Library: Policy

317:50-1-7. Certification for Medically Fragile Waiver program services

Issued 8-1-10

(a) Financial certification period for Medically Fragile Waiver program services.  The financial certification period for the Medically Fragile Waiver program is 12 months. 

(b)  Medical Certification period for Medically Fragile Waiver program services.  The medical certification period for Medically Fragile Waiver program services is 12 months.  Reassessment and redetermination of medical eligibility is completed in coordination with the annual recertification of the member's service plan. If documentation supports a reasonable expectation that the member will not continue to meet medical eligibility criteria or have a need for long term care services for more than 12 months, an independent evaluation of medical eligibility is completed before the end of the current medical certification period.