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After determining financial eligibility for Medicaid, Medicaid for the Elderly and People with Disabilities MEPD specialists determine the amount of money available for copayment. Copayment changes must always be effective on the first day of the month.

If the copayment is increasing, Program Support Unit PSU staff must send the member and managed care organization MCO notification on Form HD , Notification of Managed Care Program Services, and the increase is effective the first day of the month after the expiration of the adverse action period.

The MCO is responsible for notifying the provider. If the first day of the month occurs before the end of the adverse action period, the copayment increase is effective the first day of the subsequent month. Decreases in copayment require Form HD notification, but can be effective the first day of the month after the notification is sent.

Copayments may also change due to other circumstances. MEPD specialists inform PSU staff of fraud referrals and determine whether any corrections are necessary to the member's copayment based on a change in the amount available for copayment.

Underpayments by the member that are not part of a fraud referral, such as those based on reconciliation of variable income, result in the MEPD specialist sending a letter to the member requesting that the member pay the MCO the amount of copayment that was underpaid. The underpayment is not retroactively considered in the copayment calculation. The increase in copayment is effective the first day of the month after the expiration of the adverse action period indicated on Form HD.

Refunds due to the member require a new copayment calculation be completed. The effective date of the decrease in copayment is the first of the month after Form HD is sent. During the initial contact with the applicant or member, Program Support Unit PSU staff must explore the applicant's or member's status in the nursing facility NF and determine whether the applicant or member has a current medical necessity MN. The MN on record will be accepted as a valid MN. For initial applications, the total cost of services for an applicant's ISP must be equal to or below the individual's ISP cost limit.

Applicants exceeding the cost limit cannot elect to receive reduced services for entry to the program if this would pose a risk to the individual's health, safety and welfare.

PSU staff are also the point of contact for the coordination and monitoring of members transitioning from:. The enrollment broker determines what is preventing MCO enrollment and takes action to resolve the issue, which may include referral to the Health and Human Services Commission HHSC or contact with the individual.

Although CCSE intake staff routinely provides the initial four demographic data, there may be times when an individual requesting services is unable to furnish the date of birth.

Case managers may assess these individuals for services if it appears services can be authorized and delivered prior to enrollment. Termination is effective April Recipients can return enrollment forms via mail, complete an enrollment form at an enrollment event or presentation, or call the enrollment broker and enroll via telephone at Recipients have 30 days after receiving an enrollment packet to select an MCO. Failure to select a PCP may delay services when a physician's order or medical necessity MN determination is required.

Within 14 days of release from the interest list see Section The SOC date is July 1. This ensures the individual does not experience a break in services and does not receive concurrent services through another waiver or CCAD service. The CCSE case manager must send:. Members may change managed care organization MCO plans as often as monthly by contacting the enrollment broker at The enrollment broker makes plan changes based on the monthly cutoff periods, which occur around the middle of the month.

Depending on which day of the month before or after the enrollment broker cutoff , the plan change will either occur the first day of the next month or the month after. The change will show up on the daily enrollment file notifying the MCO of the new member. Texas Health and Human Services Commission HHSC case managers may assess all individuals whose managed care enrollment is pending if it appears CCAD services can be approved and delivered prior to enrollment in managed care.

If not, the individual's name is added to the appropriate interest list by entering the information in the Community Services Interest List CSIL system. Members are released from the interest list on a first-come, first-served basis; eligibility determinations are conducted as slots for services become available. If PSU staff determine the requested service is not being delivered by the MCO, the intake must be assigned to a case manager. The case manager processes the application and authorizes services if all eligibility criteria are met.

The PSU staff's response must be included in materials forwarded to the case manager at the time of case assignment. How the case manager proceeds with the eligibility determination process depends on the PSU's documented response.

The member is urged to consult the MCO if he or she disagrees or feels the services are not sufficient to meet her or his needs. See Section , Intake and Enrollment, for additional information on intake and referral procedures. All attempted contacts with the member or encountered delays must be documented.

PSU staff:. The following information is provided for informational purposes only regarding the disability determination process. MEPD specialists have 45 days to complete applications for individuals over age For SSI-denied Medicaid program types referenced in this section, the Medicaid program type verification includes the MEPD certification that the additional required financial criteria have been met. For these applicants or members, the losing service area must inform the gaining service area of the GR status.

The gaining service area must follow the GR process. The process is abbreviated since the member already has a:. The gaining PSU maintains contact with the member until the move is complete. Within five business days after the move, PSU staff:.

