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7.1.5 Primary Care Provider Changes
7.1.5.1 Client-Initiated Primary Care Provider Changes
A client may change primary care providers for the following reasons:
• The client is dissatisfied with the care or treatment they have received.
•The client's condition or illness would be better treated by another provider type.
•The client's new address is no longer convenient to the primary care provider's location.
•The provider leaves the program (i.e., moves, no longer accepts Medicaid, is removed from Medicaid enrollment, is no longer managed career affiliated with the Medicaid managed care program, or is deceased).
•The client/primary care provider relationship is not mutually agreeable.
HMO and PCCM Primary Care Provider Changes
Primary care provider changes for PCCM, STAR, and STAR+PLUS can be received up to the last business day of the month and made effective the first day of the next calendar month, as shown in the following example:
STAR Health
Primary care provider changes for STAR Health are effective immediately.
ICM Primary Care Provider Changes
Client requests for primary care provider changes received prior to the middle of the month usually become effective on the first day of the following month. If a client's request for a primary care provider change is received after the middle of the month, the change may become effective on the first day of the second month following the request, as shown in the example below.
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