SPOPH Revisions

26-3, Miscellaneous Changes

Revision 26-3; Effective Aug. 14, 2026

The following sections were revised in the STAR+PLUS Program Support Unit Operational Procedures Handbook:

Section	Title	Change
1230	U.S. Citizenship	Changes title to Reserved for Future use. Deletes policy language.
1240	Texas Residency	Adds clarifying language.
1250	Medical Necessity Determination	Adds clarifying language.
1521.3	Electronic Mail Communication	Adds clarifying language.
1750	PSU Staff Notification Requirements for Managed Care Compliance and Operations Unit	Changes title to PSU Staff Notification Requirements for Program Support Operations Review Team. Adds policy language.
1760	MCO Notification Requirements for Applicants and Members	Changes title to PSU Staff Notification Requirements for Managed Care Contracts and Oversight Unit. Adds policy language.
1770	MCO Notification Requirements for PSU Staff	Changes title to MCO Notification Requirements for Applicants and Members. Adds policy language.
1780	MCO Notification Requirements for PSU Staff	Adds new section.
1800	PSU Online Database Resources	Deletes policy language.
1850	Service Authorization System Online	Adds clarifying language.
3117.1	Income and Resource Verifications for MEPD	Adds clarifying language.
3117.2	Reserved for Future Use	Changes title to Unsigned Applications. Adds policy language.
3117.3	Unsigned Applications	Changes title to Medicaid Eligibility Decisions Pending Past the Program Due Date. Adds policy language.
3117.4	Medicaid Eligibility Decisions Pending Past the Program Due Date	Deletes section.
3117.5	Inquires and Complaints	Deletes section.
3118	Address Changes for Supplemental Security Income Individuals	Deletes section.
3310	Intake and Enrollment	Changes title to CCSE Referrals for the STAR+PLUS HCBS Program. Adds policy language.
3311.1	Interest List Procedures	Changes title to Interest List Management and Enrollment Broker Procedures. Adds policy language.
3312	Managed Care Enrollment	Adds clarifying language.
3313	Termination of CCSE Services Upon STAR+PLUS HCBS Program Enrollment	Adds clarifying language.
3313.1	Procedure for STAR+PLUS HCBS Program Applicants	Deletes section.
3313.2	Procedure for STAR+PLUS HCBS Program Members	Deletes section.
3320	Coordination with Medicaid for the Elderly and People with Disabilities	Updates title to Reserved for Future Use.
3321	General Eligibility Issues	Deletes section.
3321.1	Disability Determinations	Deletes section.
3322	Actions Pending Past the MEPD Due Date	Deletes section.
3423	Intrapulmonary Percussive Ventilator	Deletes section.
3510	Money Follows the Person and Managed Care	Adds clarifying language.
3511	Money Follows the Person Procedure	Adds clarifying language.
6300.2	Institutional Stay	Adds MCCO notification requirements.
6300.3	Voluntarily Declined Services	Adds clarifying language.
6400	Disenrollment Request Policy	Updates the name for MCCO.
6500	Resetting ISP Records in the TMHP LTCOP	Updates the name of Appendix XXVII.
7210	Timely or Non-timely State Fair Hearing Request	Updates the acronym CRU with A&M.
7214	State Fair Hearing Evidence Packet	Updates the acronym CRU with A&M.
7221.2	Financial Denial by MEPD or TW	Adds clarifying language.
7410	Sustained State Fair Hearing Decision	Removes good cause example.
7421	Reversed Decision – Effective Date	Adds clarifying language.
Appendix I-B	Individual Service Plan Expiring Report	Adds clarifying language.
Appendix II	Guidelines for Completing Form H1746-A MEPD Referral Cover Sheet	Updates title to Reserved for Future Use. Deletes policy language.
Appendix IV	Form H2065-D STAR+PLUS HCBS Program Reason for Denial and Comments Language	Adds clarifying language.
Appendix IX	Time Calculation	Adds clarifying language.
Appendix XIX	Nursing Facility Counter Logic	Updates title to Reserved for Future Use. Deletes policy language.
Appendix XV	Services Available from Other State Agencies	Updates title to Reserved for Future Use. Deletes policy language.
Appendix XXXI	STAR+PLUS Members Transitioning from an NF in One Service Area to the Community in Another Service Area	Changes title to PSU Activities for STAR+PLUS HCBS Applicants and Members Transitioning from an NF in One Service Area to the Community in Another Service Area. Adds clarifying language.
Appendix XXIII	Instructions and Access to CARE	Updates title to Reserved for Future Use. Deletes policy language.
Appendix XXIV	STAR+PLUS Service Area by Code	Updates title to Reserved for Future Use. Deletes policy language.
Appendix XXV	Community First Choice Support Management	Updates title to Reserved for Future Use. Deletes policy language.
Appendix XXVII	PSU Users H1700 ISP Form User Guide	Changes title to TMHP LTCOP STAR+PLUS PSU User Guide.
Appendix XXX	Relocation Function	Updates title to Reserved for Future Use. Deletes policy language.
Appendix XXXIII	STAR+PLUS HEART Naming Conventions	Updates Form H1200 upload requirements.
Appendix XXXVI	Long Term Services and Supports	Updates title to Reserved for Future Use. Deletes policy language.
Appendix XXXVII	STAR Kids Transition Activities	Updates title to Reserved for Future Use. Deletes policy language.
SPOPH Contact Us	Contact Us	Updates policy mailbox address.

