Individuals who would be ineligible if they were not enrolled in an MCO or PCCM.

  1. Law
  2. CFR 42
  3. Public Health
  4. Centers for Medicare & Medicaid Services, Department of Health and Human Services
  5. Medical Assistance Programs
  6. Eligibility in the States, District of Columbia, the Northern Mariana Islands, and American Samoa
  7. Options for Coverage
  8. Options for Coverage of Families and Children and the Aged, Blind, and Disabled
  9. Individuals who would be ineligible if they were not enrolled in an MCO or PCCM.

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§ 435.212 Individuals who would be ineligible if they were not enrolled in an MCO or PCCM.

The State agency may provide that a beneficiary who is enrolled in an MCO or PCCM and who becomes ineligible for Medicaid is considered to continue to be eligible -

(a) For a period specified by the agency, ending no later than 6 months from the date of enrollment; and

(b) Except for family planning services (which the beneficiary may obtain from any qualified provider) only for services furnished to him or her as an MCO enrollee.

[56 FR 8849, Mar. 1, 1991, as amended at 67 FR 41095, June 14, 2002]


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