SECTION 353.1103. General Provisions

(a) HHSC, in conjunction with CMS, administers the Dual Demonstration. The Medicare and Medicaid services are provided through STAR+PLUS Medicare-Medicaid Plans (MMPs).

(b) A STAR+PLUS MMP is a managed care plan contracted with CMS and HHSC to participate in the Dual Demonstration.

(c) Medicare Advantage and Medicare Part D provided through this demonstration are the responsibility of CMS.

(d) All other rules in this chapter governing Medicaid managed care apply to the Dual Demonstration, as applicable, unless specific deviations are noted in this subchapter.

(e) The Dual Demonstration serves members whose primary residence is in one of the following counties:

(1) Bexar;

(2) Dallas;

(3) El Paso;

(4) Harris;

(5) Hidalgo;

(6) Tarrant; and

(7) other counties as authorized by a federal waiver approved by CMS. The dual demonstration will not be implemented in other counties without prior public notice.

Source Note: The provisions of this §353.1103 adopted to be effective April 1, 2015, 40 TexReg 1705