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Medicaid Managed Care Proposals

The Texas Health and Human Services Commission (HHSC) is proposing several changes to Texas Medicaid and Children’s Health Insurance Program (CHIP) managed care services. The proposals are contained in the HHSC budget request and are contingent on approval by the Texas Legislature. The proposals include:

  • Expand Medicaid managed care to counties contiguous to existing service areas. The expansion would be implemented through a contract amendment to the existing Medicaid and CHIP managed care contracts.
  • Expand STAR+PLUS to El Paso and Lubbock.
  • Expand Medicaid managed care to South Texas (Hidalgo Service Area).
  • Replace the Primary Care Case Management Program (PCCM) with a capitated managed care program.
  • Carve the pharmacy benefit into the services delivered by the Medicaid and CHIP managed care plans.
  • Develop statewide Medicaid dental managed care.

Proposed Program Start Dates:

  • STAR/STAR+PLUS Contiguous Expansion: Sept. 1, 2011
  • STAR+PLUS Expansion (Lubbock and El Paso): March 1, 2012
  • Managed Care Expansion to Hidalgo Service Area: March 1, 2012 (Hidalgo, Cameron, Maverick)
  • PCCM Conversion to Capitated Managed Care: March 1, 2012
  • Medicaid Dental Managed Care: March 1, 2012

Resources:

From: Texas Health and Human Services Commission

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