Within three business days of notification of the move, ERS disenrolls the member effective the end of the month in which the member moved and re-enrolls the member to the gaining MCO. Upon receipt of Form HMC, the gaining MCO must contact the member within one business day and begin services within two business days.

Within two business days of notification of the move, ERS considers coordination of claims to limit provider impact. Once the initial enrollment period of one full month has passed, a member is eligible to change managed care organization MCO plans.

A member may request a transfer to another MCO in the service area through the state-contracted enrollment broker at any time for any reason. When a member wants to change from one MCO to another MCO in the same service area, the member or authorized representative AR must contact the enrollment broker via phone call to If the member calls after the monthly HHSC MCO enrollment cut-off date, the change will take place the first day of the second month following the change request.

Within five business days of receiving the request, the losing MCO must provide the requested documents to the gaining MCO. The gaining MCO is responsible for service delivery from the first day of enrollment. Within 14 days of notification of the new member, the gaining MCO must contact the member to discuss services needed by the member.

Within 30 days of notification of the new member, the gaining MCO must conduct a home visit to assess the member's needs. STAR Kids and STAR Health eligibility will terminate the last day of the month in which the member's 21st birthday occurs and the member must receive services through programs serving adults. The STAR Kids and STAR Health managed care organizations MCOs identify all members turning age 21 within the next 12 months and schedule a face-to-face visit with the member and the member's support person including her or his authorized representative AR , if applicable, to initiate the transition process.

The notification must include the number of PDN hours currently authorized. UR staff will conduct a desk review once all the documents noted above are received and may request a clinical review of the case by an HHSC physician to consider the use of state of Texas General Revenue GR funds to cover costs exceeding the percent cost limit. MCOs must submit documentation supporting a GR request no later than 45 days:.

Members who were approved for and are using an intrapulmonary percussive ventilator IPV are permitted to continue using the IPV if it is deemed to have a beneficial impact on the health of the member. The member must not be subjected to abrupt removal of the equipment. See Section Individuals are enrolled in managed care on the first day of the month in which discharge from the NF is planned.

This flexible enrollment process only applies to MFP. The MCO participates in community planning groups for example, the Community Transition Team and other activities related to the state's Promoting Independence Initiative.

In keeping with the Promoting Independence Initiative, the Program Support Unit PSU and managed care organizations MCOs are obligated to assist the nursing facility NF applicant or member who wants to return to the community by providing information and referrals to possible resources in the community. However, in situations where specific eligibility criteria will not be met in the foreseeable future, PSU staff have the option to deny the request for services.

Time frames are set as a guideline for denying requests pending service arrangements. A four-month time frame is the guideline used in determining pending or denying requests for services. The assessment process does not stop during this period; however, eligibility cannot be established until the member is ready to discharge from the NF.

If the applicant has an estimated date of discharge that may or may not go beyond the four—month period, PSU staff should keep the request for services open. These studies shave played a fundamental role in the revitalization of oil production in Texas, driven by these unconventional plays. The results of STARR regional studies are used by oil companies as the basic framework for their exploration efforts.

By increasing geologic understanding of new unconventional plays STARR has helped to facilitate the ongoing revolution in oil production in Texas. A variety of oil and gas companies request reservoir characterization and exploration assistance from STARR. STARR geologists and engineers provide assistance and advice to companies on: optimal development strategies; reservoir heterogeneity and their effects on oil and gas recovery; and evaluation of exploration targets.

Over the last 20 years, the STARR program has completed or is currently working on more than 60 field reservoir characterization and more than 15 regional studies with over 50 Texas oil and gas operators. We are not a treatment center. We are a group of recovering addicts and alcoholics who are working a step program alongside alternative healing methods and have been called into purpose. As a result, we are open to offering our experience, strength and hope to the next addict in want.

From this peak level production steadily decreased until about when the rate of decease leveled out as unconventional production became significant. By shale oil production from fracing the Eagle Ford Formation in South Texas and the Wolfcamp and Spraberry Formations in the Permian Basin has resulted in a dramatic increase in production. The STARR program has funded a series of key, regional projects that have aided in the development of the shale gas and shale oil revolution in Texas.

The first of these in the Barnett Shale, the first shale gas play, was conducted between and A study of the Eagle Ford Shale, the first shale oil play was conducted between and These studies shave played a fundamental role in the revitalization of oil production in Texas, driven by these unconventional plays.



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