048-47 Wyo. Code R. §§ 47-8 - Loss of Eligibility

(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.

Notes

048-47 Wyo. Code R. §§ 47-8

Adopted, Eff. 9/23/2019.