Wyoming Administrative Code
Agency 048 - Health, Department of
Sub-Agency 0037 - Medicaid
Chapter 40 - PSYCHIATRIC RESIDENTIAL TREATMENT FACILITIES
Section 40-16 - Title IV-E clients
Current through September 21, 2024
(a) Title IV-E of the Social Security Act (42 U.S.C. §§ 671-679b) is a funding stream for foster care costs. It provides for federal reimbursement for a portion of the maintenance and administrative costs of foster care for children who meet specified federal eligibility requirements.
(b) Wyoming Medicaid clients on a Title IV-E adoption program and placed in a PRTF out of state shall transfer to the receiving state's Medicaid program. 45 C.F.R. Part 1356 redefines the client's residency to that of the receiving state. Therefore, the receiving state's Medicaid program shall be notified of the placement by Wyoming Medicaid's Utilization Management vendor.
(c) If the receiving state refuses to accept the transfer of Medicaid coverage, the Wyoming Department of Health shall maintain primary clinical and placement oversight and coverage responsibility as determined medically necessary.
(d) Wyoming Medicaid's Utilization Management vendor shall engage in an agreement with the admitting facility to remain involved in the treatment and progress of the client in order to certify ongoing medical necessity of the placement.
