2100, Activities Following an MDCP Interest List Release

Body

Revision 26-1; Effective March 16, 2026

Interest List Management (ILM) unit staff must release individuals from the Medically Dependent Children Program (MDCP) interest list (IL) as program slots become available. ILM unit staff contact all released individuals by phone to notify them their names reached the top of the list and to confirm interest in applying for MDCP.

ILM unit staff create an interest list release (ILR) case record assignment in the Texas Health and Human Services (HHS) Enterprise Administrative Report and Tracking System (HEART). They assign it to Program Support Unit (PSU) staff when the individual confirms their interest in pursuing MDCP. ILM unit staff update the HEART case record. They note the individual is being released because of the first position IL option, if applicable.

2100.1 MDCP ILR: Individuals Enrolled in STAR Kids 

Revision 26-1; Effective  March 16, 2026

An individual with Supplemental Security Income (SSI) or SSI-related Medicaid is already enrolled with a STAR Kids managed care organization (MCO) and:

  • does not need to go through the process of selecting a STAR Kids MCO, unless requested for an individual who chose the first position interest list (IL) option;
  • is financially eligible for the Medically Dependent Children Program (MDCP); and
  • must have the STAR Kids Screening and Assessment Instrument (SK-SAI) completed to determine if they meet the medical necessity (MN) for MDCP.

Program Support Unit (PSU) staff must complete all the following activities. This must be done within ten business days of receipt of an MDCP interest list release (ILR) case record from Interest List Management (ILM) unit staff in the Texas Health and Human Services (HHS) Enterprise Administrative Report and Tracking System (HEART):

  • reassign the HEART case record to the appropriate PSU staff; and
  • document in the HEART case record the individual is enrolled in STAR Kids.

PSU staff must complete the following activities within five business days of receipt of the MDCP ILR case record in HEART:

  • Check the Texas Integrated Eligibility Redesign System (TIERS) to verify both:
    • Medicaid financial eligibility in the Medicaid/CHIP/CHIP perinatal History screen.
    • STAR Kids managed care enrollment in the Managed Care screen.
  • Ensure the individual does not have an open enrollment with another Medicaid waiver program by reviewing the:
    • Service Authorization System Online (SASO) Enrollment and Service Authorization records for one of the following:
      • Community Living Assistance and Support Services (CLASS) Program (Service Group (SG) 2).
      • Deaf Blind with Multiple Disabilities (DBMD) Program (SG 16).
      • Home and Community-based Services (HCS) Program (SG 21).
      • Texas Home Living (TxHmL) Program (SG 22).
    • TIERS Long Term Services and Supports (LTSS) Eligibility Periods Details screen for the Youth Empowerment Services (YES) waiver record.
  • Research the previous HEART case records for an individual who requested first position, to:
    • Ensure the individual has never pursued first position. Note: First position can only be pursued one time.
    • Determine if the individual or legally authorized representative (LAR) requested the following, if the individual qualifies for first position:
      • A new STAR Kids MCO or to remain with their current STAR Kids MCO upon ILR.
      • A different service coordinator with their current STAR Kids MCO to complete the new assessment, if applicable.
  • Upload Form H3676, Managed Care Pre-Enrollment Assessment Authorization, Section A, to the current STAR Kids MCO in the MCOHub and: 
    • Include the following in the Comments section, if the individual qualifies for first position and chooses to remain with their current STAR Kids MCO:
      • The individual or LAR has requested:
        • First position and needs to be reassessed for MDCP.
        • A different service coordinator to conduct the new assessment, if applicable.
      • The program the individual is currently receiving such as STAR Kids.
  • Mail the following enrollment packet to the individual or LAR, if the individual qualifies for first position and requests a new STAR Kids MCO:
  • Upload all applicable documents to the HEART case record.
  • Document the HEART case record.

PSU staff do not have to complete a 14-day contact for individuals enrolled in STAR Kids who will stay with their current MCO. PSU staff must refer to 2220, MCO Coordination, for information on the MCO’s responsibilities after receipt of Form H3676, Section A.

New STAR Kids MCO Requested for First Position Individuals

PSU staff must contact the individual or LAR within 14 days of the enrollment packet mail date, if the individual or LAR requested:

  • first position; and 
  • a new STAR Kids MCO. 

