Common use of Functional Eligibility Re-determination Clause in Contracts

Functional Eligibility Re-determination. Once enrolled, the MCO is responsible to assure that all members have a current and accurate level of care as determined by the Long-Term Care Functional Screen, in accordance with Section G. of this article. This includes at minimum an annual re-determination of level of care. It may also include a post-enrollment re- determination shortly after enrollment or a re-determination necessitated by a change in the member’s condition.

Functional Eligibility Re-determination. Once enrolled, the MCO is responsible to assure that all members have a current and accurate level of care as determined by the Long-Term Care Functional ScreenLTCFS, in accordance with Section G. F. of this article. This includes at minimum an annual re-determination of level of care. It may also include a post-enrollment re- re-determination shortly after enrollment or a re-determination necessitated by a change in the member’s condition.

Functional Eligibility Re-determination. Once enrolled, the MCO is responsible to assure that all members have a current and accurate level of care as determined by the Long-Term Care Functional Screen, in accordance with Section G. of this article. This includes at minimum an annual re-determination of level of care. It may also include a post-enrollment re- re-determination shortly after enrollment or a re-determination necessitated by a change in the member’s condition.

Functional Eligibility Re-determination. Once enrolled, the MCO is responsible to assure that all members have a current and accurate level of care as determined by the Long-Term Care Functional Screen, in accordance with Section G. F. of this article. This includes at minimum an annual re-determination of level of care. It may also include a post-enrollment re- determination shortly after enrollment or a re-determination necessitated by a change in the member’s condition.