42 C.F.R. § 435.212

Current through September 30, 2024
Section 435.212 - Individuals who would be ineligible if they were not enrolled in an MCO or PCCM

The State agency may provide that a beneficiary who is enrolled in an MCO or PCCM and who becomes ineligible for Medicaid is considered to continue to be eligible-

(a) For a period specified by the agency, ending no later than 6 months from the date of enrollment; and
(b) Except for family planning services (which the beneficiary may obtain from any qualified provider) only for services furnished to him or her as an MCO enrollee.

42 C.F.R. §435.212

56 FR 8849, Mar. 1, 1991, as amended at 67 FR 41095, June 14, 2002