Common use of Supporting At-Risk Enrollees Requiring Transition Clause in Contracts

Supporting At-Risk Enrollees Requiring Transition. Contractor shall have an evaluation and transition plan in place for the Enrollees of the Exchange with existing health coverage including, but not limited to, those members transferring from Major Risk Medical Insurance Program, Pre-Existing Condition Insurance Plan, AIDS Drug Assistance Program, or other individuals under active care for complex conditions and who require therapeutic provider and formulary transitions. It is the intention of the Exchange to work with Contractors and State partners to facilitate early identification of at-risk patients where possible. In a manner that is consistent with California law the evaluation and transition plan will include the following:

Supporting At-Risk Enrollees Requiring Transition. Contractor shall have an evaluation and transition plan in place for the Enrollees of the Exchange with existing health coverage including, but not limited to, those members transferring from Major Risk Medical Insurance Program, Pre-Existing Condition Insurance Plan, AIDS Drug Assistance Program, or other individuals under active care for complex conditions and who require therapeutic provider and formulary transitionstransitions . It is the intention of the Exchange to work with Contractors and State partners to facilitate early identification of at-risk patients where possible. In a manner that is consistent with California law the evaluation and transition plan will include the following: