Ch. 34, § 7. Loss of Eligibility

(a) A participant is no longer eligible for the CCW, and the Department shall terminate the participant's enrollment and provision of services, if any of the following occur: (i) The participant does not meet target group requirements; (ii) The participant does not meet financial eligibility; (iii) The participant changes residence to another state; (iv) The participant voluntarily does not receive at least one (1) waiver service, for thirty (30) consecutive calendar days, and a reevaluation conducted pursuant to Medicaid Rules Chapter 22 demonstrates the participant no longer needs an institutional level of care; (v) A re-evaluation using the level of care assessment approved by the Department demonstrates the participant no longer needs an institutional level of care; or (vi) The participant is in a nursing home, hospital, residential treatment facility, in-patient hospice, or other institutional setting, or is incarcerated for thirty (30) or more consecutive calendar days. (b) The Department may terminate a participant's CCW enrollment and provision of services if any of the following occur: (i) The participant is in an out-of-state placement or residence for six (6) consecutive months or resides out of state for six (6) consecutive months; or (ii) The participant is enrolled in a different HCBS waiver. (c) The Department shall notify the participant in writing within fifteen (15) calendar days of the date the individual is determined ineligible for CCW services. (d) In accordance with Wyoming Medicaid Rules Chapter 4, the Department shall provide notice of adverse action and the right to request an administrative hearing to any individual whose Medicaid service coverage or eligibility is denied, reduced, terminated, or suspended under this Section. (e) A participant whose CCW enrollment and services were terminated under this Section may reapply at any time. Eligibility will be determined pursuant to Section 5.