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coverage begins are to be processed as disenrollment requests; once enrolled in the MA plan, these individuals have access to an array of special election periods as described in §30.6.

Approval Period CMS may approve an MAO to use the default enrollment process for a period of up to five years. Such approval will continue after contract consolidations where the surviving contract contains the approved Plan Benefit Package or other CMS-approved changes to the Plan Benefit Package if the D-SNP Plan Benefit Package continues to be offered by the same parent organization and continues to meet all qualifying criteria for default enrollment. A contract consolidation or Plan Benefit Package crosswalk to a new Plan Benefit Package will require submission of a new default enrollment proposal.

CMS may suspend or rescind approval prior to the expiration of this period if CMS determines the MAO is not in compliance with the regulatory requirements. MAOs that do not submit renewal applications prior to the expiration of their approval period may re-initiate default enrollment only after submitting a new initial proposal and receiving approval from CMS. Renewal applications are not permitted after an approval period has expired. MAOs may not continue to use default enrollment if they are pending a response from CMS at the time their approval period expires.

40.1.6 – Passive Enrollment by CMS 42 CFR §§ 422.60(g) and 423.32(g)

Passive enrollment is a process where CMS automatically enrolls an individual into another plan. The individual receives a notice of this change and has the opportunity to accept or decline the enrollment. If the individual takes no action, the individual has made a choice to accept the enrollment. CMS permits passive enrollments in specific, limited circumstances associated with: • Immediate plan terminations, • Situations in which remaining enrolled in the plan would pose potential harm to enrollees, and • Part C Policy: Where CMS determines that passive enrollment is necessary to promote integrated care and continuity of care for full-benefit dual eligible individuals (see below).

Part C Policy: Passive enrollment is permitted in situations where CMS determines, after consulting with the relevant state Medicaid agency, passive enrollment is necessary to promote integrated care and continuity of care for full-benefit dual eligible individuals.

CMS will determine when passive enrollment is appropriate under 42 CFR § 422.60(g) and will initiate contact through the MAO’s CMS account manager to discuss with the organization. CMS will consult with the State Medicaid agency and authorize passive enrollment for full-benefit dual eligibles enrolled in an integrated dual-eligible special needs plan (D-SNP) to continue access in integrated care when: • The organization’s Medicaid managed care plan non-renews or is terminated, or an integrated D-SNP non-renews at the end of the contract year.