Common use of Enrollment Procedures Clause in Contracts

Enrollment Procedures. The CHC-MCO must have in effect written Enrollment policies and procedures for newly enrolled Participants. The CHC-MCO must also provide written policies and procedures for coordinating Enrollment information with the Department's IEB. The CHC-MCO must receive advance written approval from the Department regarding these policies and procedures. The CHC-MCO must enroll any Potential Participant who selects or is assigned to the CHC-MCO in accordance with the Enrollment and Disenrollment dating rules that are determined and provided by the Department on the Pennsylvania HealthChoices Extranet and Exhibit J, Participant CHC-MCO Selection and Assignment, regardless of the individual’s race, color, creed, religion, age, sex, national origin, ancestry, marital status, sexual orientation, gender identity, income status, program participation, Grievance status, MA category status, health status, pre-existing condition, physical or mental disability or anticipated need for healthcare. CHC-MCOs must offer assistance to Participants enrolled in their Plan with completing all paperwork necessary for the Participant to maintain MA eligibility. The Department will disenroll a Participant from the CHC-MCO when a change in residence places the Participant outside the CHC zone, as indicated on the individual county file maintained by the Department’s Office of Income Maintenance.

Enrollment Procedures. The CHC-MCO must have in effect written Enrollment policies and procedures for newly enrolled Participants. The CHC-MCO must also provide written policies and procedures for coordinating Enrollment information with the Department's IEB. The CHC-MCO must receive advance written approval from the Department regarding these policies and procedures. The CHC-MCO must enroll any Potential Participant who selects or is assigned to the CHC-MCO in accordance with the Enrollment and Disenrollment dating rules that are determined and provided by the Department on the Pennsylvania HealthChoices Extranet and Exhibit J, Participant CHC-MCO Selection and Assignment, regardless of the individual’s race, color, creed, religion, age, sex, national origin, ancestry, marital status, sexual orientation, gender identity, income status, program participation, Grievance status, MA category status, health status, pre-existing condition, physical or mental disability or anticipated need for healthcare. CHC-MCOs must offer assistance to Participants enrolled in their Plan with completing all paperwork necessary for the Participant to maintain MA eligibility. The Department will disenroll a Participant from the CHC-MCO when a change in residence places the Participant outside the CHC zone, as indicated on the individual county file maintained by the Department’s Office of Income Maintenance.