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  3. STAR Kids Program Support Unit Operational Procedures Handbook
  4. Appendix XXIV, MDCP Medical Necessity Denial Attachment - Members
    • STAR Kids Program Support Unit Operational Procedures Handbook
      • Search this Handbook
      • 1000, STAR Kids Overview
      • 2000, MDCP Intake and Initial Application
      • 3000, STAR Kids Screening and Assessment and Service Planning
      • 4000, STAR Kids Community Services
      • 5000, SB 1207 Interest List Options
      • 6000, Denials and Terminations
      • 7000, Applicant or Member Complaints and State Fair Hearings
      • 8000, Utilization Management and Review by the State
      • SKOPH Appendices
        • Appendix I, PSU User Guide for the SK-ISP Form
        • Appendix II, Form H2065-D MDCP Reason for Denial and Comments Language
        • Appendix III, LTSS Billing Matrix and Crosswalk
        • Appendix IV, MDCP Frequently Asked Questions
        • Appendix V, Time Calculation
        • Appendix VI, STAR Kids Transition Activities
        • Appendix VII, SASO Service Group, Service Code and Termination Code
        • Appendix VIII, RUG IPC Cost Limits
        • Appendix IX, STAR Kids MCOHub Naming Conventions
        • Appendix X, Income and Resource Limits
        • Appendix XI, HHSC Benefits Portal and TIERS Reference Guides
        • Appendix XII, Create an Appeal Task in the HHSC Benefits Portal
        • Appendix XIII, Long Term Services and Supports
        • Appendix XIV, State Cutoff Dates
        • Appendix XV, Guidelines for Completing Form H1746-A, MEPD Referral Cover Sheet
        • Appendix XVI, MEPD Referral Crosswalk
        • Appendix XVII, MDCP Eligibility TAC
        • Appendix XVIII, STAR Kids HEART Naming Conventions
        • Appendix XIX, Mutually Exclusive Services
        • Appendix XX, MDCP Program Description
        • Appendix XXI, Creating an Appeal in TIERS
        • Appendix XXII, Instructions and Access to CARE
        • Appendix XXIII, Community First Choice Support Management
        • Appendix XXIV, MDCP Medical Necessity Denial Attachment - Members
        • Appendix XXV, Acronyms
        • Appendix XXVI, STAR Kids Plan Codes
        • Appendix XXVII, MDCP Medical Necessity Denial Attachment - Applicants
        • Appendix XXVIII, PSU TMHP LTC Online Portal MDCP Enrollment Form User Guide
        • Appendix XXIX, Fair Hearing and Interest List Options for Aging Out of MDCP
        • Appendix XXX, County Codes and City and County List
        • Appendix XXXI, HEART Case Record Assignment Procedures
        • Appendix XXXII, STAR Kids Companion Plans
        • Appendix XXXIII, Scenario Guide for MDCP State Fair Hearing, First Position and Advanced Placement Requests
        • Appendix XXXIV, CSIL Closure Guide
      • SKOPH Glossary
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Appendix XXIV, MDCP Medical Necessity Denial Attachment - Members

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Revision 26-2; Effective June 1, 2026

Documents

  • Fair Hearing and Interest List Options for MDCP Denials - Members (English PDF)
  • Fair Hearing and Interest List Options for MDCP Denials - Members (Spanish PDF)
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