applicable individual
(6) Transition and exception regarding restriction on enrollment (A) In general Subject to subparagraph (C), the Secretary shall establish procedures for the transition of applicable individuals to— (i) a Medicare Advantage plan that is not a specialized MA plan for special needs individuals (as defined in subsection (b)(6)); or (ii) the original medicare fee-for-service program under parts A and B. (B) Applicable individuals For purposes of clause (i), the term “applicable individual” means an individual who— (i) is enrolled under a specialized MA plan for special needs individuals (as defined in subsection (b)(6)); and (ii) is not within the 1 or more of the classes of special needs individuals to which enrollment under the plan is restricted to. (C) Exception The Secretary shall provide for an exception to the transition described in subparagraph (A) for a limited period of time for individuals enrolled under a specialized MA plan for special needs individuals described in subsection (b)(6)(B)(ii) who are no longer eligible for medical assistance under subchapter XIX. (D) Timeline for initial transition The Secretary shall ensure that applicable individuals enrolled in a specialized MA plan for special needs individuals (as defined in subsection (b)(6)) prior to January 1, 2010 , are transitioned to a plan or the program described in subparagraph (A) by not later than January 1, 2013 .
Source
42 USC § 1395w-28(f)(6)
Scoping language
None identified, default scope is assumed to be the parent (part C) of this section.