STAR+PLUS Transition Member Information: Change In MCO Providers

by | Sep 11, 2024

September 11th, 2024

Effective September 1, HHSC began transitioning contracts for the STAR+PLUS program.

This document below provides STAR+PLUS members and providers with resources for assistance with go-live concerns.

 STAR+PLUS Providers by service area (MCO’s leaving, staying and new)

I am a…

I need help with…

How to get help

Member

Learning general information about the transition

See the HHSC STAR+PLUS webpage

Member

A complaint about my MCO

Contact your MCO plan first.

If the issue isn’t resolved, contact the HHSC Ombudsman

Member

STAR/CHIP, STAR Health, STAR Kids, MMP, or CHIP

Please see the HHSC Medicaid and CHIP webpage

Member

Understanding how my coverage may be impacted by the transition

Please see the Continuity of Care webpage

Provider

Contracting with an MCO

To contract with an MCO, please see the MCO provider contacts list.

If you have already connected with an MCO and have a complaint, reach out to the Health Plan Management Complaints inbox.

Provider

Understanding how the transition pay impact my billing

Please reach out to the MCO you have contracted with to understand their billing processes

Provider

Understanding how to help my clients through the transition

Please see the HHSC STAR+PLUS webpage for transition resources

 

For any STAR+PLUS transition related issues, please contact the STAR+PLUS Go Live inbox.

May 12th, 2024

STAR+PLUS Transition Member Information: HHSC recently awarded contracts to health plans (MCOs) for the STAR+PLUS Service Areas.  As detailed below, the newly awarded contracts impact many of the service areas.  The contract effective date is September 1, 2024.
  • Nine (9) of the 13 service areas were affected by the procurement and award processes:
~  Bexar, Dallas and El Paso, Harris, Hidalgo, Jefferson, Nueces, Tarrant and Travis service areas.  With the exception of Jefferson service area, each of these areas has at least one new MCO in their area.  Jefferson service area, which currently has 3 MCOs will only have 2 MCOs beginning September 1, 2024.
See slides 9 – 11 of the attached handout.
~  Lubbock, MRSA Central, MRSA East and MRSA West service areas were not affected, meaning that the current MCOs covering these areas will remain.
See slides 7 and 12 of the attached handout.
  • Letters from HHSC have been sent to current members in the nine (9) areas in which a change in MCOs is occurring.  The letters were sent In March.
  • Members in the 9 affected service areas have until July 20, 2024 to pick a new health plan (MCO) and will be sent a reminder before the deadline.                                                                                  Note: Persons satisfied with their current MCO are not required to respond to the letter, but, if they want, may switch to the new MCO or any other MCO in their area.  Of course, persons currently enrolled in a MCO which was not awarded a ‘new’ contract will need to select a health plan from the MCOs in their service area.
    • Example:  If a person resides in the Jefferson STAR+PLUS Service Area, and is currently enrolled with United Healthcare, the person will need to choose either Wellpoint or Molina since , effective September 1, 2024, United Healthcare will no longer serve that area. On the other hand, if a person residing in Jefferson STAR+PLUS service area is currently enrolled with Molina, the person can either stay with Molina, or change to the other MCO (Wellpoint) in that area.
  • HHSC is planning to conduct information sessions about the changes, but no dates were provided.
As the transition will impact the individuals providers serve and as it is not known when the information sessions/webinars will be held, we urge providers to review this information with the individuals they serve and/or their families.

Star Plus Transition Member Information

Updates For Medicaid Interest Waiver List