PSU staff must complete the following activities when contacting the individual or LAR:

  • verify receipt of the enrollment packet;
  • confirm interest in MDCP and give a general description of MDCP services;
  • explain the need to select a new STAR Kids MCO as soon as possible or one will be defaulted to them, if applicable;
  • inform the individual or LAR of the following, if applicable:
    • any delay in selecting a new STAR Kids MCO could result in a delay in the MDCP eligibility determination; and
    • the new STAR Kids MCO selection can be changed at any time but will not go into effect until after one full calendar month of MDCP service provision;
  • document the individual or LAR’s new STAR Kids MCO choice in the HEART case record if obtained during the 14-day contact; and
  • document all contact attempts and any delays in the HEART case record.

PSU staff must refer to 2120, Inability to Contact the Individual, when unable to contact the individual or LAR within 14 days of the enrollment packet mail date.

An individual must select or be defaulted to the new STAR Kids MCO so the SK-SAI can be performed. PSU staff must refer to 2010.2, MCO Selection or Default, within two business days after the 30th day an enrollment packet is mailed, if a new STAR Kids MCO was not selected.

Receipt of a New STAR Kids MCO Selection

PSU staff must complete the following activities within two business days of receipt of the new STAR Kids MCO selection, if an enrollment packet is mailed to the individual:

  • Upload Form H3676, Section A, to the new STAR Kids MCO in the MCOHub including the following in the Comments section:
    • Individual or LAR requested first position and needs to be reassessed for MDCP.
    • Program the individual is currently receiving such as STAR Kids.
    • Name of the previous STAR Kids MCO.
  • Upload Form H2067-MC, Managed Care Programs Communication, to the MCOHub notifying the losing STAR Kids MCO:
    • That the individual is transferring to a new STAR Kids MCO.
    • The name of the gaining STAR Kids MCO;
  • Email the Enrollment Resolution Services (ERS) unit notice of the individual’s new STAR Kids MCO selection with:
    • This subject line: First Position XX [member’s first and last name initials].
    • The following items in the body of the email:
      • Individual’s name.
      • Individual requested first position.
      • Medicaid identification (ID) number.
      • New STAR Kids MCO selection.
      • New STAR Kids MCO effective date. Note: The member will become active with the new STAR Kids MCO based on the state Medicaid cut-off date found in Appendix XIV, State Cutoff Dates.
  • Upload all applicable documents to the HEART case record.
  • Document the HEART case record.

PSU staff must refer to 2220 for information on the MCO’s responsibilities after receipt of Form H3676, Section A.

2100.2 MDCP ILR: Individuals Enrolled in STAR Health

Revision 26-1; Effective March 16, 2026

An individual enrolled in a STAR Health managed care organization (MCO):

  • must stay enrolled with the STAR Health MCO and will not select a STAR Kids MCO;
  • is financially eligible for the Medically Dependent Children Program (MDCP); and
  • must have the STAR Kids Screening and Assessment Instrument (SK-SAI) completed to determine if they meet the medical necessity (MN) for MDCP.

Program Support Unit (PSU) staff must complete all the following activities. This must be done within ten business days of receipt of an MDCP interest list release (ILR) case record from Interest List Management (ILM) unit staff in the Texas Health and Human Services (HHS) Enterprise Administrative Report and Tracking System (HEART):

  • reassign the HEART case record to the appropriate PSU staff; and
  • document in the HEART case record the individual is enrolled in STAR Health and does not require an enrollment packet.

PSU staff must complete the following activities within five business days of receipt of the MDCP ILR case record in HEART:

