Enrollment Activities. 2.3.1. Enrollment
Enrollment Activities. A. Enrollment EOHHS will begin self-selection (opt-in) enrollment prior to the initiation of Passive Enrollment. During this period, Medicare-Medicaid Beneficiaries eligible for the Demonstration may choose to enroll into a particular One Care plan. The first Effective Enrollment Date for this initial opt-in period is scheduled for no earlier than October 1, 2013. Eligible Medicare-Medicaid Beneficiaries who do not select a One Care plan or who do not opt out of the Demonstration will be assigned to a One Care plan during Passive Enrollment. EOHHS may conduct Passive Enrollment during the term of the Contract to assign eligible Medicare-Medicaid Beneficiaries who do not select a One Care plan and who do not opt out of the Demonstration. Individuals who opt out of the Demonstration will not be included in Passive Enrollment for the remainder of the Demonstration. Passive Enrollment to the Contractor will begin no sooner than January 1, 2014, and EOHHS will provide notice of Passive Enrollments at least 60 days prior to the effective dates to Eligible Beneficiaries, and will accept opt-out requests prior to the effective date of enrollment. EOHHS will apply intelligent methodologies, to the extent approved by CMS, to assign Eligible Beneficiaries to a One Care plan. Such methodologies may include, but not be limited to, past provider relationships. CMS and EOHHS may stop Passive Enrollment to Contractor if the Contractor does not meet reporting requirements necessary to maintain Passive Enrollment as set forth by CMS and EOHHS Enrollments and disenrollments will be processed through the EOHHS customer service vendor. EOHHS or its vendor will then submit Passive Enrollment transactions at least 60 days in advance of the effective date, to the CMS Medicare Advantage Prescription Drug (XXXX) enrollment system directly or via a third-party CMS designates to receive such transactions, and MassHealth or its vendor will receive notification on the next Daily Transaction Reply Report. The Contractor will then receive enrollment transactions through the EOHHS customer service vendor. The Contractor will also use the third-party CMS designates to submit additional enrollment-related information to XXXx, and receive files from CMS.
Enrollment Activities. Enrollment in the Senior Care Options Program is voluntary. For a MassHealth Member to be eligible to enroll in the Senior Care Options Program, the Member must be on MassHealth Standard and meet all other eligibility requirements as listed under 130 CMR 508.008 (A). Medicare eligibility is not an eligibility requirement for enrollment in the Senior Care Options program and MassHealth Members with or without Medicare may enroll in the program, provided they meet all eligibility requirements as listed under 130 CMR 508.008(A). Note: An individual enrolled in Medicare but not eligible for MassHealth Standard (i.e. not a Dual Eligible Senior) is not eligible for enrollment into the Senior Care Options program. In accordance with Section 2.1, prior to commencing the initial enrollment of MassHealth Members, the Contractor must demonstrate to EOHHS that it has been designated by CMS as a Medicare Advantage Special Needs Plan for persons dual eligible for Medicare and Medicaid and with Medicare Part D authority.
Enrollment Activities. The EBS shall complete the following enrollment activities for mandatory clients (and also for potential mandatory clients, if requested), in coordination with the plan and the Department:
Enrollment Activities. Enrollment in the Senior Care Options Program is voluntary. For a MassHealth Member to be eligible to enroll in the Senior Care Options Program, the Member must be MassHealth Standard eligible and meet all other eligibility requirements as set forth in 130 CMR 508.008(A). Medicare eligibility is not a prerequisite for enrollment in the Senior Care Options Program. MassHealth Members with or without Medicare may enroll in the Senior Care Options Program, provided they meet all eligibility requirements as set forth in 130 CMR 508.008(A). Note: An individual enrolled in Medicare but not eligible for MassHealth Standard (i.e. not a Dual Eligible Senior) is not eligible to enroll in the Senior Care Options Program. In accordance with Section 2.1, prior to commencing the initial enrollment of MassHealth Members, the Contractor must demonstrate to EOHHS that it has been designated by CMS as a Medicare Advantage Special Needs Plan for persons dually eligible for Medicare and Medicaid and has Medicare Part D authority in the counties in which services are to be rendered under this Contract.
Enrollment Activities. Enrollment in the Senior Care Options Program is voluntary. In accordance with Section 2.1, prior to commencing the initial enrollment of members, the Contractor must demonstrate to EOHHS that it has been designated by CMS as a Medicare Advantage Special Needs for persons dual eligible for Medicare and Medicaid and with Medicare Part D authority.
Enrollment Activities
