Common use of Member Disenrollment Clause in Contracts

Member Disenrollment. In accordance with 42 CFR 438.3(d)(3), the Contractor may neither terminate enrollment nor encourage a member to disenroll because of his or her health care needs or a change in health care status. A member’s health care utilization patterns may not serve as the basis for disenrollment from the Contractor. The Contractor must notify the DFR, in the manner prescribed by the State, within thirty (30) calendar days of the date it becomes aware of the death of one of its members, giving the member's full name, address, Social Security Number, member identification number and date of death. The Contractor will have no authority to pursue recovery against the estate of a deceased Medicaid member.

Member Disenrollment. In accordance with 42 CFR 438.3(d)(3), the Contractor may neither terminate enrollment nor encourage a member to disenroll because of his or her health care needs or a change in health care status. A member’s health care utilization patterns may not serve as the basis for disenrollment from the Contractor. The Contractor must notify the DFR, in the manner prescribed by the State, within thirty (30) calendar days of the date it becomes aware of the death of one of its members, giving the member's full name, address, Social Security Number, member identification number and date of death. The Contractor will have no authority to pursue recovery against the estate of a deceased Medicaid member.. EXHIBIT 1 SCOPE OF WORK