Change in Living Arrangement Prior to. Capitation Cut-off. If the MCO discovers and promptly notifies the STATE that an Enrollee was Institutionalized prior to the first effective date of MSC+ or MSHO enrollment, and was assigned an RCC of “A” or “B” for MSHO or the Nursing Facility benefit for MSC+, based on the information in MMIS at the time of enrollment, the STATE will retroactively close the “P” span so that the plan will not have liability for Medicaid Nursing Facility days for this Enrollee, unless the conditions for a new Nursing Facility benefit period are met.
Appears in 6 contracts
Samples: Contract for Minnesota Senior Health Options and Minnesota Senior Care Plus Services, Contract for Minnesota Senior Health Options and Minnesota Senior Care Plus Services, Contract for Minnesota Senior Health Options and Minnesota Senior Care Plus Services
Change in Living Arrangement Prior to. Capitation Cut-off. off. If the MCO discovers and promptly notifies the STATE that an Enrollee was Institutionalized prior to the first effective date of MSC+ or MSHO enrollment, and was assigned an RCC of “A” or “B” for MSHO or the Nursing Facility benefit for MSC+, based on the information in MMIS at the time of enrollment, the STATE will retroactively close the “P” span so that the plan will not have liability for Medicaid Nursing Facility days for this Enrollee, unless the conditions for a new Nursing Facility benefit period are met.
Appears in 2 contracts
Samples: Contract for Minnesota Senior Health Options and Minnesota Senior Care Plus Services, Contract for Minnesota Senior Health Options and Minnesota Senior Care Plus Services
Change in Living Arrangement Prior to. Capitation Cut-off. If the MCO discovers and promptly notifies the STATE that an Enrollee was Institutionalized prior to the first effective date of MSC+ or MSHO enrollment, and was assigned an RCC of “A” or “B” for MSHO or the Nursing Facility benefit for MSC+, based on the information in MMIS at the time of enrollment, the STATE will retroactively close the “P” span so that the plan will not have liability for Medicaid Nursing Facility days for this Enrollee, unless the conditions for a new Nursing Facility benefit period are met.met.
Appears in 2 contracts
Samples: Contract for Minnesota Senior Health Options and Minnesota Senior Care Plus Services, Contract for Minnesota Senior Health Options and Minnesota Senior Care Plus Services
Change in Living Arrangement Prior to. Capitation Cut-off. off. If the MCO discovers and promptly notifies the STATE that an Enrollee was Institutionalized prior to the first effective date of MSC+ or MSHO enrollment, and was assigned an RCC of “A” or “B” for MSHO or the Nursing Facility benefit for MSC+, based on the information in MMIS at the time of enrollment, the STATE will retroactively close the “P” span so that the plan will not have liability for Medicaid Nursing Facility days for this Enrollee, unless the conditions for a new Nursing Facility benefit period are met.met.
Appears in 1 contract
Samples: Contract for Minnesota Senior Health Options and Minnesota Senior Care Plus Services
Change in Living Arrangement Prior to. Capitation Cut-off. off. If the MCO discovers and promptly notifies the STATE that an Enrollee was Institutionalized prior to the first effective date of MSC+ or MSHO enrollment, and was assigned an RCC of “A” or “B” for MSHO or the Nursing Facility benefit for MSC+, based on the information in MMIS at the time of enrollment, the STATE will retroactively close the “P” span so that the plan will not have liability for Medicaid Nursing Facility days for this Enrollee, unless the conditions for a new Nursing Facility benefit period Benefit Period are met.
Appears in 1 contract
Samples: Contract for Minnesota Senior Health Options and Minnesota Senior Care Plus Services
