Common use of Passive Enrollment Process Clause in Contracts

Passive Enrollment Process. When determined in the best interest of a Dual Eligible Member to maintain continuity of integrated care through aligned enrollment between their companion Medicaid MCO and selected MAO, each as offered by the same parent/affiliated organization, it is AHCCCS’ sole option to request the opportunity of and consult with CMS for implementing the applicable passive enrollment requirements of 42 CFR 422.60(g) to address the circumstances described at 42 CFR 422.60(g)(1)(iii). MAO shall implement passive enrollment requirements and procedures only as directed or instructed by CMS or AHCCCS, in accordance with but not limited to, such terms, conditions, or requirements as provided by 42 CFR 422.60(g)(3), 422.60(g)(4)(ii), 422.60(g)(5), and applicable regulatory guidance. MAO shall provide CMS or AHCCCS with any data or information within the timeframes or specifications requested, as determined necessary, to facilitate passive enrollment activities.

Passive Enrollment Process. When determined in the best interest of a Full Benefit Dual Eligible Member Members to maintain continuity of integrated care through aligned enrollment between their companion Medicaid MCO and selected MAO, each as offered by the same parent/affiliated organization, it is AHCCCS’ sole option to request the opportunity of and consult with CMS for implementing the applicable passive enrollment requirements of 42 CFR 422.60(g) to address the circumstances described at 42 CFR 422.60(g)(1)(iii). MAO shall implement passive enrollment requirements and procedures only as directed or instructed by CMS or AHCCCS, in accordance with with, but not limited to, such terms, conditions, or requirements as provided by 42 CFR 422.60(g)(3), 422.60(g)(4)(ii), 422.60(g)(5), and applicable regulatory guidance. MAO shall provide CMS or AHCCCS with any data or information within the timeframes or specifications requested, as determined necessary, to facilitate passive enrollment activities.