Rocky Mountain PACE participants may disenroll at any time, effective the last day of the month of the disenrollment.
(a) In disenrolling a participant, the PACE organization must take the following actions:
- Use the most expedient process allowed under Medicare and Medicaid procedures, as set forth in the PACE program agreement.
- Coordinate the disenrollment date between Medicare and Medicaid (for a participant who is eligible for both Medicare and Medicaid).
- Give reasonable advance notice to the participant.
(b) Until the date enrollment is terminated, the following requirements must be met:
- PACE participants must continue to use PACE organization services and remain liable for any premiums.
- The PACE organization must continue to furnish all needed services.
(c) To facilitate a participant’s reinstatement in other Medicare and Medicaid programs after disenrollment, the PACE organization must do the following:
- Make appropriate referrals and ensure medical records are made available to new providers within 30 days.
- Work with CMS and the State administering agency to reinstate the participant in other Medicare and Medicaid programs for which the participant is eligible.
[64 FR 66279, Nov. 24, 1999, as amended at 84 FR 25676, June 3, 2019]