Tracking for Lifetime Spending Limits Available in the Long-Term Care Online Portal

Date: February 19, 2025

Attention: STAR Kids Providers

Effective date: February 21, 2025

Call to action: Texas Children’s Health Plan (TCHP) would like to make STAR Kids providers aware that starting on February 21, 2025; enhancements will be made to the Texas Medicaid & Healthcare Partnership (TMHP) Long-Term Care Online Portal (LTCOP). Users will soon be able to track and determine if a person receiving services with lifetime or periodic limits has met their lifetime spending limit.

How this impacts providers: The LTCOP enhancements will include the following:

Improved utilization tracking: The TMHP Claims Management System will configure and track service limit utilization data in LTCOP.
Expanded user access: Home and Community-based Services (HCS) and Texas Home Living (TxHmL) providers and local intellectual and developmental disability authorities (LIDDAs) will be able to access utilization data to check how much of a lifetime or periodic limit has been used before requesting new services.
Enhanced search capabilities: Users submitting 3608 and 8582 Individual Plan of Care (IPC) forms will be able to search for utilization information using various criteria, including paid claim dollar amounts.
Flexibility for future services: This enhancement is designed to accommodate future services with lifetime or periodic limits, such as legislatively mandated employment readiness services.
Accurate and timely information: This enhancement ensures that providers and LIDDAs have accurate and timely information to support service planning and prevent unnecessary disruptions for individuals receiving services.

Next step for Providers: Providers need to prepare for these changes. HCS and TxHmL providers and LIDDAs that do not have an LTCOP account must create an administrator or user account. Instructions on how to create an account are available in the TMHP Account Setup for HCS and TxHmL Waiver Programs Quick Reference Guide (QRG).

Resources:

Providers can use the Provider Quick Reference Contact List for HCS and TxHmL to find guidance about specific issues from Health and Human Services Commission staff.
Providers and LIDDAs are encouraged to visit the TMHP 1915(c) Waiver Programs web page for recent news, reference materials, education, and bulletins.

If you have any questions, please email Provider Relations at: providerrelations@texaschildrens.org.

For access to all provider alerts: https://www.texaschildrenshealthplan.org/providers/provider-news/provider-alerts.