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Effective January 1, 2026: EVV Impacts due to Discontinued Dual Demonstration Pilot Program

Date: 11/21/25

Beginning January 1, 2026, the Texas Health and Human Service Commission (HHSC) will discontinue the Dual Demonstration Program with the STAR+PLUS Medicare-Medicaid Plans (MMPs) listed demonstration counties:

  • Bexar County: Molina Healthcare of Texas.
  • Dallas County: Molina Healthcare of Texas and Superior HealthPlan.
  • El Paso County: Molina Healthcare of Texas.
  • Harris County: Molina Healthcare of Texas and United Healthcare.
  • Hidalgo County: Molina Healthcare of Texas and Superior HealthPlan.

HHSC will end the MMP plan codes in these demonstration counties. MMP members will choose a STAR+PLUS Managed Care Organization (MCO) in their service area to continue their services. To view the ending MMP plan codes and the STAR+PLUS MCO plan codes in the demonstration service areas, please reference HHSC’s EVV Impacts Due to Dual Demonstration Pilot Program Discontinued Jan. 1 notice.

(Example: The MMP plan code for Superior HealthPlan in Dallas is 9K. The STAR+PLUS MCO plan code for Superior in Dallas is 9H. Due to the discontinuation of the Dual Demonstration Program, the plan code for MMP members who choose to stay with Superior as their STAR+PLUS MCO is 9H).

The link below lists STAR+PLUS MCOs and MCO plan codes that the MMP members can select to transition to:

Payment of Services as of January 1, 2026

Beginning January 1, 2026, program providers, financial management services agencies (FMSAs), and Proprietary System Operators (PSOs) will have a new MCO payer plan code for their MMP members and must bill the new payer with dates of service on or after January 1, 2026.

Program providers, FMSAs, and PSOs using a third-party vendor for billing need to notify the third-party vendor about the changes.

Program Provider, FMSA, and PSO Responsibilities

Program providers, FMSAs, and PSOs should continue to use the current authorization in the Electronic Visit Verification (EVV) system for their members through December 31, 2025.

For dates of service beginning January 1, 2026, and after, program providers, FMSAs, and PSOs should:

  • Identify the STAR+PLUS MCO and plan code that their MMP member transitioned to.
  • Create a new authorization for the former MMP member, using the new STAR+PLUS MCO’s plan code and applicable information from the authorization that ends on December 31, 2025.
  • Manually enter the former MMP member’s new STAR+PLUS authorization into their EVV system.

Program providers, FMSAs, and PSOs can check their members’ eligibility and MCO assignment using one of the following methods:

  • The C21/SAVERR-based TMC EV and 270/271 eligibility inquiry is limited to access only current month eligibility information.
  • The EaaS/TIERS-based 270/271 or Medicaid Client Portal supports eligibility inquiry for future dates up to the end of the following month. Providers can use this to check eligibility.

Program providers, FMSAs, and PSOs must continue to submit claims with EVV Required services directly to Texas Medicaid & Healthcare Partnership (TMHP) for EVV claims matching.

Additional Resources: