New Mexico Administrative Code
Title 8 - SOCIAL SERVICES
Chapter 315 - OTHER LONG TERM CARE SERVICES
Part 2 - PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE)
Section 8.315.2.17 - DISENROLLMENT OF PARTICIPANTS
Current through Register Vol. 35, No. 18, September 24, 2024
All voluntary and involuntary disenrollments will be documented and available for review by the state medicaid agency. The provider will inform the ISD office when a participant is being disenrolled either voluntarily or involuntarily. Disenrollment is effective by the first day of the second calendar month following the date in which enrollment has changed.
A. Voluntary disenrollment: A participant may begin the process of voluntary disenrollment at any time during the month. The provider shall use the most expedient process allowed by medicaid and medicare procedures while ensuring a coordinated disenrollment date. Until enrollment is terminated, the participants are required to continue using the PACE program services and remain liable for any premiums. The provider shall continue to provide all needed services until the date of termination.
B. Involuntary disenrollment: A participant may be involuntarily disenrolled if the participant: