<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".02" citation="COMAR 10.67.02.02" title_num="10" subtitle_num="67" chapter_num="02" heading="Enrollment.">
  <paragraph num="A.">
    <text>The Department shall make available through its website and upon request provide a paper copy of the following:</text>
    <paragraph num="(1)">
      <text>Materials regarding each MCO providing services in the eligible individual’s county of residence including, but not limited to:</text>
      <paragraph num="(a)">
        <text>Information about how to access the provider directory and drug formulary, with instructions for how to request paper copies if needed;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>A schedule of the benefits offered, including any benefits offered beyond the basic required package described in COMAR 10.67.06;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Which, if any, benefits are provided directly by the Department;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>If applicable, a list of services that the MCO does not provide, reimburse for, or provide coverage of, because of moral or religious objections, and information about where and how to obtain these services;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>The requirements for each MCO to provide adequate access to covered services, including the network adequacy standards established in COMAR 10.67.05; and</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Quality and performance indicators for each MCO, including enrollee satisfaction; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Materials about the managed care program, including:</text>
      <paragraph num="(a)">
        <text>The MCO enrollment and disenrollment process; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The basic features of managed care.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>Any forms necessary to select an MCO; and</text>
    </paragraph>
    <paragraph num="(4)">
      <text>The toll-free telephone number of the enrollment unit.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Only the Department, or its designee, is authorized to enroll individuals into MCOs.</text>
  </paragraph>
  <paragraph num="C.">
    <text>A participant found eligible for Maryland Medicaid under 42 U.S.C §1902(a)(10)A(i) shall be assigned to:</text>
    <paragraph num="(1)">
      <text>The MCO the participant chooses at the time of application; or</text>
    </paragraph>
    <paragraph num="(2)">
      <text>If the participant does not choose, an MCO with available capacity that is accepting new participants in the participant’s service area.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Except for a participant found eligible as described in §C of this regulation, a participant, including a child in foster care or kinship care, shall:</text>
    <paragraph num="(1)">
      <text>Have 28 days from the day the Department mails its eligibility notification in which to select an MCO; or</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Be assigned to an MCO with available capacity that is accepting new participants in the participant’s service area.</text>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>All Managed Care Program eligible family members who live in the same household shall be assigned to the same MCO.</text>
  </paragraph>
  <paragraph num="F.">
    <text>Newborns.</text>
    <paragraph num="(1)">
      <text>A newborn shall be automatically enrolled from birth in its biological mother’s MCO.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The MCO is responsible for the newborn’s health care from birth until the newborn enrolls into another MCO.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>A newborn, automatically assigned to its biological mother’s MCO, is not eligible to change MCOs for family unity as described in COMAR 10.67.02.06A(1)(b) and (c) during the first 90 days of enrollment.</text>
    </paragraph>
  </paragraph>
  <paragraph num="G.">
    <text>Effective Date of Enrollment. Enrollment in an MCO shall be effective at 12:01 a.m. on the 10th calendar day beginning with the day on which the Department notifies the MCO of the enrollment.</text>
  </paragraph>
  <paragraph num="H.">
    <text>Upon the approval of the Department and the MCO, a participant may select an MCO that does not serve the participant’s service area.</text>
  </paragraph>
  <paragraph num="I.">
    <text>The Department or its designee shall submit the enrollee's choice of PCP to the enrollee's selected MCO at the time of enrollment.</text>
  </paragraph>
</regulation>