26-2, Miscellaneous Changes

Revision Notice 26-2; Effective June 1, 2026

The following sections were revised in the STAR+PLUS Program Support Unit Operational Procedures Handbook:

Section	Title	Change
3111	Dual-Eligible Members	Updates title to Interest List Procedures. Deletes text.
3210	Service Areas	Updates title to Reserved for Future Use. Deletes text.
3223	Hospice Services	Deletes section.
3330	STAR+PLUS Individual Requesting an Upgrade to the STAR+PLUS HCBS Program	Adds clarifying language.
3411	Transferring from One MCO to Another Within the Same Service Area	Removes use of Monthly Plan Change report.
3412	Transferring from One MCO to Another in a Different Service Area	Removes PSU coordination in MCO transfers.
3421.1	Twelve Months Prior to the Member's 21st Birthday	Removes Appendix XIV content.
3515	Non-STAR+PLUS Individual Residing in a Nursing Facility	Adds clarifying language.
4700	Hospice Services	Adds new section.
6300.4	Financial Eligibility	Adds clarifying language for applicants.
7421	Reversed Decision – Effective Date	Adds clarifying language.
Appendix VII	Acronyms	Adds acronym for A&M unit.
Appendix XIV	Determination of High Needs Status for the STAR+PLUS HCBS Program	Updates title to Reserved for Future Use.
Appendix XVII	State Cutoff Dates	Adds 2026 cutoff dates.
Appendix XXIV	Reserved for Future Use	Updates title to STAR+PLUS Service Area by County.
Appendix XXXIV	STAR+PLUS MCOHub Naming Conventions	Updates naming conventions for Form H3676.
Appendix XXXV	SASO Data Entry Guide	Removes PSU coordination in MCO transfers.
Appendix XXXIX	CSIL Closure Guide	Adds new appendix.

26-1, Miscellaneous Changes

Revision 26-1; Effective Feb. 20, 2026

The following sections were revised in the STAR+PLUS Program Support Unit Operational Procedures Handbook:

