Common use of Required Involuntary Disenrollments Clause in Contracts

Required Involuntary Disenrollments. Texas and CMS shall terminate an Enrollee’s Enrollment in the STAR+PLUS MMP upon the occurrence of any of the conditions enumerated in Section 40.2 of the most current Medicare-Medicaid Plan Enrollment and Disenrollment Guidance or upon the occurrence of any of the conditions described in this section. Except for the CMT’s role in reviewing documentation related to an Enrollee’s residence outside the Service Area or alleged material misrepresentation of information regarding third-party reimbursement coverage, as described in this section, the CMT shall not be responsible for processing Disenrollments under this section. Further, nothing in this section alters the obligations of the parties for administering Disenrollment transactions described elsewhere in this Contract.

Required Involuntary Disenrollments. Texas and CMS shall terminate an Enrollee’s Enrollment in the STAR+PLUS MMP upon the occurrence of any of the conditions enumerated in Section 40.2 of the most current Medicare-Medicaid Plan Enrollment and Disenrollment Guidance or upon the occurrence of any of the conditions described in this sectionSection. Except for the CMT’s role in reviewing documentation related to an Enrollee’s residence outside the Service Area or alleged material misrepresentation of information regarding third-party reimbursement coverage, as described in this sectionSection, the CMT shall not be responsible for processing Disenrollments disenrollments under this sectionSection. Further, nothing in this section Section alters the obligations of the parties Parties for administering Disenrollment disenrollment transactions described elsewhere in this Contract.. 288

Required Involuntary Disenrollments. Texas and CMS shall terminate an Enrollee’s Enrollment in the STAR+PLUS MMP upon the occurrence of any of the conditions enumerated in Section 40.2 of the most current Medicare-Medicaid Plan Enrollment and Disenrollment Guidance or upon the occurrence of any of the conditions described in this sectionSection. Except for the CMT’s role in reviewing documentation related to an Enrollee’s residence outside the Service Area or alleged material misrepresentation of information regarding third-party reimbursement coverage, as described in this sectionSection, the CMT shall not be responsible for processing Disenrollments disenrollments under this sectionSection. Further, nothing in this section Section alters the obligations of the parties Parties for administering Disenrollment disenrollment transactions described elsewhere in this Contract.