(a) In this section, “health home” means a primary care provider practice or specialty care provider practice that incorporates several features, including comprehensive care coordination, family-centered care, and data management, that are focused on improving outcome-based quality of care and increasing patient and provider satisfaction under Medicaid.
(b) Subject to Sections 540.0701 and 540.0753, the commission shall establish a mandatory STAR Kids capitated managed care program tailored to provide Medicaid benefits to children with disabilities. The program must:
(1) provide Medicaid benefits customized to meet the health care needs of program recipients through a defined system of care;
(2) better coordinate recipient care under the program;
(3) improve recipient:
(A) access to health care services; and
(B) health outcomes;
(4) achieve cost containment and cost efficiency;
(5) reduce:
(A) the administrative complexity of delivering Medicaid benefits; and
(B) the incidence of unnecessary institutionalizations and potentially preventable events by ensuring the availability of appropriate services and care management;
(6) require a health home; and
(7) for recipients who receive long-term services and supports outside of the Medicaid managed care organization, coordinate and collaborate with long-term care service providers and long-term care management providers.

Text of section effective on April 01, 2025