Memo to Long Term Care Facilities on Disenrollment Issues (05/26/15): Warning us of consequences for dis-enrolling beneficiaries without their knowledge or consent

CMS has released a Memo to LTC Providers warning us of consequences if we can't prove that we did not dis-enroll a beneficiary without their knowledge or consent.  For those of you in MMP dual-eligible demonstration states - California, Illinois, Massachusetts, Michigan, New York, Ohio, South Carolina, Texas, and Virginia - they call us out on MMP dis-enrollment, too:

0. CONSEQUENCES OF BENEFICIARY DISENROLLMENT BY A LTC FACILITY
   If documentation of a beneficiary’s request to change enrollment cannot be provided by a LTC facility, CMS will consider the enrollment not to be legally valid, cancel the enrollment action and, if necessary and appropriate, reinstate the beneficiary’s MA, MAPD or MMP coverage as if never disenrolled (Medicare Managed Care Manual, Chapter 2, Sec. 40.6). CMS will be reporting these incidents to the Medicare Drug Integrity Contractor (MEDIC) that investigates fraud and abuse incidents.