  • Check the Texas Integrated Eligibility Redesign System (TIERS) to verify:
    • Medicaid financial eligibility in the Medicaid/CHIP/CHIP perinatal History screen.
    • STAR Health managed care enrollment in the Managed Care screen.
  • Ensure the individual does not have an open enrollment with another Medicaid waiver program by reviewing the:
    • Service Authorization System Online (SASO) Enrollment and Service Authorization records for one of the following:
      • Community Living Assistance and Support Services (CLASS) Program (Service Group (SG) 2).
      • Deaf Blind with Multiple Disabilities (DBMD) Program (SG 16).
      • Home and Community-based Services (HCS) Program (SG 21).
      • Texas Home Living (TxHmL) Program (SG 22).
    • TIERS Long Term Services and Supports (LTSS) Eligibility Periods Details screen for the Youth Empowerment Services (YES) waiver record.
  • Research the previous HEART case records for an individual who requested first position to:
    • Ensure the individual has never pursued first position. Note: First position can only be pursued one time.
    • Determine if the individual or legally authorized representative (LAR) requested that a different service coordinator complete the new assessment, if the individual qualifies for first position. 
  • Upload Form H3676, Managed Care Pre-Enrollment Assessment Authorization, Section A, to the STAR Health MCO in the MCOHub, updating the Comments section to:
    • Request the STAR Health MCO:
      • Contact the primary medical consenter, or secondary if the primary medical consenter is unavailable, to complete the MDCP assessment.
      • Provide the name and mailing address of the primary or secondary medical consenter when communicating the outcome of the assessment to PSU staff. Note: PSU staff must not update Form H3676, Section A, with the primary or secondary medical consenter’s contact information unless it has been documented in the HEART case record.
    • Note the individual or LAR requested first position and a different service coordinator to conduct the new assessment, if applicable.
  • Email the Department of Family and Protective Services (DFPS) Developmental Disability Specialist (DDS) Manager the following information:
    • This email subject line: Referral for MDCP Assessment for STAR Health Member XX [first letter of the individual’s first and last name].
    • The following items in the body of the email:
      • Individual’s name.
      • Medicaid identification (ID) number.
      • Date of birth (DOB).
      • Notice that a referral for an MDCP assessment was submitted to the STAR Health MCO on MM/DD/YYYY. PSU staff will send a follow up email when an MDCP eligibility determination is made. Note: The DFPS DDS Manager is not required to respond to PSU staff’s notification a referral for an MCDP assessment has been submitted.
  • Upload all applicable documents to the HEART case record.
  • Document the HEART case record.

The PSU staff are not required to complete a 14-day contact for individuals enrolled in STAR Health. 

PSU staff must refer to 2220, MCO Coordination, for information on the MCO’s responsibilities after receipt of Form H3676, Section A.

2100.3 MDCP ILR: Individuals Enrolled in STAR and Individuals Receiving Other Types of Medicaid

Revision 26-1; Effective March 16, 2026

Individuals enrolled in a STAR managed care organization (MCO) and individuals who receive other types of Medicaid not related to Supplemental Security Income (SSI), must go through the process of:

  • selecting or being defaulted to a STAR Kids MCO;
  • a financial eligibility determination for the Medically Dependent Children Program (MDCP), if applicable; and
  • completing the STAR Kids Screening and Assessment Instrument (SK-SAI) to determine if they meet the medical necessity (MN) for MDCP.

Program Support Unit (PSU) staff must complete all the following activities. This must be done within ten business days of receipt of an MDCP interest list release (ILR) case record from Interest List Management (ILM) unit staff in the Texas Health and Human Services (HHS) Enterprise Administrative Report and Tracking System (HEART):

PSU staff must complete the following activities within five business days of receipt of the MDCP ILR case record in HEART:

