Enrollee Choice. (A) The Department shall determine eligibility for Enrollment and will offer Potential Enrollees a choice among all health plans available in the Service Area. (B) The Department will inform Potential Enrollees of Medicaid benefits. (C) The Medicaid Eligible Individual’s intent to enroll is established when the applicant selects the Contractor, either verbally or by signing a choice of health care delivery form or equivalent. If the Enrollee does not choose a Health Plan, the Department may automatically assign the Enrollee to a health plan based on a methodology approved by CMS. This initiates the action to send an advance notification to the Contractor. (D) Medicaid enrollees made eligible for a retroactive period prior to the current month are not eligible for Contractor enrollment during the retroactive period.
Appears in 3 contracts
Samples: Contract, Health Services Agreement, Contract
Enrollee Choice. (A) The Department or the Department’s designee shall determine eligibility for Enrollment and will offer Potential Enrollees a choice among all health plans Health Plans available in the Service Area.
(B) The Department will inform Potential Enrollees of Medicaid benefits.
(C) The Medicaid Eligible Individual’s intent to enroll is established when the applicant selects the Contractor, either verbally or by signing a choice of health care delivery form or equivalent. If the Enrollee does not choose a Health Plan, the Department may shall automatically assign the Enrollee to a health plan Health Plan based on a methodology approved by CMS. This initiates the action to send an advance notification to the Contractor.
(D) Medicaid enrollees Enrollees made eligible for a retroactive period prior to the current month are not eligible for Contractor enrollment during the retroactive period.
Appears in 2 contracts
Samples: Accountable Care Organization (Aco) Contract, Accountable Care Organization (Aco) Contract