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  3. STAR+PLUS Program Support Unit Operational Procedures Handbook
  4. Appendix XI, STAR+PLUS HCBS Program Medical Necessity Denial Attachment
    • STAR+PLUS Program Support Unit Operational Procedures Handbook
      • Search this Handbook
      • 1000, State of Texas Access Reform Plus (STAR+PLUS) Managed Care
      • 2000, Reserved for Future Use
      • 3000, STAR+PLUS HCBS Program Eligibility
      • 4000, STAR+PLUS HCBS Program Services
      • 5000, Medically Fragile Group and General Revenue Funds Process
      • 6000, Denials and Terminations
      • 7000, Applicant or Member Complaints and State Fair Hearings
      • SPOPH Appendices
        • Appendix I-A, Unusual End Dates Report
        • Appendix I-B, Individual Service Plan Expiring Report
        • Appendix I-C, Mismatched ISP and MN End Dates Report
        • Appendix I-D, Loss of Enrollment Report
        • Appendix II, Guidelines for Completing Form H1746-A, MEPD Referral Cover Sheet
        • Appendix III, Medicaid Type Program Codes for STAR+PLUS HCBS Program and CFC
        • Appendix IV, Form H2065-D STAR+PLUS HCBS Program Reason for Denial and Comments Language
        • Appendix V, MEPD Referral Crosswalk
        • Appendix VI, STAR+PLUS Inquiry Chart
        • Appendix VII, Acronyms
        • Appendix VIII, Income and Resource Limits
        • Appendix IX, Time Calculation
        • Appendix X, STAR+PLUS HCBS Cost Limits
        • Appendix XI, STAR+PLUS HCBS Program Medical Necessity Denial Attachment
        • Appendix XII, STAR+PLUS HCBS Program Description
        • Appendix XIII, Your Financial Rights in an Assisted Living Facility STAR+PLUS
        • Appendix XIV, Reserved for Future Use
        • Appendix XV, Services Available from Other State Agencies
        • Appendix XVI, SASO Service Group, Service Code and Termination Code
        • Appendix XVII, State Cutoff Dates
        • Appendix XVIII, Mutually Exclusive Services
        • Appendix XIX, Nursing Facility Counter Logic
        • Appendix XX, STAR+PLUS HCBS Program Eligibility TAC
        • Appendix XXI, Creating an Appeal in TIERS
        • Appendix XXII, HHSC Benefits Portal and TIERS Reference Guides
        • Appendix XXIII, Instructions and Access to CARE
        • Appendix XXIV, STAR+PLUS Service Area by County
        • Appendix XXV, Community First Choice Support Management
        • Appendix XXVI, HEART Case Record Assignment Procedures
        • Appendix XXVII, PSU Users H1700/ISP Form User Guide
        • Appendix XXVIII, County Codes and City and County List
        • Appendix XXIX, STAR+PLUS Plan Codes and Contract Numbers
        • Appendix XXX, Relocation Function
        • Appendix XXXI, STAR+PLUS Members Transitioning from an NF in One Service Area to the Community in Another Service Area
        • Appendix XXXII, Create an Appeal Task in the HHSC Benefits Portal
        • Appendix XXXIII, STAR+PLUS HEART Naming Conventions
        • Appendix XXXIV, STAR+PLUS MCOHub Naming Conventions
        • Appendix XXXV, SASO Data Entry Guide
        • Appendix XXXVI, Long Term Services and Supports
        • Appendix XXXVII, STAR Kids Transition Activities
        • Appendix XXXVIII, CCSE Region by Service Area
        • Appendix XXXIX, CSIL Closure Guide
      • SPOPH Forms
      • SPOPH Glossary
      • SPOPH Revisions
      • SPOPH Policy Updates
      • SPOPH Contact Us

Appendix XI, STAR+PLUS HCBS Program Medical Necessity Denial Attachment

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Revision 25-3; Effective Aug. 4, 2025

English: Appendix XI, Fair Hearing Options for STAR+PLUS HCBS Program Denials (PDF)

Spanish: Appendix XI, Opciones de audiencia imparcial para las denegaciónes del programa HCBS de STAR+PLUS (PDF)

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