Rhode Island Code of Regulations
Title 210 - Executive Office of Health and Human Services
Chapter 30 - Medicaid for Children, Families, and Affordable Care Act (ACA) Adults
Subchapter 05 - Service Delivery Options
Part 2 - Medicaid Managed Care Delivery Options
Section 210-RICR-30-05-2.50 - Reasons for Disenrollment
Universal Citation: 210 RI Code of Rules 30 05 2.50
Current through March 25, 2025
A. EOHHS may disenroll Medicaid eligible MCO members for a variety of reasons including, but not limited to, any of the following:
1.
Death;
2. Loss of
eligibility;
3. Selection of
another MCO during open enrollment;
4. Change of residence outside of the MCO's
service area;
5. Non-payment of
premium share;
6.
Incarceration;
7. Permanent
placement in Eleanor Slater Hospital;
8. Long-term placement in a nursing facility
for more than thirty (30) days (does not apply to RIte Care members);
9. Disenrollment as the result of a formal
grievance filed by the member against the MCO; or
10. Disenrollment as the result of a formal
grievance filed by the MCO against the member.
Disclaimer: These regulations may not be the most recent version. Rhode Island may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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