Common use of Eligibility Redeterminations Clause in Contracts

Eligibility Redeterminations. Contractor must redetermine the eligibility of Enrollee in a MCE or HCCI program at least once every twelve (12) months. A. These eligibility redeterminations cannot use income eligibility standards more restrictive during the period of redetermination than those “in effect” during the period of the MCE or HCCI recipient’s initial eligibility determination. B. Each redetermination must include a reassessment of the recipient’s eligibility for Medi-Cal and the CHIP. If upon redetermination a recipient is determined ineligible the recipient shall be disenrolled in according with Provision 2, Disenrollment, and referred to the county Medi-Cal office, if appropriate.