Medicaid recipients must select health plan by Feb. 10

The Brownsville Community Health Center is hosting a fair on Saturday to help people navigate an important change that will soon take effect for all Medicaid clients in the Rio Grande Valley.

The change, which is tied to the state budget crisis last year, will bring programs called STAR and STAR+PLUS to provide managed-care health services for Medicaid clients in the region beginning March 1.

Medicaid recipients must choose one from at least five managed-care plans that will operate under the STAR or STAR+PLUS programs, Alix Flores, BCHC marketing director, said

Representatives from the various plans will be at the BCHC fair to talk to Medicaid recipients and help fill out necessary paperwork, he said.

The fair will be from 10 a.m. to 2 p.m. Saturday at the BCHC’s New Horizon facility at 191 E. Price Road.

The deadline for all Medicaid clients for making a choice and submitting paperwork is Feb. 10, Flores said.

Medicaid clients may make their selection by mailing the forms to the Texas Health and Human Services Commission, postmarked no later than Feb. 10; calling 800-964-2777; or going to an HHSC office, HHSC spokeswoman Stephanie Goodman said.

"If someone missed the deadline, the state will automatically enroll them in a plan," she said. "We'll try to make sure it's a plan that includes their doctor. The clients can still make selections or change their selection after Feb. 10, but they might not be in the health plan of their choice on March 1."

Flores said under the change, each Medicaid plan will have the same basic benefits, but services called "value adds" will be different among the plans. Medicaid clients will be asked to choose which plan’s "value adds" best fit their family.

In general, children and families will fall under the STAR program, while STAR+PLUS is for the elderly or those with disabilities.

"We’re the last area in the entire state to go into managed care," Flores said.

January 2011 Medicaid enrollment for Cameron County was 108,747 people, while in Hidalgo County 222,567 were enrolled, according to Texas Health and Human Services Commission figures.

Managed healthcare services in the state have been expanded with the goal of containing costs by avoiding duplicate services as clients pick one plan that will manage their care.

The change was proposed as one remedy to the state’s budget shortfall last year that reached billions of dollars. In particular, it was proposed that a ban on managed care in three South Texas counties — Cameron, Hidalgo and Maverick — be lifted.

"There was a lot of waste, if we’re going to be frank," Flores said. "It needs to be more efficient, but we don’t want to limit what families are used to getting."

BCHC Executive Director Paula Gomez, who is a member of the state’s medical care advisory committee, said there is a savings figure tied to the move towards managed care, but that she isn’t sure it will make a difference.

"There are still a lot of questions," she said, noting the imminent Feb. 10 deadline and the program’s statewide rollout on March 1.

Goodman, the HHSC spokeswoman, said STAR was previously used only in urban areas.

"I’m not sure of the history, but I think a South Texas lawmaker placed the provision in a large bill, probably due to provider concerns over managed care," Goodman said of the ban targeting only three counties. "At the time, we only had managed care in urban areas so we never attempted to use it in the smaller counties around the three counties where it was banned."

Flores said the BCHC hopes to have a large crowd on Saturday.

"If we see a huge line we’re going to stay until we’re finished," he said.

For more information visit www.TXMedicaidEvents.com, call the state hotline at 1-800-964-2777, go to a local office of the Texas Health and Human Services Commission, call BCHC at 548-7400 or contact your healthcare provider. www.TXMedicaidEvents.com

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1-800-964-2777