048-2 Wyo. Code R. §§ 2-7 - Medical Eligibility Statement of Purpose

(a) Children's Special Health in Wyoming provides services for Children with Special Health Care Needs who have chronic conditions which may be rehabilitated. MHR/NBIC provides limited financial assistance to high risk pregnant women and/or infants receiving tertiary care as ordered by their provider(s).

(i) The CSH Program provides services for Children with Special Health Care Needs such as congenital anomalies, cardiac problems, neurological difficulties, tumors, rehabilitation secondary to trauma or infectious disease, and other specific chronic conditions.

(ii) MCH is not a health care provider. Each client is expected to have a primary care physician, obstetrician, or pediatrician to provide care.

(iii) Case management of each client is done by the family and health care providers in conjunction with MCH.

(iv) CSH may provide for diagnostic evaluation regarding conditions that may qualify for the Program. Following the initial diagnostic evaluation, a determination is made regarding medical eligibility.

(v) MCH clients are treated by providers who are approved by MCH. Specific requirements for provider approval are available at the MCH State office.

(vi) CSH Wyoming health care providers are given priority when equivalent care is available Wyoming,

(vii) MCH coverage is only provided for those diagnoses for which the client has been determined to be medically eligible.

(viii) MCH services shall be authorized by the Program before reimbursement is honored.

(ix) Financial assistance through MCH is constrained by available funding. Services may be altered to reflect current resources available.

Notes

048-2 Wyo. Code R. §§ 2-7