Common use of Services During Periods of Temporary Absence Clause in Contracts

Services During Periods of Temporary Absence. Services are provided during a member’s temporary absence from the MCO service area in accordance with Medicaid rules as specified in Wis. Admin. Code §§ DHS 103.03(3) and 104.01(6). If a member asks the MCO to provide services during a temporary absence from its service area, the MCO shall conduct two tests to determine whether to provide the services: Income Maintenance Residency Test Request that Income Maintenance complete a residency test to determine whether the member is still considered a resident of a county within the MCO’s service area. If no, the member is no longer a resident and he/she loses eligibility and must be disenrolled. If yes, the member remains a resident and the MCO must go on to the second test.

Services During Periods of Temporary Absence. Services are provided during a member’s temporary absence from the MCO service area in accordance with Medicaid rules as specified in Wis. Admin. Code §§ DHS 103.03(3) and 104.01(6). If a member asks the MCO to provide services during a temporary absence from its service area, the MCO shall conduct two tests to determine whether to provide the services: Income Maintenance Residency Test Request that Income Maintenance complete a residency test to determine whether the member is still considered a resident of a county within the MCO’s service area. If no, the member is no longer a resident and he/she the member loses eligibility and must be disenrolled. If yes, the member remains a resident and the MCO must go on to the second test.