048-3 Wyo. Code R. § 3-1

Current through April 27, 2019
Section 3-1 - Statement of Purpose

These rules and regulations are adopted to implement the Divisions authority to deny application or modify, suspend or terminate benefits under any MCH Program for the following reasons:

(a) The applicant/client is not a bona fide resident of the State;

(b) The applicant fails or refuses to provide documentation of residency;

(c) The applicant/client fails or refuses to submit, within a required time frame, a financial status report for the purpose of determining reimbursement obligation/co-pay liability;

(d) The applicant/client fails or refuses to apply for benefits from other payment sources;

(e) The applicant/client submits false statements of fact designed to enhance that person's eligibility status for MCH Program benefits;

(f) The applicant/client fails to meet financial and/or medical eligibility requirements;

(g) The applicant/client refuses to reimburse the Program after being notified of third party benefits or recipient reimbursement obligation;

(h) The applicant/client notifies the Program that MCH benefits are no longer required;

(i) The client is requesting and/or receiving services from a provider who is not enrolled in MCH;

(j) The applicant/client fails to file application in a timely manner;

(k) The applicant/client submits false claims to the MCH Program;

(l) The applicant/client has not complied with the MCH approved medical treatment plan;

(m) The funds allocated for payment on behalf of the client are exhausted;

(n) The CSH client reaches their 19th birthday;

(o) The client dies;

(p) The day an MHR client completes genetic testing; or

(q) The day an MHR/NBIC client is discharged from a tertiary care facility.

048-3 Wyo. Code R. § 3-1