NorthSTAR Contract: FY 2015 - FY 2017

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ValueOptions Contract and Appendices

North Texas Behavioral Health Authority Contract and Additional Documents


ValueOptions Contract and Appendices — September 1, 2015 - August 31, 2017 

Contract

ValueOptions Contract

General Provisions - Vendor

Appendices

(0) Table of Contents

(1) Definitions

(2A) Medical Records Standards

(2B) Crisis Redesign Service Standards

(3A) Coordination Agreement STAR-NorthSTAR

(3B) Coordination Agreement - CHIP-NorthSTAR

(4A) Performance Incentives Outline

(4B) Performance Penalties

(5) Adverse Determinations and Appeals

(6) Medicaid Eligibility Criteria Grid

(7) Mental Health Priority Population

(8A) Scope of Benefits (Mental Health)

(8B) Scope of Benefits (Chemical Dependency)

(9) Special Children’s Programs

(10) Outpatient Competency Restoration Programs

(11) Medicaid Rate Setting Methodology

(12) Coordination of Care Between CRCGs and BHO

(13A) Assessment Instrument: Adult

(13B) Assessment Instrument: Child

(14) Provider Credentialing and Recredentialing

(15) Financial Eligibility Determination Form

(16) Pharmacy Guidelines

(17) Financial Statistical Report BHFSR

(18A) HUB Subcontracting Plan Form

(18B) Instructions to HUB Subcontracting Plan Form

(19) Utilization Review for Chemical Dependency

(20A) Data Submission Specs - NS Contract 2015-17

(20B) Data Submission Specs - CMBS Document Access Role

(20C) Data Submission Specs - Encounter

(20D) Data Submission Specs - From BHO PBM

(20E) Data Submission Specs - From BHO Provider

(20F) Data Submission Specs - From BHO Taxonomy

(20G) Data Submission Specs - Enro-Auxil

(20H) Data Submission Specs - NPPS to BHO

(20I) Data Submission Specs - To NS Dx

(21) Training and Competency Requirements

(22) Service and Lab Codes

(23) Enrollee and Provider Complaints and Appeals

(24A) Provider Network Change Report – Individual Provider

(24B) Provider Network Change Report – Facility Provider

(25) Cannabis Youth Treatment Services

(26) Confidentiality Agreement

(27) Quality Improvement Report

(28) Waste, Abuse and Fraud Prevention Compliance Plan

(29) Quality Monitoring Strategies

(30) Draft Budget

(31) Youth Empowerment Services

(32) Probate Court-Ordered Outpatient MH Treatment

(33) BHO Referral to HCBS-AMH


North Texas Behavioral Health Authority (NTBHA) Contract and Documents

NTBHA Contract

NTBHA Contract 2016-2017
FY16 DSHS Contract General Provisions
FY16 Federal Grant Subrecipient Additional Provisions

Exhibits

Exhibit A: NTBHA Affidavit for Board Member
Exhibit B: NTHBA Affidavit of Executive Director
Exhibit C: Submissions Schedule
Exhibit D: Data Exchange and Continuity of Care
Exhibit E: MOU for Coordinated Services
Exhibit F: SFY16 Draw Request

Categorical Budget

2016-17 Categorical Budget

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Last updated January 11, 2016