Temporary Management. In addition to the remedies listed in section 5.5, the STATE shall impose temporary management of the MCO if the STATE finds that the MCO has repeatedly failed to meet the substantive requirements of §§ 1903(m) or 1932 of the SSA. If the STATE enforces a remedy for breach under this section, the STATE shall provide the MCO written notice of the remedy to be imposed. When imposing this sanction the STATE shall: 5.6.1 Allow Enrollees the right to terminate enrollment without cause and notify the affected Enrollees of their right to disenroll; 5.6.2 Not delay the imposition of temporary management to provide a hearing; and 5.6.3 Maintain temporary management of the MCO until the STATE determines that the MCO can ensure that the sanctioned behavior will not recur. [42 CFR §438.706(b)]
Appears in 2 contracts
Samples: Contract for Minnesota Senior Health Options and Minnesota Senior Care Plus Services, Contract for Minnesota Senior Health Options and Minnesota Senior Care Plus Services
Temporary Management. In addition to the remedies listed in section 5.5, the STATE shall impose temporary management of the MCO if the STATE finds that the MCO has repeatedly failed to meet the substantive requirements of §§ 1903(m) or 1932 of the SSA. If the STATE enforces a remedy for breach under this section, the STATE shall provide the MCO written notice of the remedy to be imposed. imposed. When imposing this sanction the STATE shall:shall:
5.6.1 Allow Enrollees the right to terminate enrollment without cause and notify the affected Enrollees of their right to disenroll;
5.6.2 Not delay the imposition of temporary management to provide a hearing; and
5.6.3 Maintain temporary management of the MCO until the STATE determines that the MCO can ensure that the sanctioned behavior will not recur. [42 CFR §438.706(b)]
Appears in 1 contract
Samples: Contract for Special Needs Basiccare Program Services
Temporary Management. In addition to the remedies listed in section 5.5, the STATE shall impose temporary management of the MCO if the STATE finds that the MCO has repeatedly failed to meet the substantive requirements of §§ §1903(m) or 1932 of the SSA. If the STATE enforces a remedy for breach under this section, the STATE shall provide the MCO written notice of the remedy to be imposed. imposed. When imposing this sanction the STATE shall:shall:
5.6.1 5.7.1 Allow Enrollees the right to terminate enrollment without cause and notify the affected Enrollees of their right to disenroll;
5.6.2 5.7.2 Not delay the imposition of temporary management to provide a hearing; and
5.6.3 5.7.3 Maintain temporary management of the MCO until the STATE determines that the MCO can ensure that the sanctioned behavior will not recur. [42 CFR §438.706(b)]
Appears in 1 contract
Samples: Contract for Special Needs Basiccare Program Services