Page 2060

West Virginia Income Maintenance Manual Chapter 24

West Virginia Income Maintenance Manual Page 135 Chapter 24 Long Term Care

Medical necessity must be verified annually at redetermination with a letter from the Utilization Management Contractor (UMC) stating the client continues to be eligible. If the client continues to meet financial and medical requirements, Medicaid eligibility for waiver services is established. Continued medical eligibility for services is monitored by the BMS. Medicaid is continued when the case is in hearing status or an extension has been granted by the Office of I/DD Waiver Services in the BMS due to circumstances beyond the individual’s control. Information about I/DD Waiver Services is found on the BMS website on the Office of Home and Community-Based Services page. The I/DD Waiver application (WV-BMS-IDD-01) needed to determine medical eligibility can be found on the BMS website and on the DFA intranet forms page.

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Page 2060

Official source

West Virginia Income Maintenance Manual Chapter 24

West Virginia Income Maintenance Manual Page 135 Chapter 24 Long Term Care

Medical necessity must be verified annually at redetermination with a letter from the Utilization Management Contractor (UMC) stating the client continues to be eligible. If the client continues to meet financial and medical requirements, Medicaid eligibility for waiver services is established. Continued medical eligibility for services is monitored by the BMS. Medicaid is continued when the case is in hearing status or an extension has been granted by the Office of I/DD Waiver Services in the BMS due to circumstances beyond the individual’s control. Information about I/DD Waiver Services is found on the BMS website on the Office of Home and Community-Based Services page. The I/DD Waiver application (WV-BMS-IDD-01) needed to determine medical eligibility can be found on the BMS website and on the DFA intranet forms page.