  • Check the Texas Integrated Eligibility Redesign System (TIERS) to verify:
    • Medicaid financial eligibility in the Medicaid/CHIP/CHIP perinatal History screen.
    • Managed care enrollment in the Managed Care screen.
  • Ensure the individual does not have an open enrollment with another Medicaid waiver program by reviewing the:
    • Service Authorization System Online (SASO) Enrollment and Service Authorization records for one of the:
      • Community Living Assistance and Support Services (CLASS) Program (Service Group (SG) 2)
      • Deaf Blind with Multiple Disabilities (DBMD) Program (SG 16)
      • Home and Community-based Services (HCS) Program (SG 21)
      • Texas Home Living (TxHmL) Program (SG 22)
    • TIERS Long Term Services and Supports (LTSS) Eligibility Periods Details screen for the Youth Empowerment Services (YES) waiver record.
  • Refer to Appendix XVI, Medicaid Program Actions, to determine if Form H1746-A, MEPD Referral Cover Sheet, must be faxed to the Medicaid for Elderly and People with Disabilities (MEPD) specialist for a financial eligibility determination.
  • Fax Form H1746-A to the MEPD specialist, if applicable. Note: The MEPD specialist notifies PSU staff of the financial eligibility determination within 45 days, or up to 90 days if it is necessary to get a disability determination.
  • Refer to 2010.2, MCO Selection or Default, for information on defaulting an individual to a STAR Kids companion plan, if the individual is enrolled in a STAR MCO.
  • For an individual who has a STAR Kids companion plan and requested first position, research the previous HEART case records, to:
    • Ensure the individual has never pursued first position. Note: First position can only be pursued one time.
    • Determine if the individual or LAR requested the following, if the individual qualifies for first position:
      • A new STAR Kids MCO or to remain with their previous STAR Kids companion plan upon ILR.
      • A different service coordinator with their previous STAR Kids companion plan, if applicable.
  • Upload Form H3676, Managed Care Pre-Enrollment Assessment Authorization, Section A, to the STAR Kids companion plan in the MCOHub, if applicable, and note:
    • All zeros for the Social Security Number (SSN), if the individual does not have an established SSN.
    • The following in the Comments section, if the individual requested first position and to remain with the previous STAR Kids companion plan: 
      • Individual or LAR requested first position and needs to be reassessed for MDCP.
      • A different service coordinator must conduct the new assessment, if applicable or:
  • Mail the following enrollment packet to the individual or LAR, if the individual qualifies for first position and has a STAR Kids companion plan, but requested a new STAR Kids MCO:
    • Form 2600-C
    • Form H2053-B
    • STAR Kids Comparison Charts
    • STAR Kids Report Cards
    • Appendix IV
    • Appendix XX
    • A postage-paid envelope 
  • Upload all applicable documents to the HEART case record.
  • Document the HEART case record.

PSU staff do not complete a 14-day contact for individuals released from the MDCP interest list (IL) who were defaulted to a STAR Kids companion plan. PSU staff must refer to 2220, MCO Coordination, for information on the MCO’s responsibilities after receipt of Form H3676, Section A, if the form was uploaded to the STAR Kids companion plan.

14th Day Contact

PSU staff must contact the individual or LAR within 14 days of the enrollment packet mail date, if the individual:

  • receives Medicaid but is not enrolled in an MCO;
  • is enrolled in a STAR MCO that does not operate a STAR Kids companion plan; or 
  • has a STAR Kids companion plan but requested first position and a new STAR Kids MCO.

PSU staff must complete the following activities when contacting the individual or LAR:

  • verify receipt of the enrollment packet;
  • confirm interest in MDCP and give a general description of MDCP services;
  • explain the need to select a STAR Kids MCO as soon as possible or one will be defaulted to them, if applicable;
  • inform the individual or LAR of the following, if applicable:
    • any delay in selecting a new STAR Kids MCO could result in a delay in the MDCP eligibility determination; and
    • the new STAR Kids MCO selection can be changed at any time but will not go into effect until after one full calendar month of MDCP service provision;
  • document the individual or LAR’s STAR Kids MCO choice in the HEART case record if obtained during the 14-day contact; and
  • document all contact attempts and any delays in the HEART case record.

PSU staff must refer to 2120, Inability to Contact the Individual, when unable to contact the individual or LAR within 14 days of the enrollment packet mail date.

The following individuals must select or be defaulted to a STAR Kids MCO so the MCO can perform the SK-SAI:

  • an individual:
    • who receives Medicaid but is not enrolled in an MCO;
    • enrolled in a STAR MCO that does not operate a STAR Kids companion plan; or 
    • who has a STAR Kids companion plan but requested first position and a new STAR Kids MCO.

PSU staff must refer to:

PSU staff must refer to 6300, Denials and Terminations, for information on MDCP case closure when:

  • notification is received about the individual’s death; or
  • the individual or LAR decline MDCP services..

2100.4 MDCP ILR: Individuals Not Receiving Medicaid or Individuals Enrolled in CHIP  

Revision 26-1; Effective March 16, 2026

An individual who does not receive Medicaid and is not enrolled in a managed care organization (MCO), including those enrolled in the Children’s Health Insurance Program (CHIP), must go through the process of:

  • selecting or being defaulted to a STAR Kids MCO;
  • being tested to determine if they meet financial eligibility for the Medically Dependent Children Program (MDCP); and
  • completing the STAR Kids Screening and Assessment Instrument (SK-SAI) to determine if they meet the medical necessity (MN) for MDCP.

Program Support Unit (PSU) staff must complete the following activities within ten business days of receipt of an MDCP interest list release (ILR) case record from Interest List Management (ILM) unit staff in the Texas Health and Human Services (HHS) Enterprise Administrative Report and Tracking System (HEART):

PSU staff must complete the following activities within five business days of receipt of the MDCP ILR case record in HEART:

  • Check the Texas Integrated Eligibility Redesign System (TIERS) to verify:
    • Medicaid financial eligibility in the Medicaid/CHIP/CHIP perinatal History screen.
    • Managed care enrollment in the Managed Care screen.
  • Ensure the individual does not have an open enrollment with another Medicaid waiver program by reviewing the:
    • Service Authorization System Online (SASO) Enrollment and Service Authorization records for one of the:
      • Community Living Assistance and Support Services (CLASS) Program (Service Group (SG) 2)
      • Deaf Blind with Multiple Disabilities (DBMD) Program (SG 16)
      • Home and Community-based Services (HCS) Program (SG 21) 
      • Texas Home Living (TxHmL) Program (SG 22)
    • TIERS Long Term Services and Supports (LTSS) Eligibility Periods Details screen for the Youth Empowerment Services (YES) waiver record.
  • Research the previous HEART case records for an individual who requested first position, to: 
    • Ensure the individual has never pursued first position. Note: First position can only be pursued one time.
    • Determine if the individual or LAR requested the following, if the individual qualifies for first position:
      • A new STAR Kids MCO or to remain with their previous STAR Kids MCO upon ILR.
      • A different service coordinator with their previous STAR Kids MCO, if applicable. 
  •  Upload all applicable documents to the HEART case record.
  • Document the HEART case record.

14th Day Contact

PSU staff must contact the individual or LAR within 14 days of the enrollment packet mail date to:

  • verify receipt of the enrollment packet;
  • confirm interest in MDCP and give a general description of MDCP services;
  • explain the following as applicable:
    • the Medicaid application process and the need to return Form H1200 within 30 days from of the enrollment packet mail date;
    • the need to select a STAR Kids MCO as soon as possible or one may be defaulted to them;
  • inform the individual or LAR that:
    • any delay returning the Medicaid application could result in a delay in the MDCP eligibility determination, if applicable;
    • the STAR Kids MCO selection can be changed at any time, but the change will not go into effect until after one full calendar month of MDCP service provision;
  • document the individual or LAR’s STAR Kids MCO choice in the HEART case record if obtained during the 14-day contact;
  • document all contact attempts and any delays in the HEART case record.

PSU staff must refer to 2120, Inability to Contact the Individual, when unable to contact the individual or LAR within 14 days of the enrollment packet mail date.

PSU staff must check the HHS Benefits Portal to verify Form H1200 was received if the individual or LAR states Form H1200 was submitted during the 14-day contact.

An individual or LAR must select or be defaulted to a STAR Kids MCO so the MCO can perform the SK-SAI. PSU staff must refer to:

PSU staff must refer to:

  • 2010.1, Incomplete Enrollment Packet, within two business days of receipt of an enrollment packet with an unsigned Form H1200.
  • 6300, Denials and Terminations, for information on MDCP case closure when:
    • notification is received about the individual’s death; or
    • the individual or LAR:
      • decline MDCP services; or
      • failed to return Form H1200 within 30 days from the date an enrollment packet is mailed.

2120 Inability to Contact the Individual

Revision 26-2; Effective June 1, 2026

Program Support Unit (PSU) staff who cannot contact an individual or the legally authorized representative (LAR) within 14 days from the date the enrollment packet was mailed must make another attempt to contact the individual or LAR. PSU staff must complete the contact attempt by the 30th day from the date the enrollment packet was mailed if the individual or LAR has not returned:

PSU staff must complete the actions in the following sections, if:

PSU staff should not try to contact an individual if the Texas Health and Human Services Commission (HHSC) receives notification about the individual’s death. PSU staff must refer to 6300.1, Death, for more information on processing a Medically Dependent Children Program (MDCP) case closure due to an individual’s death.

PSU staff must refer to 2310, Contacting the Interest List Management Unit to Reopen a Closed Interest List Release, for more information about processing reopen requests.

2130 Declining Medically Dependent Children Program Services

Revision 25-1; Effective May 16, 2025

Program Support Unit (PSU) staff must refer to 6300.3, Voluntarily Declined Services, for information on processing the Medically Dependent Children Program (MDCP) case closure within two business days of notification the individual or legally authorized representative (LAR) decline MDCP services.