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TITLE 1ADMINISTRATION
PART 15TEXAS HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 353MEDICAID MANAGED CARE
SUBCHAPTER LTEXAS DUAL ELIGIBLES INTEGRATED CARE DEMONSTRATION PROJECT
RULE §353.1107Member Enrollment and Disenrollment

(a) HHSC and CMS, or their designee(s), conduct enrollment and disenrollment activities.

(b) HHSC and CMS establish procedures for enrolling new members into participating MMPs, including enrollment periods and time limits within which enrollment must occur.

(c) HHSC assigns eligible individuals to an MMP based on current Medicare or Medicaid enrollment.

(d) Beginning 60 days prior to the enrollment of an eligible individual in the Dual Demonstration, HHSC sends initial and reminder notifications of the proposed assigned MMP to the eligible individual, informing the individual of their right to either opt out of the Dual Demonstration or to select another MMP.

(e) At any time prior to enrollment, individuals may choose not to participate in the Dual Demonstration, or to select another MMP in their county by notifying HHSC or CMS.

(f) Once enrolled, individuals may notify HHSC or CMS of the choices referenced in subsection (e) of this section at any time. An individual's choice to not participate in the Dual Demonstration or to select another MMP is effective the first day of the month following the date the individual notified HHSC or CMS.


Source Note: The provisions of this §353.1107 adopted to be effective April 1, 2015, 40 TexReg 1705

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