Section 29-7 - Case management of recipients receiving high cost services and/or recipients with severe medical problems (a) The division is authorized to monitor recipients receiving high cost services and/or recipients with severe medical problems.
(b) If the Department determines that a recipient receiving high cost services and/or a recipient with a severe medical problem could receive appropriate covered services at a lower cost to the Medic-aid program, it shall: - (i) Determine if appropriate services may be furnished in a different setting at a lower cost to the Medicaid program;
- (ii) Identify the provider or providers that can provide appropriate services;
- (iii) Coordinate and facilitate placement of the recipient in the appropriate setting and for necessary transportation;
- (iv) Notify the provider(s) from whom the recipient is receiving services of the date after which such services shall not be reimbursable unless furnished by a provider or providers specified by the Department; and
- (v) Notify the recipient, and the recipients legal guardian or other authorized individual, of the date after which such services shall not be reimbursable unless furnished by a provider or providers specified by the Department.
(b) Notice. All notices shall be pursuant to Section 10.
048-29 Wyo. Code R. § 29-7