MM3
CMS-Required Outcome
CMS-required outcome
The system disenrolls members at the request of the plan and in accordance with state procedures.
Default metrics
- Disenrollment requested by the enrollee. Without cause, at the following times:
- During the 90 days following the date of the beneficiary's initial enrollment into the MCO, PIHP, PAHP, PCCM, or PCCM entity, or during the 90 days following the date the State sends the beneficiary notice of that enrollment, whichever is later.
- At least once every 12 months thereafter.
Regulatory sources
- 42 CFR 438.56(b) (c), and (d)