Member Initiated Disenrollment and Change of CCN Sample Clauses

Member Initiated Disenrollment and Change of CCN. A member shall remain in the CCN unless the member submits a written, electronic or oral request to disenroll, transfer to another CCN for cause or the member becomes ineligible for Medicaid and/or CCN enrollment. The member may disenroll from the CCN by: • Requesting disenrollment, without cause, at any time during the ninety (90) days following the date of the member’s initial enrollment or re- enrollment with the CCN; • Requesting disenrollment, with cause, after the first 90 days through a written, electronic or oral request to disenroll. or transfer to another CCN; or • Becoming ineligible for Medicaid/CHIP and/or CCN enrollment. Oral requests to disenroll shall be confirmed by the Enrollment Broker by return call with written documentation, or in writing to the requestor. If a member’s request to disenroll is not acted on within sixty (60) days, the request for disenrollment shall be considered approved. A member who is a voluntary enrollee (See §6.1 of this Provider Agreement) may request disenrollment from a CCN without cause at any time.
Sample 1
AutoNDA by SimpleDocs
Member Initiated Disenrollment and Change of CCN. A member shall remain in the CCN unless the member submits a written, electronic or oral request to disenroll, transfer to another CCN for cause or the member becomes ineligible for Medicaid and/or CCN enrollment. The member may disenroll from the CCN by: • Requesting disenrollment, without cause, at any time during the ninety (90) days following the date of the member’s initial enrollment or re- enrollment with the CCN; • Requesting disenrollment, with cause, after the first 90 days through a written, electronic or oral request to disenroll. or transfer to another CCN; or • Becoming ineligible for Medicaid/CHIP and/or CCN enrollment. Oral requests to disenroll shall be confirmed by the Enrollment Broker by return call with written documentation, or in writing to the requestor. If a member’s request to disenroll is not acted on within sixty (60) days, the request for disenrollment shall be considered approved. A member who is a voluntary enrollee may request disenrollment from a CCN without cause at any time. A member who is a mandatory enrollee may request disenrollment from the CCN as follows: • For cause, at any time: The following are considered cause for disenrollment by the member: o The member moves out of the CCN’s service area; o The CCN does not, because of moral or religious objections, cover the service the member seeks; o The member needs related services (for example, a cesarean section and a tubal ligation) to be performed at the same time; not all related services are available within the CCN’s network of providers; and the member’s PCP or another provider determines that receiving the services separately would subject the enrollee to unnecessary risk; and o Other reasons, including but not limited to, poor quality of care, lack of access to services specified under the Provider Agreement, or lack of access to providers experienced in dealing with the member’s health care needs. • Without cause, at the following times: o During the ninety (90) days following the date of the member's initial enrollment with the CCN or the date the Enrollment Broker sends the member notice of the enrollment, whichever is later; o At least once a year during the annual open enrollment period thereafter; o Upon automatic reenrollment under 42 CFR §438.56(g), if a temporary loss of Medicaid eligibility has caused the member to miss the annual disenrollment opportunity; or o If DHH imposes the intermediate sanction provisions specified in 42 CFR §438.702(a)(3). •...
Sample 1

Related to Member Initiated Disenrollment and Change of CCN

  • Sole Source as Grounds for Rejection of a Change Order If a Change Order is submitted to Contractor for the purposes of adding a Bulletin to this Contract and said Bulletin designates a Sole Source from which Contractor is required to procure goods or services necessary to perform the Work, which Sole Source has not been designated previously, Contractor shall be entitled to reject the proposed Change Order if the designated Sole Source refuses to provide to Contractor the warranties, bonds, terms or schedule required under the Contract Documents, including any warranty or terms or schedule required by Bulletins referenced in the proposed Change Order. In such event, Contractor shall give written notice to the Owner rejecting the proposed Change Order and, if possible, shall accompany said written notice with a proposal from Contractor for changes or modifications to the Bulletin so as to eliminate the Sole Source designation but to achieve goods or services equal in quality or function. The Owner may then require the Design Professional to revise the subject Bulletin so as to eliminate the designation of the Sole Source by incorporation of Contractor's proposal or otherwise. Upon revision of the Bulletin by the Design Professional and approval thereof by the Owner, the Owner shall again submit to the Contractor a proposed Change Order for the purpose of adding the revised Bulletin to this Contract. If the Owner decides to retain the Sole Source in the Change Order and Contractor cannot acquire the full contractually required warranties from the Sole Source, Contractor shall be held only to the warranty terms and schedule obtainable from the Sole Source.

  • For Lump Sum Change Order The payment and extension of time (if any) provided by this Change Order constitutes compensation in full to the Contractor and its Subcontractors and Suppliers for all costs and markups directly and indirectly attributable to the Change Order herein, for all delays related thereto and for performance of changes within the time stated.

  • SALARY DETERMINATION FOR EMPLOYEES IN ADULT EDUCATION PCA Article B.3 does not apply in School District No. 34 (Abbotsford).

  • Grantee’s Notification of Change of Contact Person or Key Personnel The Grantee shall notify in writing their contract manager assigned within ten days of any change to the Grantee's Contact Person or Key Personnel.

  • Termination for Change of Control This Agreement may be terminated immediately by SAP upon written notice to Provider if Provider comes under direct or indirect control of any entity competing with SAP. If before such change Provider has informed SAP of such potential change of control without undue delay, the Parties agree to discuss solutions on how to mitigate such termination impact on Customer, such as stepping into the Customer contract by SAP or by any other Affiliate of Provider or any other form of transition to a third party provider.

  • Dependent Care Salary Reduction Plan The Employer agrees to maintain the current dependent care salary reduction plan that allows eligible employees, covered by this Agreement, the option to participate in a dependent care reimbursement program for work-related dependent care expenses on a pretax basis as permitted by federal tax law or regulation.

  • Termination for Changes in Budget or Law The JBE’s payment obligations under this Agreement are subject to annual appropriation and the availability of funds. Expected or actual funding may be withdrawn, reduced, or limited prior to the expiration or other termination of this Agreement. Funding beyond the current appropriation year is conditioned upon appropriation of sufficient funds to support the activities described in this Agreement. The JBE may terminate this Agreement or limit Contractor’s Services (and reduce proportionately Contractor’s fees) upon Notice to Contractor without prejudice to any right or remedy of the JBE if: (i) expected or actual funding to compensate Contractor is withdrawn, reduced or limited; or (ii) the JBE determines that Contractor’s performance under this Agreement has become infeasible due to changes in applicable laws.

  • Proposing Integration Activities in the Planning Submission No integration activity described in section 6.3 may be proposed in a CAPS unless the LHIN has consented, in writing, to its inclusion pursuant to the process set out in section 6.3(b).

  • CERTAIN TERMINATIONS PROHIBITED; CERTAIN CANCELLATIONS NON-APPEALABLE The following circumstances will not be considered a valid basis for termination of this agreement, and will be considered non- appealable or irrelevant to an appeal of a cancellation fee assessment:

  • Notification of Compromise or Potential Compromise The compromise or potential compromise of Confidential Information must be reported to the DSHS Contact designated on the contract within one (1) business day of discovery. Contractor must also take actions to mitigate the risk of loss and comply with any notification or other requirements imposed by law or DSHS.

Time is Money Join Law Insider Premium to draft better contracts faster.