§ 40-8.13-2. Beneficiary choice.
Any managed long-term-care arrangement shall offer beneficiaries the option to decline participation and remain in traditional Medicaid and, if a duals demonstration project, traditional Medicare. Beneficiaries must be provided with sufficient information to make an informed choice regarding enrollment, including:
(1) Any changes in the beneficiary’s payment or other financial obligations with respect to long-term-care services and supports as a result of enrollment;
(2) Any changes in the nature of the long-term-care services and supports available to the beneficiary as a result of enrollment, including specific descriptions of new services that will be available or existing services that will be curtailed or terminated;
(3) A contact person who can assist the beneficiary in making decisions about enrollment;
(4) Individualized information regarding whether the managed care organization’s network includes the healthcare providers with whom beneficiaries have established provider relationships. Directing beneficiaries to a website identifying the plan’s provider network shall not be sufficient to satisfy this requirement; and
(5) The deadline by which the beneficiary must make a choice regarding enrollment, and the length of time a beneficiary must remain enrolled in a managed care organization before being permitted to change plans or opt out of the arrangement.
History of Section.
P.L. 2014, ch. 145, art. 18, § 6.