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December 2016 Texas Medicaid Provider Procedures Manual

Medicaid Managed Care Handbook : 5 STAR+PLUS Program : 5.2 STAR+PLUS Client Enrollment : 5.2.1 Enrollment of Newborns

Children born to STAR+PLUS clients will be automatically enrolled with the STAR MCO in the service area operated by the same STAR+PLUS MCO if available. The effective date of the newborn’s enrollment is the same as the newborn’s date of birth. If the STAR+PLUS MCO does not also operate a STAR MCO in the service area, the newborn is placed into Texas Medicaid fee-for-service, and the mother is given the opportunity to choose a STAR MCO for the newborn.
Hospitals that submit the newborn’s birth certificate information using the DSHS Bureau of Vital Statistics (BVS) electronic Certificate Manager software and the Hospital Report (Newborn Child or Children) (Form 7484), receive a rapid and efficient assignment of a newborn Medicaid identification number. This process expedites reimbursement to hospitals and other providers involved in newborn care including pharmacies providing outpatient prescription benefits for medically-needy newborns.
For more information or to comment on the process for expedited assignment of a newborn Medicaid identification number, providers can call 1-512-458-7367.

Texas Medicaid & Healthcare Partnership
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