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West Virginia Income Maintenance Manual Chapter 24

West Virginia Income Maintenance Manual Page 174 Chapter 24 Long Term Care

24.62 ESTABLISHING MEDICAL NECESSITY

The Bureau for Medical Services (BMS) contract agency determines medical necessity for Children with Serious Emotional Disorder (CSED) waiver services. The BMS contract agency notifies the Community Services Manager (CSM) by memorandum of the Notice of Decision, client's name, and the date that medical necessity for CSED waiver services was established. Medicaid is continued when the case is in hearing status or an extension has been granted by the Office of HCBS waiver services in the BMS due to circumstances beyond the client’s control.

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Page 2099

Official source

West Virginia Income Maintenance Manual Chapter 24

West Virginia Income Maintenance Manual Page 174 Chapter 24 Long Term Care

24.62 ESTABLISHING MEDICAL NECESSITY

The Bureau for Medical Services (BMS) contract agency determines medical necessity for Children with Serious Emotional Disorder (CSED) waiver services. The BMS contract agency notifies the Community Services Manager (CSM) by memorandum of the Notice of Decision, client's name, and the date that medical necessity for CSED waiver services was established. Medicaid is continued when the case is in hearing status or an extension has been granted by the Office of HCBS waiver services in the BMS due to circumstances beyond the client’s control.