Common use of Assignment of PCP Clause in Contracts

Assignment of PCP. The MCO must have written policies and procedures for assigning each of its members to a PCP. At the time of enrollment in the MCO, the enrollment broker will inquire as to the enrollee’s preference of PCPs (based on network information provided by the MCO). If such a preference is indicated during communications with the enrollment broker, this information will be collected as part of enrollment and included with the enrollment information given to BMS and the MCO. If no PCP selection is made, or if the selected PCP’s panel is closed, the MCO must assume responsibility for assisting the enrollee with PCP selection. MCOs must make a PCP assignment within 10 days after a Medicaid beneficiary is enrolled in the MCO. The process whereby MCOs assign PCPs to enrollees must take into consideration such known factors as current provider relationships and location of residence. The MCO then must notify the enrollee in writing of his or her PCP’s name, location and office telephone number, and the process for selecting a new PCP if the enrollee so desires.