Wyoming Administrative Code
Agency 048 - Health, Department of
Sub-Agency 0037 - Medicaid
Chapter 47 - CHILDREN'S MENTAL HEALTH WAIVER (CMHW) AND CARE MANAGEMENT ENTITY (CME) RULES
Section 47-8 - Loss of Eligibility
Universal Citation: WY Code of Rules 47-8
Current through September 21, 2024
(a) A participant shall be determined no longer eligible for CME program services when:
(i) The youth is no longer Medicaid
eligible;
(ii) The youth moves out
of the State;
(iii) The youth ages
out of the program;
(iv) The youth
is incarcerated;
(v) The youth is
no longer financially eligible;
(vi) The youth is no longer clinically
eligible;
(vii) The youth is
determined eligible for any excluded program/population pursuant to Section 4
of this Chapter;
(viii) The youth
is an out-of-home placement longer than one hundred eighty (180)
days;
(ix) The CME provider's
agreement with CMS and the Department is not renewed or is terminated;
or
(x) The CME provider is unable
to offer health care services due to the loss of contracts with outside
providers.
(b) An enrollee may appeal their loss of eligibility pursuant to the grievance process outlined in Section 22 of this Rule.
Disclaimer: These regulations may not be the most recent version. Wyoming may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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