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2.46 Transitioning Members between MCOs and Delivery Systems A. It may be necessary to transition a Medicaid member between MCOs or from one (1) delivery system – RHP to RIte Care or vice versa – for a variety of reasons: 1. Change in MCOs within a delivery system – The transition between Medicaid MCOs may occur as a result of change in MCO during open enrollment or a change that is ordered as part of a grievance resolution. The MCOs have written policies and procedures for transferring relevant patient information, including medical records and other pertinent materials, when transitioning a member to or from another MCO. The MCO must transfer this information at no cost to the member. 2. Change in delivery systems – Medicaid members may be transitioned from one managed care delivery system into another as a result of changes in eligibility status. Adults enrolled in RIte Care who are between the ages of nineteen (19) and sixty-four (64) may be eligible under the MACC group for adults when their dependent children age out of MACC group for children. Once a RHP member has given birth, both newborn and/or parents may be transitioned to RIte Care if income is within the eligibility thresholds set forth in Medicaid Affordable Care Coverage Groups Overview and Eligibility Pathways (Subchapter 00 Part 1 of this Chapter). Enrollment in MCOs during such transitions will strive to preserve the continuity of care to the full extent feasible. Accordingly, Medicaid members enrolled in a particular MCO subject to a delivery system transition will be enrolled in the same health plan, if participating, in the new delivery system. 2.47 Grievances, Appeals, and Hearings A. The State provides a grievance and appeals process that MCO providers and Medicaid enrollees must use when seeking redress against health plans. This is the same process that the MCOs must use when seeking to disenroll members who are habitually non-compliant or who pose a threat to plan employees or other members. See Part 10-05-2 of this Title, Appeals Process and Procedures for EOHHS Agencies and Programs, for additional information. 2.48 MCO Initiated Disenrollment A. The MCO may seek disenrollment of a member who is habitually non-compliant or poses a threat to MCO employees or other members. An MCO initiated disenrollment, is subject to an administrative review process by EOHHS and must follow the following requirements: 1. MCO disenrollment requests – For an MCO to disenroll a Medicaid member, the MCO must send a request, along with accompanying