STAR+PLUS HMOs definition
Examples of STAR+PLUS HMOs in a sentence
For STAR+PLUS HMOs, the Medicaid STP requirements apply to all Service Areas, except ▇▇▇▇▇▇ County within the ▇▇▇▇▇▇ Service Area.
The Operational Start Date is September 1, 2006 for STAR and CHIP HMOs, January 1, 2007 for CHIP Perinatal HMOs, and February 1, 2007 for the STAR+PLUS HMOs.
Note that STAR+PLUS HMOs are not required to contract with Hospitals for Inpatient Stays, but are required to contract with Hospitals for Outpatient Hospital Services.
STAR+PLUS HMOs will be notified when Providers are added to the list of STPs for a Service Area.
No later than the Contract execution date, STAR+PLUS HMOs must update the information above and provide any additional information as it relates to the STAR+PLUS Program.
STAR+PLUS HMOs are responsible for professional charges during every month for which the HMO receives a full capitation for a Member.
STAR+PLUS HMOs must also provide Functionally Necessary Community Long-term Care Services to all Members beginning on the Member’s date of enrollment regardless of pre-existing conditions, prior diagnosis and/or receipt of any prior health care services.
For STAR+PLUS HMOs, HHSC will negotiate and implement Performance Improvement Goals for the first full fiscal year following the STAR+PLUS Operational Start Date.
Section 8.3 includes the additional scope of work that applies only to STAR+PLUS HMOs.
Section 8.2 includes the additional Medicaid scope of work that applies only to the STAR and STAR+PLUS HMOs.