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this exemption, "extraordinary circumstances" may include but not be limited to: a. The existence of an unusual and life-threatening medical condition which requires medical treatment that cannot be provided or arranged by the ESI plan; b. The existence of a chronic, severe medical condition for which the Medicaid member has a long-standing treatment relationship for that condition with a provider who does not participate in the ESI plan and/or refuses to enroll as a Medicaid participating provider. 3. Other programs – If good cause has been granted for any other benefit program administered by EOHHS or DHS, the good cause exemption will be honored by the RIte Share Program. 4. Nature of request – Enrollment exemptions requested due to extraordinary circumstances must be in writing, with appropriate documentation (letter from physician, medical records, restraining orders, or others as indicated), and signed by the Medicaid member, parent/caretaker or person designated to make the request on their behalf. 5. Basis of the determination – EOHHS makes RIte Share participation exemption determinations on a case-by-case basis after considering all required documentation and any other relevant information pertaining to the request. An exemption may be granted for any length of time during the period in which the extraordinary circumstances exist. When an exemption is granted, Medicaid member is enrolled in the appropriate Medicaid managed care plan in accordance with Part 2 of this Subchapter. 6. Limits – An individual's preference to continue a treatment relationship with a doctor or other health care provider who does not participate in the RIte Share plan or Medicaid program does not in and of itself constitute an "extraordinary circumstance." 3.22 Notice and Appeal Rights

Medicaid applicants and recipients shall receive timely notification of eligibility and enrollment determinations and the right to appeal. EOHHS shall also provide timely notification, including appeal rights, of any adverse decisions that reduce or terminate benefits. See Part 10-05-2 of this Title for full statement of these rights. 3.23 Severability

If any provisions of these regulations or the application thereof to any person or circumstance shall be held invalid, such invalidity shall not affect the provisions