Md. Code Regs. 10.67.02.05

Current through Register Vol. 51, No. 25, December 13, 2024

Section 10.67.02.05 - Reassignment

A. Once every 12 months, a Program recipient may elect to:

(1) Maintain enrollment with the recipient's current MCO;

(2) Enroll in another MCO in the recipient's local access area; or

(3) Enroll in an MCO outside the recipient's local access area, upon the approval of the Department and the MCO.

B. The Department shall notify the enrollee no less than 60 days before the start of each new enrollment period.

C. If the enrollee fails to respond timely to the Department's notice of opportunity to change MCOs, the Department shall reassign the enrollee in the same MCO in which the enrollee is currently enrolled.

D. The Department shall reassign into the same MCO from which the recipient was last enrolled any recipient disenrolled from an MCO who, within 120 days of disenrollment, regains:

(1) Eligibility for Medicaid; or

(2) Maryland Medicaid Managed Care Program eligibility lost for any of the reasons listed in Regulation .06B of this chapter.

E. A Program participant who has been disenrolled from an MCO because the Department terminated the MCO's contract shall be assigned to another MCO subject to Regulation .O2D of this chapter.

Md. Code Regs. 10.67.02.05

Regulations .05 recodified from 10.09.63.05 effective 46:22 Md. R. 976, eff. 11/1/2019