Section	Title	Change
1280	Appropriate Living Arrangement	Adds AFC and ALF as allowable settings.
1300	STAR+PLUS Services and Service Delivery Options	Adds clarifying language.
1310	Program Services	Deletes section.
1311	Services Available Under STAR+PLUS	Deletes section.
1312	Long Term Services and Supports	Deletes section.
1320	Services Available to STAR+PLUS Members	Deletes section.
1330	Acute Care Services Included Under the MCO Capitation Payment	Deletes section.
1340	Long Term Services and Support Listing	Deletes section.
1350	Services Available to STAR+PLUS HCBS Program Members	Deletes section.
1400	MCO Service Coordination	Adds clarifying language.
4000	STAR+PLUS HCBS Program Services	Adds clarifying language.
4100	Adult Foster Care	Changes title to STAR+PLUS Acute Care Services. Updates text.
4110	STAR+PLUS Acute Care Services	Deletes section.
4111	Adult Foster Care Purpose	Deletes section.
4112	Reserved for Future Use	Deletes section.
4113	Adult Foster Care Services	Deletes section.
4120	Minimum Standards for All AFC Homes and Providers	Deletes section.
4121	AFC Homes with Four or More Residents and Members	Deletes section.
4122	Small Homes for One to Three Residents and Members	Deletes section.
4123	MCO Responsibilities	Deletes section.
4130	Adult Foster Care Eligibility	Deletes section.
4131	AFC Intake, Assessment and Response to Request for Services	Deletes section.
4132	Reserved for Future Use	Deletes section.
4133	Adult Foster Care Classification Levels	Deletes section.
4133.1	Levels of Adult Foster Care Members	Deletes section.
4133.2	AFC Homes Corresponding to AFC Member Levels	Deletes section.
4134	Adult Protective Services and Adult Foster Care	Deletes section.
4134.1	Placement of APS Clients in AFC	Deletes section.
4134.2	APS Investigations of AFC Providers	Deletes section.
4135	Private Pay Individuals in AFC	Deletes section.
4140	AFC MCO Procedures	Deletes section.
4141	Eligibility Determination	Deletes section.
4142	Service Planning	Deletes section.
4150	Finalizing the Member’s Plan of Care	Deletes section.
4151	Member and AFC Home Provider Agreement	Deletes section.
4152	Reserved for Future Use	Deletes section.
4153	Trust Funds	Deletes section.
4154	Hospital Leave	Deletes section.
4160	Monitoring Quality of Care	Deletes section.
4170	Reserved for Future Use	Deletes section.
4180	Annual Reassessment of the AFC Member	Deletes section.
4200	Assisted Living Services	Changes title to STAR+PLUS Long-Term Services and Supports. Updates text.
4210	Assisted Living Services Introduction	Deletes section.
4211	Housing Options in Licensed Personal Care Facilities	Deletes section.
4211.1	Single Occupancy Apartments	Deletes section.
4211.2	Double Occupancy Apartments	Deletes section.
4220	Description of Services	Deletes section.
4221	Requirements Related to Assisted Living Facility	Deletes section.
4222	Reserved for Future Use	Deletes section.
4223	Reserved for Future Use	Deletes section.
4224	Reserved for Future Use	Deletes section.
4230	Other Services Available to Members	Deletes section.
4240	Reserved for Future Use	Deletes section.
4241	Personal Leave	Deletes section.
4242	Nursing Services for Members in an ALF	Deletes section.
4243	Response to ALF Member Condition Change	Deletes section.
4244	Hospital and Nursing Facility Stays	Deletes section.
4245	Reserved for Future Use	Deletes section.
4250	Standards for Operation	Deletes section.
4251	Facility Reporting and Notification Requirements	Deletes section.
4252	Member Documentation	Deletes section.
4260	Reserved for Future Use	Deletes section.
4270	Copayment and Trust Fund Records	Deletes section.
4271	Copayment	Deletes section.
4272	Trust Fund Records or Written Receipts	Deletes section.
4273	Records and Receipts	Deletes section.
4274	Reserved for Future Use	Deletes section.
4275	Reserved for Future Use	Deletes section.
4276	Payment of Copayment and Room and Board from Trust Fund	Deletes section.
4277	Member Authorization	Deletes section.
4300	Respite Care Services	Changes title to STAR+PLUS HCBS Program Service Array. Updates text.
4310	Service Coordination Duties Related to Respite Care	Deletes section.
4311	MCO Approval to Exceed the Respite Care Service Cap	Deletes section.
4320	In-Home Respite Care Services	Deletes section.
4330	Out-of-Home Respite Care Services	Deletes section.
4331	Member Eligibility	Deletes section.
4332	Provider Qualifications	Deletes section.
4333	Description of Services	Deletes section.
4334	Respite Care Services in a Personal Care Facility or AFC Home	Deletes section.
4335	Respite Care Services in a Nursing Facility	Deletes section.
4340	Room and Board Charges	Deletes section.
4400	Emergency Response Services	Changes title to Individual Service Plan. Updates text.
4410	ERS Introduction	Deletes section.
4420	ERS Program Purpose	Deletes section.
4430	ERS Member Eligibility	Deletes section.
4440	ERS Referral and Selection of Providers	Deletes section.
4450	ERS Duties	Deletes section.
4460	Provider Duties	Deletes section.
4500	Home-Delivered Meals	Changes title to Adult Foster Care Home Services. Updates text.
4510	Home-Delivered Meals Description	Deletes section.
4520	Provider Responsibilities	Deletes section.
4520.1	Frozen or Shelf-Stable Meals	Deletes section.
4600	Transition Assistance Services	Changes title to Assisted Living Facility Services. Updates text.
4610	Transition Assistance Services Introduction	Deletes section.
4611	Transition Assistance Services Service Description	Deletes section.
4620	Transition Assistance Services Procedures at the Initial Interview	Deletes section.
4630	Identification of Needed Items and Services	Deletes section.
4640	Items and Services Included Under TAS	Deletes section.
4640.1	Deposits	Deletes section.
4640.2	Household Needs	Deletes section.
4640.3	Housewares	Deletes section.
4640.4	Small Appliances	Deletes section.
4640.5	Cleaning Supplies	Deletes section.
4640.6	Other Items Not Listed	Deletes section.
4641	Services and Items Not Included in TAS	Deletes section.
4642	Site Preparation	Deletes section.
4650	Estimated Cost of Items and Services	Deletes section.
4651	Totaling the Estimated Cost and Authorization of TAS	Deletes section.
4652	Changes to the Authorization	Deletes section.
4660	Transition Assistance Services Agency Responsibilities	Deletes section.
4670	Three-Day Monitor Required	Deletes section.
4680	Failure to Leave the Nursing Facility	Deletes section.
7100	Reserved for Future Use	Changes title changed to Complaints. Updates text.
7110	PSU Staff Compliant Escalation Procedures	Adds section.
7420	Reversed State Fair Hearing Decision	Adds clarifying language.
8000	Specific STAR+PLUS HCBS Program Services	Deletes section.
8100	Home and Community Based Services	Deletes section.
8110	Program Overview	Deletes section.
8111	Service Introduction	Deletes section.
8112	Service Locations for STAR+PLUS HCBS Program	Deletes section.
8113	General Requirements for MCOs	Deletes section.
8114	Individual Service Plan	Deletes section.
8115	Reserved for Future Use	Deletes section.
8116	Reserved for Future Use	Deletes section.
8117	Reserved for Future Use	Deletes section.
8118	Personal Assistance Services	Deletes section.
8118.1	Description of Personal Assistance Services	Deletes section.
8118.2	Personal Assistance Services Attendants	Deletes section.
8200	Reserved for Future Use	Deletes section.
8300	Therapy Services	Deletes section.
8310	Cognitive Rehabilitation Therapy	Deletes section.
8320	Initiation of Assessment and Therapy	Deletes section.
8330	Responsibilities of Licensed Therapists in STAR+PLUS HCBS Program	Deletes section.
8400	Adaptive Aids and Medical Supplies	Deletes section.
8410	List of Adaptive Aids and Medical Supplies	Deletes section.
8420	Reserved for Future Use	Deletes section.
8430	Reserved for Future Use	Deletes section.
8440	Reserved for Future Use	Deletes section.
8450	Time Frames for Purchase and Delivery of Adaptive Aids and Medical Supplies	Deletes section.
8451	Time Frames for Adaptive Aids	Deletes section.
8452	Time Frames for Medical Supplies	Deletes section.
8500	Dental Services	Deletes section.
8510	Allowable Dental Services	Deletes section.
8600	Minor Home Modifications	Deletes section.
8610	Responsibilities Pertaining to Minor Home Modifications	Deletes section.
8620	List of Minor Home Modifications	Deletes section.
8630	Minor Home Modification Service Cost Lifetime Limit	Deletes section.
8640	Landlord Approval for Minor Home Modifications	Deletes section.
8700	Employment Services	Deletes section.
8710	Employment Assistance	Deletes section.
8720	Supported Employment	Deletes section.
Appendix I-D	Loss of Eligibility Report	Adds clarifying language.
Appendix VII	Acronyms	Adds LOE acronym for Loss of Enrollment.
Glossary	Glossary	Adds term for Appeals and Mitigation unit.

