210 R.I. Code R. 210-RICR-30-05-2.50

Current through December 3, 2024

Section 210-RICR-30-05-2.50 - Reasons for Disenrollment

A. EOHHS may disenroll Medicaid eligible MCO members for a variety of reasons including, but not limited to, any of the following:

1. Death;

2. Loss of eligibility;

3. Selection of another MCO during open enrollment;

4. Change of residence outside of the MCO's service area;

5. Non-payment of premium share;

6. Incarceration;

7. Permanent placement in Eleanor Slater Hospital;

8. Long-term placement in a nursing facility for more than thirty (30) days (does not apply to RIte Care members);

9. Disenrollment as the result of a formal grievance filed by the member against the MCO; or

10. Disenrollment as the result of a formal grievance filed by the MCO against the member.

210 R.I. Code R. 210-RICR-30-05-2.50

Amended effective 10/5/2021
Amended effective 12/12/2023
Amended effective 3/17/2024