Common use of Discretionary Involuntary Disenrollment Clause in Contracts

Discretionary Involuntary Disenrollment. 2.3.3.1. 42 C.F.R. § 422.74 and Sections 40.3 and 40.4 of the Medicare- Medicaid Plan Enrollment and Disenrollment Guidance, including Massachusetts-specific modifications, provide instructions to One Care Plans on discretionary involuntary disenrollment. This Contract, the regulation, and other guidance provide procedural and substantive requirements the Contractor must follow prior to being approved to involuntarily disenroll an Enrollee. If all of the procedural requirements are met to the satisfaction of EOHHS and CMS, EOHHS and CMS will decide whether to approve or deny each request for involuntary disenrollment based on an assessment of the particular facts associated with each request, including an assessment of whether the Contractor followed all of the necessary procedural and Enrollee notice requirements.

Discretionary Involuntary Disenrollment. 2.3.3.1. 42 C.F.R. § 422.74 and Sections 40.3 and 40.4 of the Medicare- Medicare-Medicaid Plan Enrollment and Disenrollment Guidance, including Massachusetts-specific modifications, provide instructions to One Care Plans on discretionary involuntary disenrollment. This Contract, the regulation, and other guidance provide procedural and substantive requirements the Contractor must follow prior to being approved to involuntarily disenroll an Enrollee. If all of the procedural requirements are met to the satisfaction of EOHHS and CMS, EOHHS and CMS will decide whether to approve or deny each request for involuntary disenrollment based on an assessment of the particular facts associated with each request, including an assessment of whether the Contractor followed all of the necessary procedural and Enrollee notice requirements.