1. (a) All supplemental security income (SSI) and SSI-related clients and clients who qualify for Medicaid benefits as medical assistance only (MAO) clients must receive their Medicaid services through the STAR+PLUS pilot. Clients will have a choice among at least two Health Maintenance Organizations.

2. (b) SSI or SSI-related clients who are receiving services from the following programs are excluded from participation in STAR+PLUS:

   1. (1) Frail Elderly waiver;
   2. (2) Community Living Assistance and Support Services (CLASS) waiver;
   3. (3) Deaf Blind Multiple Disabled waiver;
   4. (4) Mental Health/Mental Retardation (MHMR) Home and Community-based Services (HCS) waiver and Home and Community based Services-OBRA (HCS- OBRA) waiver;
   5. (5) Medically Dependent Children Program (MDCP) waiver;
   6. (6) clients receiving services in residential MHMR facilities;
   7. (7) clients who qualify for Medicaid based on residency in a nursing facility (Medical Assistance Only);
   8. (8) members of a managed care organization after four months of residency in a nursing home; and
   9. (9) clients who are in a nursing facility prior to managed care enrollment.
3. (c) SSI clients under 21 years of age, SSI clients receiving ongoing rehabilitative services through the local mental health authority, and SSI clients on the waiting list to receive MHMR HCS waiver services will have the option of STAR+PLUS participation or choosing the Primary Care Case Management Program for their acute care services and remaining fee-for-service for their long term care services.

Source Note:The provisions of this §353.603 adopted to be effective December 1, 1997, 22 TexReg 11403; amended to be effective December 1, 2000, 25 TexReg 11666; transferred effective September 1, 2004, as published in the Texas Register September 17, 2004, 29 TexReg 9013.