D.C. Mun. Regs. tit. 29, r. 29-1503

Current through Register Vol. 71, No. 49, December 6, 2024

Rule 29-1503 - ENROLLMENT CEILING

1503.1

The Administrator shall limit the number of persons eligible for enrollment according to demonstration program requirements for budget neutrality. To remain within the demonstration program's budget parameters, the Administrator shall set and modify the enrollment ceiling in consultation with the CMS.

1503.2

If the number of applicants for participation in the demonstration program exceeds the enrollment ceiling, IMA shall select enrollees and a waiting list as follows:

(a) During the initial enrollment period IMA shall select eligible individuals in the order the applications are received until the number of participants reaches the enrollment ceiling.

(b) During the initial enrollment period IMA shall select individuals not eligible for immediate enrollment for a waiting list in the order the applications are received.

(c) After the initial enrollment period and after all persons on the initial waiting list have been placed or deemed ineligible for placement, IMA shall enroll eligible persons in the order that their applications are received.

(d) After the initial enrollment period IMA shall place individuals not eligible for immediate enrollment on a waiting list, and persons on the waiting list shall become eligible for enrollment in the order that their applications were received.

1503.3

Space in the demonstration program may become available when initial demonstration program enrollees disenroll from the demonstration program. Disenrollment may occur for the following reasons:

(a) Death of an enrollee;

(b) Failure to continue to satisfy eligibility requirements; or

(c) Eligibility for Medicaid coverage without need of the demonstration program.

1503.4

The number of participants in the traditional Medicaid program shall not affect the enrollment ceiling.

D.C. Mun. Regs. tit. 29, r. 29-1503

Emergency Rulemaking published at 49 DCR 11457 (December 20, 2002) [EXPIRED]; as amended by Emergency Rulemaking published at 50 DCR 3876 (May 16, 2003) [EXPIRED]; as amended by Final Rulemaking published at 50 DCR 6183 (August 1, 2003)