Code of Maryland Regulations (Last Updated: April 6, 2021) |
Title 10. Maryland Department of Health |
Part 5. |
Subtitle 67. MARYLAND HEALTHCHOICE PROGRAM |
Chapter 10.67.02. Maryland Medicaid Managed Care Program: Eligibility and Enrollment |
Sec. 10.67.02.05. Reassignment
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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 recipients 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. 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.
D. The MCO shall assign the recipient to the primary care provider of record at the time of the recipient's disenrollment.
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 .02D of this chapter.