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Revision 26-1; Effective Feb. 20, 2026
The STAR+PLUS Loss of Enrollment Report gives Program Support Unit (PSU) staff a list of STAR+PLUS Home and Community Based Services (HCBS) program members who have lost Medicaid eligibility or managed care enrollment. PSU staff must conduct coordination activities to either reestablish eligibility, managed care enrollment, or close the authorization(s) in the Service Authorization System Online (SASO).
Report Fields
PCN — The member’s nine-digit Medicaid number.
Name — The member’s last name, first name and middle initial when provided.
RG — The three-digit risk group number.
Plan Code — The two-digit managed care organization (MCO) plan code where the member is currently enrolled.
TP — The member’s two-digit Medicaid Type Program (TP).
PSU Entry Field
Eligibility Re-established? — PSU staff check the Texas Integrated Eligibility Redesign System (TIERS) to determine if Medicaid eligibility or managed care enrollment was reestablished. Enter yes, if it has and enter no, if not.
Is manual managed care enrollment needed, if yes? — PSU staff must check TIERS to determine if Medicaid eligibility and managed care enrollment were established if the response to the previous column was yes. PSU staff send an email to the Enrollment Resolution Services (ERS) mailbox if manual managed care enrollment is needed.
Provide the date Form H2065-D was sent, if no. — PSU staff enter the date Form H2065-D, Notification of Managed Care Program Services was sent.
Was the decision appealed? — PSU staff enter yes or no. No further action is needed if the response to this question is no. Continue to the next section, if yes.
Was eligibility re-established, if yes? — PSU staff check TIERS to determine if Medicaid eligibility or managed care enrollment was re-established. Enter yes, if it has enter no if not. No further action is necessary if the response to this question is no.
If eligibility was re-established, is manual managed care enrollment needed? — PSU staff must check TIERS to determine if managed care enrollment was established if the response to the previous column was yes. PSU staff send an email to the ERS mailbox if manual managed care enrollment is needed.
Pending at PSU — Enter yes or no.
Pending at MCO — Enter yes or no.
Pending at MEPD — Enter yes or no.
Comments — Enter any comments relevant to the actions taken.
The STAR+PLUS Loss of Enrollment Report is a monthly report. PSU staff must research, resolve and respond to the requestor within 14 days of receipt. Completion of the report itself is due within 14 days of receipt and does not negate policy about denial notifications. Refer to 1700, Notification Requirements. The notification must still be sent within two business days.
Note: SASO files used by PES staff to produce this report are a snapshot in time. They may not reflect registrations at the point of receipt.