Section 210-RICR-30-05-3.20 - Failure to EnrollA. Failure to enroll in the ESI plan is grounds for termination of Medicaid eligibility for the non-pregnant parent(s) or caretaker over the age of nineteen (19) in the household. 1. Discontinuation - EOHHS sends a "Notice of Discontinuation", stating that Medicaid eligibility has been terminated for adults in the household due to the failure to enroll in the RIte Share-approved plan. Anyone in the household subject to the notice may reapply (for inactive cases) or request reinstatement (for active Medicaid cases) if they choose to comply with RIte Share, if an exemption from participation is granted, or if the individual no longer has access to the ESI. Please refer to § 3.5 of this Part.2. Disqualification - Procedures for handling cases in which the policy holder is not eligible for Medicaid are the same as for an eligible policy holder, with one exception: The Medicaid agency sends a "Notice of Disqualification" to the policy holder indicating that ESI costs will not be paid by EOHHS. Please refer to § 3.5 of this Part.B. Both the "Notice of Discontinuation" and the "Notice of Disqualification" shall include a statement indicating that any affected Medicaid-eligible individuals in the household have the right to appeal and to request a hearing to contest the change in eligibility and the enrollment decision.210 R.I. Code R. 210-RICR-30-05-3.20
Amended effective 8/6/2019