Common use of Voluntary and Involuntary Disenrollment Clause in Contracts

Voluntary and Involuntary Disenrollment. All MCO enrollees will remain continuously enrolled throughout the term of this Contract, except in situations where clients lose their Medicaid eligibility, are admitted to a skilled nursing facility (SNF) or nursing facility, voluntarily disenroll, or are re-categorized into a Medicaid coverage category not included in the managed care delivery system. BMS will notify the MCO of all disenrollment, by means of a monthly enrollment roster report which explicitly identifies terminations from enrollment and the cause of the disenrollment (e.g. loss of Medicaid eligibility, change in eligibility status to a coverage code not included in the managed care initiative, voluntary switching to another MCO, or other causes). BMS has federal authority to implement an enrollment lock in policy in which enrollees are locked-in to a single MCO for a twelve (12) month period though may request to change their MCO enrollment in accordance with 42 CFR §438.56. Should BMS implement this policy during the Contract year, the MCO will be required to supply all necessary information requested by the enrollment broker regarding BMS’ enrollee lock-in program.

Voluntary and Involuntary Disenrollment. All MCO enrollees will remain continuously enrolled throughout the term of this Contract, except in situations where clients lose their Medicaid eligibility, are admitted to a skilled nursing facility (SNF) or nursing facility, voluntarily disenroll, or are re-categorized into a Medicaid coverage category not included in the managed care delivery system. BMS The Department will notify the MCO of all disenrollment, by means of a monthly enrollment roster report which explicitly identifies terminations from enrollment and the cause of the disenrollment (e.g. loss of Medicaid eligibility, change in eligibility status to a coverage code not included in the managed care initiative, voluntary switching to another MCO, or other causes). BMS The Department has federal authority to implement an enrollment lock in policy in which enrollees are locked-in to a single MCO for a twelve (12) month period though may request to change their MCO enrollment in accordance with 42 CFR §438.56. Should BMS the Department implement this policy during the Contract year, the MCO will be required to supply all necessary information requested by the enrollment broker regarding BMS’ the Department’s enrollee lock-in program.