Section 540.0851 - [Effective 4/1/2025] Star Kids Managed Care Program(a) In this section, "health home" means a primary care provider practice or specialty care provider practice that incorporates several features, including comprehensive care coordination, family-centered care, and data management, that are focused on improving outcome-based quality of care and increasing patient and provider satisfaction under Medicaid.(b) Subject to Sections 540.0701 and 540.0753, the commission shall establish a mandatory STAR Kids capitated managed care program tailored to provide Medicaid benefits to children with disabilities. The program must: (1) provide Medicaid benefits customized to meet the health care needs of program recipients through a defined system of care;(2) better coordinate recipient care under the program;(3) improve recipient:(A) access to health care services; and(4) achieve cost containment and cost efficiency;(5) reduce:(A) the administrative complexity of delivering Medicaid benefits; and(B) the incidence of unnecessary institutionalizations and potentially preventable events by ensuring the availability of appropriate services and care management;(6) require a health home; and(7) for recipients who receive long-term services and supports outside of the Medicaid managed care organization, coordinate and collaborate with long-term care service providers and long-term care management providers. (Gov. Code, Secs. 533.00253(a)(2), (b).)Tex. Gov't. Code § 540.0851
Added by Acts 2023, Texas Acts of the 88th Leg.- Regular Session, ch. 769,Sec. 1.01, eff. 4/1/2025.