Decision | Updates language. |
| Sustained State Fair Hearing Decision for Applicants | Updates language. |
| Sustained State Fair Hearing Decision for Members With Continued MDCP Benefits | Updates language to incorporate the first position and advancement placement options. |
| Sustained State Fair Hearing Decision for Members Without Continued MDCP Benefits | Updates language to incorporate the first position and advancement placement options. |
| 7510.4 | First Position and Advanced Placement Requests After a Sustained MN Denial | Adds new section. |
| Glossary | Glossary | Adds new terms and definitions. |
| Appendix XVIII | STAR Kids HEART Naming Conventions | Updates language. |
| Appendix XXIV | Fair Hearing and Interest List Options for MDCP Denials - Members | Changes tile to MDCP Medical Necessity Denial Attachment – Members. Changes language in attachments and makes them accessible. |
| Appendix XXVII | Fair Hearing Options for MDCP Denials - Applicants | Changes tile to MDCP Medical Necessity Denial Attachment – Applicants. Changes language in attachments and makes them accessible. |
| Appendix XXIX | Fair Hearing and Interest List Options for Aging Out of MDCP | Changes language in attachments and makes them accessible. |
| Appendix XXXII | STAR Kids Companion Plans | Adds STAR Kids companion plan codes. |
| Appendix XXXIII | Scenario Guide for MDCP State Fair Hearing, First Position and Advanced Placement Requests | Adds new Appendix. |
25-4, Miscellaneous Changes
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Revision Notice 25-4; Effective Dec. 12, 2025
The following sections were revised in the STAR Kids Program Support Unit Operational Procedures Handbook:
| Section | Title | Change |
|---|---|---|
| 1210 | Medical Necessity Determination | Changes RUG level to PDPM LTC level. Updates language. |
| 1210.1 | Texas Administrative Code Medical Necessity Determination Requirements | Changes title to Reserved for Future Use. |
| 1270 | Financial Eligibility | Updates link to MEPD Referral Crosswalk. Updates language. |
| 2100.3 | Individuals Enrolled in STAR and Individuals Receiving Other Types of Medicaid | Changes title to Individuals Enrolled in STAR or Individuals Receiving Other Types of Medicaid. Updates language and link to MEPD Referral Crosswalk. |
| 2230 | PSU Staff Coordination | Changes title to MDCP ILR: PSU Staff Coordination. Updates language. |
| 2426 | ILM Unit Procedures for Assigning an Individual Approved for a Limited NF Stay to PSU Staff | Changes title to Individual Approved for an MFP Limited NF Stay: ILM Unit Procedures. Updates language. |
| 2427 | PSU Procedures for an Individual Approved for a Limited NF Stay | Changes title to Individual Approved for an MFP Limited NF Stay: PSU Procedures. Updates language. |
| 2427.1 | PSU Procedures for an Individual Approved for a Limited NF Stay without Medicaid (Including an Individual Enrolled in CHIP) | Changes title to MFP Limited NF Stay: Individuals Enrolled in STAR Kids and STAR Health. Updates language. |
| 2427.2 | PSU Procedures for an Individual Approved for a Limited NF Stay with Medicaid and Not Enrolled in STAR Kids | Changes title to MFP Limited NF Stay: Individuals Enrolled in STAR or Individuals Receiving Other Types of Medicaid. Updates language. |
| 2427.3 | PSU Procedures for an Individual Approved for a Limited NF Stay and Currently Enrolled in STAR Kids | Changes title to MFP Limited NF Stay: Individuals Not Receiving Medicaid or Individuals Enrolled in CHIP. Updates language. |
| 2428 | PSU and MCO Staff Coordination Procedures for an MDCP Applicant Approved for a Limited NF Stay | Changes title to MFP Limited NF Stay: MCO Coordination. Updates language. |
| 2428.1 | MFP Limited NF Stay: PSU Staff Coordination | Adds section. |
| 3200 | Member Reassessment | Updates language. |
| 3210 | Medically Dependent Children Program Eligibility | Changes title to Reassessment of Medical Necessity Determination. Changes RUG level to PDPM LTC level. Updates language. |
| 3210.1 | Texas Administrative Code Medically Dependent Children Program Eligibility Requirements | Deletes section. |
| 3210.2 | Reassessment of Medical Necessity Determination | Deletes section. |
| 3210.3 | Texas Administrative Code Medical Necessity Determination Requirements | Deletes section. |
| 7000 | Applicant or Member Appeal Requests and State Fair Hearings | Changes title to Applicant or Member Complaints and State Fair Hearings |
| 7100 | Appeals and State Fair Hearings | Changes title to Complaints. Updates language. |
| 7110 | PSU Staff Compliant Escalation Procedures | Adds section. |
| 7200 | State Fair Hearing Procedures for Medically Dependent Children Program | Changes title to State Fair Hearing Procedures for MDCP. Updates language. |
| 7201 | Timely or Non-timely State Fair Hearing Request | Updates language. |
| 7400 | Complaints | Changes title to Reserved for Future Use. |
| 7522 | New Assessment Required by State Fair Hearing Decision | Changes RUG level to PDPM LTC level. |
| Appendix XXV | Acronyms | Adds LTCOP, PDPM and YES to list. |