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HHSC will enroll individuals into Primary Home Care (PHC) who meet the PHC immediate or expedited criteria, as described in Section 2310, Criteria for Immediate or Expedited Responses to Service Requests, when they are listed in the Texas Integrated Eligibility Redesign System (TIERS) as a candidate for STAR PLUS enrollment.However, mandatory STAR PLUS individuals who are not yet enrolled with an MCO, and do not meet immediate or expedited criteria, will be referred to the Enrollment Broker.Medicaid recipients must take the card to doctor or dental appointments and to the pharmacy.

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Since there are no immediate or expedited criteria for DAHS enrollment, individuals seeking these services will be available upon enrollment into the STAR PLUS program.

DAHS facility initiated referrals which take place for individuals pending STAR PLUS enrollment will not be reimbursed by HHSC.

The card should not be thrown away, even if the recipient is denied Medicaid, since the card will be reused if the individual later regains eligibility.

Form H1027-A, Medicaid Eligibility Verification, is a secure form, not available on the website and must be ordered.

Individuals who are already enrolled with an MCO and request PHC or Day Activity and Health Services (DAHS) from HHSC must be advised to contact their MCO.

HHSC will not enroll individuals in DAHS when they are listed in TIERS as a candidate for STAR PLUS enrollment.

Revision 17-1; Effective March 15, 2017 For interest list procedures involving managed care, see the Revision 17-1; Effective March 15, 2017 When the Austin Document Processing Center (DPC) receives an application in which a request for an HHSC referral exists, the DPC will fax the first three pages of the application and a cover sheet to the HHSC local office.

Upon receipt of the application, HHSC staff will review each of the referrals and contact the individual to determine if the individual is interested in HHSC services and take the following actions: The document processing center address is: Document Processing Center P. Box 149024 Austin, TX 78714-9024 Fax Number: 877-236-4123 Revision 18-1; Effective June 15, 2018 When a request for service is received by telephone, written referral or in person, the HHSC staff who conducts intake for community care services or who receives a request for service gives the requester information about HHSC CCAD services and determines what service is being requested and whether HHSC provides that service.

During the initial interview, the case worker screens all applicants for potential eligibility for CAS and determines whether or not the applicant will be referred to MEPD for CAS.

Certain services require special intake procedures. For details, see Section 4000, Specific CCAD Services.

However, the form instructions are available on the Texas Health and Human Services Forms website for completion of the form.

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