Common use of Change in Living Arrangement Prior to Clause in Contracts

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.

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.‌

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.

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.

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.‌