R414-140-4. Restrictions on Changes in Enrollment

(1)(a) The department shall give Medicaid members a choice of at least two health plans. (b) Each new applicant for Medicaid in a mandatory enrollment county shall be offered an orientation about Medicaid and the CHCDP. (i) A health program representative employed by the department shall conduct the orientation and enroll Medicaid members in a health plan. (ii) During the orientation, each member shall be presented with health plan options. (2) The department restricts the disenrollment rights of members who are required to enroll with a health plan in accordance with 42 CFR 438.56. Disenrollment rights are restricted for a period of up to 12 months, except during the first three months of the member's initial enrollment with a health plan, if: (a) the member chooses a different health plan during the department's annual open enrollment period; (b) the member moves out of the health plan's service area; or (c) the member requests to select a different health plan for good cause and the department approves the request.