12 Va. Admin. Code § 30-122-40 - Waiver services; when not authorized
A. The FIS, CL, and BI waiver services,
collectively known as Developmental Disabilities (DD) Waivers, shall not be
authorized or reimbursed by DMAS for an individual who resides outside of the
physical boundaries of the Commonwealth.
B. Waiver services (with the exception of
transition services) shall not be furnished to individuals who are inpatients
of a hospital, nursing facility, ICF/IID, or inpatient rehabilitation facility.
Individuals with DD who are inpatients of these facilities may receive support
coordination services as described in
12VAC30-50-440
or
12VAC30-50-490.
1. The support coordinator may recommend
waiver services that would promote the individual's exiting from an
institutional placement.
2.
However, the FIS, CL, or BI waiver services shall not be provided until the
individual has exited the institution and has been enrolled in the
waiver.
C. DMAS shall
not reimburse providers for the costs of room and board attributed to the
member, education, services covered by other payers, or participation in social
or recreational activities.
Notes
Statutory Authority: § 32.1-325 of the Code of Virginia; 42 USC § 1396 et seq.
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