Common use of Voluntary Disenrollment Clause in Contracts

Voluntary Disenrollment. The STAR+PLUS MMP shall have a mechanism for receiving timely information about all disenrollments from the STAR+PLUS MMP, including the effective date of disenrollment, from CMS and HHSC or its Administrative Services Contractor. All disenrollment-related transactions will be performed by HHSC or the Administrative Services Contractor consistent with the Enrollment effective date requirements set forth in the Medicare-Medicaid Enrollment and Disenrollment Guidance. Subject to 42 C.F.R. §§ 423.100 and 423.153(f), Enrollees can elect to disenroll from the STAR+PLUS MMP or the Demonstration at any time and enroll in another STAR+PLUS MMP, a STAR+PLUS MCO, a Medicare Advantage plan, PACE; or may elect to receive services through Medicare fee-for-service (FFS) and a prescription drug plan and to receive Medicaid services in accordance with the Texas State Plan and any waiver programs (if eligible). CMS will alert HHSC and the STAR+PLUS MMP of individuals identified as at risk or potentially at risk for abuse or overuse of specified prescription drugs that may not be disenrolled. Disenrollments received by HHSC or its Administrative Services Contractor, or by CMS or its contractor, either orally or in writing, by the last calendar day of the month will be effective on the first calendar day of the following month. 2.3.5.1.1. The STAR+PLUS MMP may not request disenrollment on behalf of an Enrollee, except as outlined in Section 40.3 of the Medicare-Medicaid Plan Enrollment and Disenrollment Guidance. 2.3.5.1.2. The STAR+PLUS MMP shall be responsible for ceasing the provision Covered Services to an Enrollee upon the effective date of disenrollment.

Voluntary Disenrollment. The STAR+PLUS MMP shall have a mechanism for receiving timely information about all disenrollments from the STAR+PLUS MMP, including the effective date of disenrollment, from CMS and HHSC or its Administrative Services Contractor. All disenrollment-related transactions will be performed by HHSC or the Administrative Services Contractor consistent with the Enrollment effective date requirements set forth in the Medicare-Medicaid Enrollment and Disenrollment Guidance. Subject to 42 C.F.R. §§ 423.100 and 423.153(f), Enrollees can elect to disenroll from the STAR+PLUS MMP or the Demonstration at any time and enroll in another STAR+PLUS MMP, a STAR+PLUS MCO, a Medicare Advantage plan, PACE; or may elect to receive services through Medicare fee-for-service (FFS) and a prescription drug plan and to receive Medicaid services in accordance with the Texas State Plan and any waiver programs (if eligible). CMS will alert HHSC and the STAR+PLUS MMP of individuals identified as at risk or potentially at risk for abuse or overuse of specified prescription drugs that may not be disenrolled. Disenrollments received by HHSC or its Administrative Services Contractor, or by CMS or its contractor, either orally or in writing, by the last calendar day of the month will be effective on the first calendar day of the following month.. 287 2.3.5.1.1. The STAR+PLUS MMP may not request disenrollment on behalf of an Enrollee, except as outlined in Section 40.3 of the Medicare-Medicaid Plan Enrollment and Disenrollment Guidance.. 288 2.3.5.1.2. The STAR+PLUS MMP shall be responsible for ceasing the provision Covered Services to an Enrollee upon the effective date of disenrollment.. 288