STAR Kids

Community First Health Plans provides healthcare for children and youth who receive disability-related Medicaid in the Bexar service delivery area. The program is the first Medicaid managed care program specifically for people who are 20 and younger, have a disability, and use Medicaid.

Become a Provider

STAR Kids Program

Children who receive Medicare will keep using Medicare for basic health services and prescriptions ordered by their doctor. Families will receive assistance with coordinating care. Community First Health Plans will provide service coordination, which will help identify needs and connect members to services and qualified providers. Community First’s service coordinators will assess each member’s specific needs to help the family and health plan create a unique individual service plan. Service coordinators will provide a standard screening and assessment, STAR Kids Screening and Assessment (SK-SAI), to determine each child’s needs as they relate to health and independent living.

Program Benefits and Services

STAR Kids is designed to meet the unique needs of children and youth with disabilities. The program will include access to benefits such as:

  • Prescription drugs
  • Hospital care
  • Primary and specialty care
  • Preventive care
  • Personal care services
  • Private duty nursing
  • Durable medical equipment and supplies
  • MDCP services

Patient Requirements

The STAR Kids Program covers children and youth ages 20 and younger who receive Supplemental Security Income-related Medicaid, live in a community-based intermediate care facility for individuals with an intellectual disability or related condition (ICF/IID) or nursing facility, or are enrolled in a home and community based services waiver program including:
  • Medically Dependent Children Program (MDCP)
  • Home and Community-based services (HCS)
  • Community Living Assistance and Support Services (CLASS)
  • Deaf Blind with Multiple Disabilities (DBMD)
  • Texas Home Living (TxHmL)
  • Youth Empowerment Services (YES)

Texas Health Steps

The Texas Medicaid Early Periodic Screening, Diagnosis, and Treatment (EPSDT) program is a federally mandated health care program of prevention, diagnosis, and treatment for Medicaid recipients who are ages of birth through 20 years of age. In Texas, the EPSDT program is known as Texas Health Steps. Texas Health Steps is administered by the Department of State Health Services (DSHS).

Through outreach,Texas Health Steps staff, or contractors encourage STAR Members to use Texas Health Steps preventive medical checkup services when they first become eligible for Medicaid/Texas Health Steps and when they are periodically due for their yearly medical checkup in their birthday month.

On request by the client, the Medical Transportation Program (MTP) assists the client with scheduling transportation. Refer to the MTP section on page 23 of this Provider Manual for more detailed information.

Texas Health Steps medical providers must perform medical checkups on any client who is currently enrolled in Medicaid and who are ages of birth through 20 years of age. Providers also are encouraged to notify the client when he or she is due for the next medical checkup according to the Texas Health Steps Periodicity Schedule.

Note: Newly enrolled STAR Members must receive a Texas Health Steps medical checkup within 60 days from enrollment.

Provider Training Schedule

To register for training sessions, please call (210) 358-6030 or email nmcfhp@cfhp.com.

Free online provider education is available, and many include Continuing Education credits. Check out the online options offered by Texas Health and Human Services Commission (HHSC).

For additional information on the STAR Kids Program, visit Health & Human Services

Access our library of benefits and resources available to our members from our Knowledge Base.

Handbooks, manuals, and CFHP newsletters are available in print, free of charge, and mailed within 5 days, by calling 1-800-434-2347 or by making a request through your secure Provider Login.

Nurse Advise Hotline

Nurse Advice Line (210) 227-2347 or toll free at 1-800-434-2347

CFHP does not require a referral for a Member to see a specialist. Some specialist’s offices may require or prefer to have a “Referral.” Members should ask their PCP to confirm with the specialist if a referral is needed from the PCP for you to be seen.

If the specialist is not-network, CFHP will work to complete a  Letter of Agreement (LOA)/ Single Case Agreement with the non-network specialist. These LOA/Single Case Agreements can be for one or several visits and lengths of time depending on the medical necessity as determined by CFHP.

Any downtime for routine scheduled maintenance for Provider-facing systems are posted to CFHP’s website and shared with CFHP staff. Id a toll-free number is provided that is also shared.

For outages and/or unplanned downtime, information will be posted to CFHP’s website and appropriate toll-free numbers will be posted and shared with CFHP staff.

If you are a provider and need to reach CFHP after hours or on weekends, please call (210) 227-2347.