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The key distinction is not stability, but contamination control

[7] Long-term use has also been associated with liver damage

Despite the prohibition on mandatory enrollment in Medicare managed care, one tool that states and plans have had to enroll dual eligible beneficiaries in aligned Medicare and Medicaid plans is "seamless conversion." This process allows a DSNP to passively enroll Medicaid beneficiaries who are newly eligible for Medicare (i.e., just turning age 65 or at the end of the 2-year Social Security Disability Insurance waiting period), if they are already enrolled in that plan's companion Medicaid product

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