Common use of Re-enrollment Clause in Contracts

Re-enrollment. An MSHO or MSC+ Enrollee who is identified within ninety (90) days of losing Medical Assistance eligibility for not more than three months, or for any break of time within a three month period and establishes continuous Medical Assistance eligibility with no break in eligibility may be re-enrolled for the month following disenrollment and subsequent months in the same MCO without completing a new enrollment form. Upon re-enrollment, the STATE may update the Enrollee’s Rate Cell Category using information from the MCO, Care System, or MMIS/MAXIS. The status of the one hundred and eighty (180) day SNF/NF benefit at disenrollment will resume upon re- enrollment. The STATE shall pay the Medical Assistance portion of the Capitation Payment for the month of coverage in which the Enrollee was reinstated. For MSC+, if an Enrollee is disenrolled for any reason and subsequently becomes eligible to enroll, the STATE shall reenroll the Enrollee in the same MCO, unless the Enrollee requests a change in MCOs in accordance with section 3.2.1 In no circumstance shall the MCO randomly assign an Enrollee to a Primary Care Provider upon reenrollment.

Re-enrollment. ‌ 3.5.8.1 An MSHO or MSC+ Enrollee who is identified within ninety (90) days of losing Medical Assistance eligibility for not more than three months, or for any break of time within a three month period and establishes continuous Medical Assistance eligibility with no break in eligibility may be re-enrolled for the month following disenrollment and subsequent months in the same MCO without completing a new enrollment form. Upon re-enrollment, the STATE may update the Enrollee’s Rate Cell Category using information from the MCO, Care System, or MMIS/MAXIS. The status of the one hundred and eighty (180) day SNF/NF benefit at disenrollment will resume upon re- re-enrollment. The STATE shall pay the Medical Assistance portion of the Capitation Payment for the month of coverage in which the Enrollee was reinstated. . 3.5.8.2 For MSC+, if an Enrollee is disenrolled for any reason and subsequently becomes eligible to enroll, the STATE shall reenroll the Enrollee in the same MCO, unless the Enrollee requests a change in MCOs in accordance with section 3.2.1 3.5.1‌ 3.5.8.3 In no circumstance shall the MCO randomly assign an Enrollee to a Primary Care Provider upon reenrollment.reenrollment.‌

Re-enrollment. ‌ 3.5.8.1 An MSHO or MSC+ Enrollee who is identified within ninety (90) days of losing Medical Assistance eligibility for not more than three months, or for any break of time within a three month period and establishes continuous Medical Assistance eligibility with no break in eligibility may be re-enrolled for the month following disenrollment and subsequent months in the same MCO without completing a new enrollment form. Upon re-enrollment, the STATE may update the Enrollee’s Rate Cell Category using information from the MCO, Care System, or MMIS/MAXIS. The status of the one hundred and eighty (180) day SNF/NF benefit at disenrollment will resume upon re- re-enrollment. The STATE shall pay the Medical Assistance portion of the Capitation Payment for the month of coverage in which the Enrollee was reinstated. . 3.5.8.2 For MSC+, if an Enrollee is disenrolled for any reason and subsequently becomes eligible to enroll, the STATE shall reenroll the Enrollee in the same MCO, unless the Enrollee requests a change in MCOs in accordance with section 3.2.1 3.5.1 3.5.8.3 In no circumstance shall the MCO randomly assign an Enrollee to a Primary Care Provider upon reenrollment.

Re-enrollment. (A) An MSHO or MSC+ Enrollee who is identified within ninety (90) days of losing Medical Assistance eligibility for not more than three months, or for any break of time within a three month period and establishes continuous Medical Assistance eligibility with no break in eligibility may be re-enrolled for the month following disenrollment and subsequent months in the same MCO without completing a new enrollment form. Upon re-enrollment, the STATE may update the Enrollee’s Rate Cell Category using information from the MCO, Care System, or MMIS/MAXIS. The status of the one hundred and eighty (180) day SNF/NF benefit at disenrollment will resume upon re- enrollment. The STATE shall pay the Medical Assistance portion of the Capitation Payment for the month of coverage in which the Enrollee was reinstated. . (B) For MSC+, if an Enrollee is disenrolled for any reason and subsequently becomes eligible to enroll, the STATE shall reenroll the Enrollee in the same MCO, unless the Enrollee requests a change in MCOs in accordance with section 3.2.1 3.2.1 (C) In no circumstance shall the MCO randomly assign an Enrollee to a Primary Care Provider upon reenrollment.

Re-enrollment. ‌ An MSHO or MSC+ Enrollee who is identified within ninety (90) days of losing Medical Assistance eligibility for not more than three months, or for any break of time within a three month period and establishes continuous Medical Assistance eligibility with no break in eligibility may be re-enrolled for the month following disenrollment and subsequent months in the same MCO without completing a new enrollment form. Upon re-enrollment, the STATE may update the Enrollee’s Rate Cell Category using information from the MCO, Care System, or MMIS/MAXIS. The status of the one hundred and eighty (180) day SNF/NF benefit at disenrollment will resume upon re- enrollment. The STATE shall pay the Medical Assistance portion of the Capitation Payment for the month of coverage in which the Enrollee was reinstated. For MSC+, if an Enrollee is disenrolled for any reason and subsequently becomes eligible to enroll, the STATE shall reenroll the Enrollee in the same MCO, unless the Enrollee requests a change in MCOs in accordance with section 3.2.1 In no circumstance shall the MCO randomly assign an Enrollee to a Primary Care Provider upon reenrollment.

Re-enrollment. (A) An MSHO or MSC+ Enrollee who is identified within ninety (90) days of losing loses Medical Assistance eligibility for not more than three months, or for any break of time within a three month period and establishes continuous Medical Assistance eligibility with no break in eligibility period, may be re-re- enrolled for the month following disenrollment and subsequent months in the same MCO without completing a new enrollment form. Upon re-enrollment, the STATE may update the Enrollee’s Rate Cell Category using information from the MCO, Care System, or MMIS/MAXIS. The status of the one hundred and eighty (180) day SNF/NF benefit at disenrollment will resume upon re- re-enrollment. The STATE shall pay the Medical Assistance portion of the Capitation Payment for the month of coverage in which the Enrollee was reinstated. . (B) For MSC+, if an Enrollee is disenrolled for any reason and subsequently becomes eligible to enroll, the STATE shall reenroll the Enrollee in the same MCO, unless the Enrollee requests a change in MCOs in accordance with section 3.2.1 3.3.1. (C) In no circumstance shall the MCO randomly assign an Enrollee to a Primary Care Provider upon reenrollment.