Text of section effective on April 01, 2025
Sec. 540.0851.  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
(B)  health outcomes;
(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.
Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.