MCO Selection and Assignment. 29 A.2.4.5 Effective Date of Enrollment 31 A.2.4.6 Eligibility and Enrollment Data 32 A.2.4.7 Enrollment Period 32 A.2.4.8 Transfers from Other MCOs 34 A.2.4.9 Enrollment of Newborns 34 A.2.4.10 Information Requirements Upon Enrollment 35
MCO Selection and Assignment. 3.2.2.1 In the event the State contracts with an MCO that was not contracting with the State to provide Medicaid managed care services prior to the effective date of this Contract (a new MCO), the State will implement an automatic assignment mechanism to assign clients to all contracting MCOs such that all contracting MCOs achieve initial minimum membership levels as determined by the State.
3.2.2.2 The State shall Enroll clients required to enroll in DSHP and DSHP Plus in an MCO. Enrollment in an MCO may be the result of a client’s selection of a particular MCO or assignment by the State in accordance with this Section 3.2.2 of the Contract.
3.2.2.3 Clients who are Enrolled in an Incumbent MCO
3.2.2.3.1 The State will conduct an open enrollment in October of each year for DSHP and DSHP Plus clients who are already Enrolled in an MCO to select a contracted MCO with enrollment effective the Start Date of Operations.
MCO Selection and Assignment. 29 2.4.5 Effective Date of Enrollment 32 2.4.6 Eligibility and Enrollment Data 34 2.4.7 Enrollment Period 34 2.4.8 Transfers from Other MCOs 36 2.4.9 Enrollment of Newborns 36 2.4.10 Information Requirements Upon Enrollment 37 2.5 DISENROLLMENT FROM AN MCO 38 2.5.1 General 38 2.5.2 Acceptable Reasons for Disenrollment from an MCO 38 2.5.3 Unacceptable Reasons for Disenrollment from an MCO 38 2.5.4 Informing TENNCARE of Potential Ineligibility 39 2.5.5 Effective Date of Disenrollment from an MCO 39 2.6 BENEFITS/SERVICE REQUIREMENTS AND LIMITS 39 2.6.1 CONTRACTOR Covered Benefits 39 2.6.2 TennCare Benefits Provided by TENNCARE 52
MCO Selection and Assignment. 34 A.2.4.5 Effective Date of Enrollment 36 A.2.4.6 Eligibility and Enrollment Data 37 A.2.4.7 Enrollment Period 37 A.2.4.8 Transfers from Other MCOs 39 A.2.4.9 Enrollment of Newborns 39 A.2.4.10 Information Requirements Upon Enrollment 40 A.2.5 DISENROLLMENT FROM AN MCO 41 A.2.5.1 General 41 A.2.5.2 Acceptable Reasons for Disenrollment from an MCO 41 A.2.5.3 Unacceptable Reasons for Disenrollment from an MCO 41 A.2.5.4 Informing TENNCARE of Potential Ineligibility 42 A.2.5.5 Effective Date of Disenrollment from an MCO 42 A.2.6 BENEFITS/SERVICE REQUIREMENTS AND LIMITS 42 A.2.6.1 CONTRACTOR Covered Benefits 42 A.2.6.2 TennCare Benefits Provided by TENNCARE 5
MCO Selection and Assignment. Enrollment with an MCO may be the result of an Enrolled Member’s selection of a particular Contractor or assignment by the Agency.
MCO Selection and Assignment
