Common use of Medicaid Non-capitated Services Clause in Contracts

Medicaid Non-capitated Services. The following Texas Medicaid programs, services, or benefits have been excluded from MCO Covered Services. Medicaid Members are eligible to receive these Non-capitated Services on a Fee-for-Service basis, or through a Dental MCO (for most dental services). MCOs should refer to relevant chapters in the Texas Provider Procedures Manual for more information. 1. Texas Health Steps dental (including orthodontia); 2. Texas Health Steps environmental lead investigation (XXX); 3. Early Childhood Intervention (ECI) case management/service coordination; 4. Early Childhood Intervention Specialized Skills Training; 5. DSHS Targeted Case Management - coordinated by LMHAs; 6. DSHS mental health rehabilitation; 7. Case Management for Children and Pregnant Women; 8. Texas School Health and Related Services (SHARS); 9. Department of Assistive and Rehabilitative Services Blind Children's Vocational Discovery and Development Program; 10. tuberculosis services provided by DSHS-approved providers (directly observed therapy and contact investigation); 11. Health and Human Services Commission's Medical Transportation; 12. DADS hospice services; 13. Court-Ordered Commitments to inpatient mental health facilities as a condition of probation; 14. for STAR, Personal Care Services for persons birth through age 20 are Non-capitated Services; 15. for STAR+PLUS, nursing facility services are Non-capitated Services; and

Medicaid Non-capitated Services. The following Texas Medicaid programs, services, or benefits have been excluded from MCO Covered Services. Medicaid Members are eligible to receive these Non-capitated Services on a Fee-for-Service basis, or through a Dental MCO (for most dental services). MCOs should refer to relevant chapters in the Texas Medicaid Provider Procedures Manual for more information. 1. Texas Health Steps dental (including orthodontia); 2. Texas Health Steps environmental lead investigation (XXX); 3. Early Childhood Intervention (ECI) case management/service coordination; 4. Early Childhood Intervention Specialized Skills Training; 5. DSHS Targeted Case Management - coordinated by LMHAsLMHAs (until August 31, 2014); 6. DSHS mental health rehabilitationrehabilitation (until August 31, 2014); 7. Case Management for Children and Pregnant Women; 8. Texas School Health and Related Services (SHARS); 9. Department of Assistive and Rehabilitative Services Blind Children's Vocational Discovery and Development Program; 10. tuberculosis services provided by DSHS-approved providers (directly observed therapy and contact investigation); 11. Health and Human Services Commission's Medical Transportation; 12. DADS hospice services; 13. Court-Ordered Commitments to inpatient mental health facilities as a condition of probation; 14. for STAR, Texas Health Steps Personal Care Services for persons Members birth through age 20 are Non-capitated Services; 20; 15. for STAR+PLUS, nursing facility Nursing Facility services are Non-capitated Services; and(until August 31, 2014);