016.06.75-231.300. Right To Change PASSE For Cause

AR ADC 016.06.75-231.300Arkansas Administrative CodeEffective: January 1, 2019

West's Arkansas Administrative Code
Title 016. Department of Human Services
Division 06. Division of Medical Services
Rule 75. Section II--Provider-Led Arkansas Shared Savings Entity (Passe) Program
Section 230.000. Members Rights and Protections
Effective: January 1, 2019
Ark. Admin. Code 016.06.75-231.300
016.06.75-231.300. Right To Change PASSE For Cause
Currentness
A member may not change their PASSE outside of the 90-day period following initial assignment or during the annual open enrollment period, unless cause for transition is met.
Cause for transition, as described in 42 CFR ยง 438.56, is as follows:
A. The member moves out of the state;
B. The PASSE for which the member is assigned is sanctioned pursuant to this manual, the PASSE Provider Agreement, or any state or federal regulations and laws;
C. The PASSE does not, because of moral or religious objections, cover the service the member seeks; or
D. Other reasons, including poor quality of care, lack of access to services covered under the PASSE agreement, or lack of access to providers experienced in dealing with the member's care needs, as determined by DHS in its sole discretion.

Credits

Adopted Jan. 1, 2019.
Current with amendments received through February 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 016.06.75-231.300, AR ADC 016.06.75-231.300
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