25-5, Miscellaneous Changes

Revision Notice 25-5; Effective Dec. 17, 2025

The following sections were revised in the STAR+PLUS Program Support Unit Operational Procedures Handbook:

Section	Title	Change
1260	Individual Service Plan Cost Limit	Updates RUG acronym with PDPM.
1870	Texas Medicaid & Healthcare Partnership Long Term Care Online Portal	Updates RUG acronym with PDPM.
3412	Transferring from One MCO to Another in a Different Service Area	Updates RUG acronym with PDPM.
3514	STAR+PLUS Individual Residing in a Nursing Facility	Updates RUG acronym with PDPM.
3515	Non-STAR+PLUS Individual Residing in a Nursing Facility	Adds clarifying language.
7200	State Fair Hearing Procedures for STAR+PLUS HCBS Program	Adds clarifying language.
7221	Type of Denials	Adds clarifying language.
7221.2	Financial Denial by MEPD or TW	Updates CRU acronym to A&M.
7221.4	Other Denial Reasons	Adds clarifying language.
7222.1	Continuation of STAR+PLUS HCBS Program During a State Fair Hearing	Updates CRU acronym to A&M.
7310	Action Taken on the State Fair Hearing Decision	Adds clarifying language.
7400	State Fair Hearing Decision Actions	Updates state fair hearing decisions.
7410	Sustained State Fair Hearing Decision	Adds clarifying language.
7421	Reversed Decision – Effective Date	Adds clarifying language.
7422	New Assessment Required by State Fair Hearing Decision	Updates RUG acronym with PDPM.
Appendix I-D	Reserved for Future Use	Adds appendix titled Loss of Enrollment Report.
Appendix I-E	Reserved for Future Use	Deletes appendix.
Appendix I-F	Loss of Eligibility Report	Deletes appendix.
Appendix VII	Acronyms	Adds LTCOP and PDPM acronyms.
Appendix XXIX	STAR+PLUS Plan Codes and Contract Numbers	Adds end dates for MMPs.
Appendix XXXV	SASO Data Entry Guide	Replaces RUG with PDPM.

SPOPH Revisions

26-3, Miscellaneous Changes

Body

26-2, Miscellaneous Changes

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26-1, Miscellaneous Changes

Body

25-5, Miscellaneous Changes

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