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TITLE 1ADMINISTRATION
PART 15TEXAS HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 353MEDICAID MANAGED CARE
SUBCHAPTER HSTAR HEALTH
RULE §353.702Member Participation

(a) Children and young adults in the following categories are eligible to participate in the STAR Health program:

  (1) a child in the conservatorship of the Department of Family and Protective Services (DFPS), if the state as conservator elects to place the child in the STAR Health program;

  (2) a young adult from age 18 through the month of his or her 22nd birthday who voluntarily agrees to continue in foster care placement, if the state as conservator elects to place the child in the STAR Health program;

  (3) a young adult from age 18 through the month of his or her 21st birthday who is a FFCC member or participating in the MTFCY Program; and

  (4) a young adult from age 21 through the month of his or her 23rd birthday who is participating in the FFCHE Program.

(b) Although young adults participating in the FFCHE Program are not Medicaid beneficiaries under Title XIX of the Social Security Act, they receive the same covered services and benefits as other eligible participants in the STAR Health program.

(c) A young adult described in subsection (a)(2) and (3) of this section may choose to transfer from the STAR Health program to the STAR program.

(d) All FFCHE members are enrolled in STAR Health and do not qualify as a FFCC member.

(e) The following Medicaid recipients cannot participate in the STAR Health program:

  (1) Children and youth who have been adjudicated and placed with the Texas Youth Commission (TYC) or Texas Juvenile Probation Commission (TJPC);

  (2) Children and youth from other states who are placed in Texas through the Interstate Compact Placement Commission (ICPC) as defined by DFPS in 40 TAC Chapter 700, Subchapter S (relating to Interstate Placement of Children);

  (3) Children and youth in Medicaid-paid facilities such as nursing facilities, state schools, or ICF-IIDs;

  (4) Children and youth who are dual eligible;

  (5) Children and youth who are in the conservatorship of DFPS who are placed outside of Texas;

  (6) Children and youth who are receiving adoption assistance Medicaid as defined by DFPS in 40 TAC Chapter 700, Subchapter H (relating to Adoption Assistance Program); and

  (7) Children who are declared manifestly dangerous as defined by the Texas Department of Health Services in accordance with 25 TAC Chapter 415, Subchapter G (relating to Determination of Manifest Dangerousness).


Source Note: The provisions of this §353.702 adopted to be effective March 1, 2012, 37 TexReg 1283; amended to be effective September 1, 2014, 39 TexReg 5873

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