Passive Enrollment. Passive Enrollment is effective no sooner than sixty (60) Days after beneficiary notification of the right to select the Contractor’s MMP. RI EOHHS may passively enroll into the Demonstration only Medicaid fee- for-service beneficiaries, or other Eligible Beneficiaries who are not enrolled in a Medicare Advantage plan or otherwise ineligible for Passive Enrollment. All other Eligible Beneficiaries who are not passively enrolled into the Demonstration will be provided the option to opt-in. Individuals currently enrolled in PACE may not be passively enrolled into the Contractor’s MMP. As part of the Enrollment process, RI EOHHS will exclude individuals identified as at-risk or potentially at-risk for abuse or overuse of specified prescription drugs per 42 C.F.R. §§ 423.100 and 423.153(f). CMS and RI EOHHS may stop Passive Enrollment to Contractor’s MMP if the Contractor does not meet reporting requirements necessary to maintain Passive Enrollment as set forth by CMS and RI EOHHS. Enrollees who otherwise are included in Medicare reassignment effective January 1 of a given year either from their current Medicare Prescription Drug Plan (PDP) or terminating Medicare Advantage Prescription Drug Plan (MA-PD) to another PDP, will not be eligible for Passive Enrollment that same year. For example: those reassigned to a new PDP effective January 1, 2016, will be eligible for Passive Enrollment into the Contractor’s MMP effective no earlier than January 1, 2017. Passive Enrollment activity will be coordinated with CMS activities such as annual reassignment and daily auto-assignment for individuals with the Part D Low Income Subsidy.
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