Reminder: STAR Kids and STAR Health LTSS Physician Requirements
Date: 08/28/20
Superior HealthPlan’s STAR Kids and STAR Health waiver program allows qualifying members to receive initial or ongoing services under the Long-Term Care Services and Supports (LTSS) in the Home and Community-Based Services (HCBS), Community First Choice (CFC) and/or Medically Dependent Children Program (MDCP). Members that meet program requirements are eligible to receive the following services, but are not limited to:
- Minor Home Modifications (MHM)
- Respite Services.
- Flexible Family Support Services (FFSS)
- Transition Assistance Services (TAS)
- Adaptive Aids (AA)
- Supported Employment (SE)
- Community First Choice (CFC) Services
- Employment Assistance (EA)
In order to qualify for services, the member must have a medical necessity that meets nursing facility level of care. These additional services can be provided under the waiver program that can assist in keeping the member safe in a community setting. Superior will conduct a Screening and Assessment Instrument (SAI) to determine the member’s medical needs. A copy of the SAI is available to providers on Superior’s Secure Provider Portal.
Providers must submit the Physician Certification (2601 Form) certifying that the member may benefit from CFC and/or MDCP services under the supervision of an MD/DO. The form is located on Superior’s Provider Forms webpage, and must be completed and returned to Superior by:
- Fax: 1-866-703-0502
- E-mail, using Adobe e-Signature: SHP.Intake@SuperiorHealthPlan.com
- Mail: Superior HealthPlan, ATTN: MN - Intake, 711 N. Carancahua St., Suite 600, Corpus Christi, TX 78401
For any questions, please call Superior’s Service Coordination department at:
- STAR Kids: 1-844-433-2074
- STAR Health: 1-866-912-6283