Common use of Transition Plan for New STAR+PLUS Members Clause in Contracts

Transition Plan for New STAR+PLUS Members. The MCO must provide a transition plan for Members enrolled in the STAR+PLUS Program. HHSC, or the previous STAR+PLUS MCO contractor, will provide the MCO with information such as detailed care plans and names of current providers, for newly enrolled Members already receiving Long-term Services and Supports, including Nursing Facility Services, at the time of enrollment in the MCO. The MCO must ensure that current providers are paid for Medically Necessary and Functionally Necessary Covered Services that are delivered in accordance with the Member’s existing care plan after the Member is enrolled in the MCO and until the transition plan is developed. The transition planning process must include the following:

Transition Plan for New STAR+PLUS Members. The MCO must provide a transition plan for Members enrolled in the STAR+PLUS Program. HHSC, or and/or the previous STAR+PLUS MCO contractor, will provide the MCO with information such as detailed care plans and Care Plans, names of current providers, etc., for newly enrolled Members already receiving Long-term Services and Supports, including Nursing Facility Services, Supports at the time of enrollment in the MCO. The MCO must ensure that current providers are paid for Medically Necessary and Functionally Necessary Covered Services that are delivered in accordance with the Member’s existing care treatment/Long-Term Services and Supports plan after the Member is has become enrolled in the MCO and until the transition plan is developed. The transition planning process must include include, but is not limited to, the following: