42 C.F.R. § 435.212

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

Last amended: 2017Year: 2026Length: 91 wordsSubsections: 2Official source

Cite as 42 C.F.R. § 435.212 (2026)

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]
42 C.F.R. § 435.212: Individuals who would be ineligible if they were not enrolled in an MCO or PCCM. | Justis AI