Body
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. |