048-46 Wyo. Code R. § 46-14

Current through April 27, 2019

Section 46-14 - Prohibited Use of Waiver Funds

(a) The following services are not eligible for waiver services reimbursement:

• (i) The care of individuals residing in a hospital, nursing facility, ICF/ID, or other institutional placement;

• (ii) Waiver services provided to a person under guardianship by a spouse of the participant, a guardian of a participant age 18 and over, or an owner or officer of a provider organization serving their ward, shall not directly or indirectly receive reimbursement for providing waiver services;

• (iii) Room and board, except when provided as part of respite in a facility, other than a private residence, approved by Medicaid;

• (iv) Services currently covered under the Medicaid State Plan;

• (v) Services to an individual if it is reasonably expected that the cost of these services would exceed the cost of services provided in an ICF/ID, calculated by using the current annual ICF/ID rate; or

• (vi) Service settings reimbursed by another state agency, such as the Department of Family Services or Department of Education.

(b) No direct service that is the responsibility of the school system shall be authorized as a waiver service. The Division shall not authorize waiver services for the hours the child is attending school or in a vocational program. Regular school hours and days apply for a child who receives home schooling or an adjusted school day.

(c) Any individual eligible for funding for specialized services under the Developmental Disabilities Services Act shall apply for and accept any federal Medicaid benefits for which they may be eligible and benefits from other funding sources within the Department; the Department of Education, specifically including the Department of Workforce Services and Division of Vocational Rehabilitation; and other agencies to the maximum extent possible.

048-46 Wyo. Code R. § 46-14

Adopted, Eff. 6/21/2017.

Amended, Eff. 7/26/2018.