WY · guidance
Wyo. Medicaid Institutional Provider Manual § 16.1.2
Hospice Benefit Revocation
When a Member chooses to revoke their hospice election, a copy of the Hospice Benefit Revocation
Form (see Section 16.1.2.1 Hospice Benefit Revocation Form) must be submitted to Wyoming Medicaid
Provider Services and the Long Term Care Unit (see Section 2.1 Quick Reference). The hospice lock-in will
be removed from the Member’s file and they will be able to receive services as applicable.
Only the WDH Hospice Revocation Form will be accepted by Medicaid.
Provenance
- Source
- www.wyomingmedicaid.com
- Retrieved
- 2026-10-02
- Edition
- wy-ipm-16-2026-10-01
- Content hash
b61ce83a32d0be635d2da8f0d29c3700f409dd6ac11edaa9557cf2484ccd49ac
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