Form F-10142 Interagency Notification of Termination of Medicaid Waiver Eligibility for a Community Waiver Participant - Wisconsin

Form F-10142 Interagency Notification of Termination of Medicaid Waiver Eligibility for a Community Waiver Participant - Wisconsin

What Is Form F-10142?

This is a legal form that was released by the Wisconsin Department of Health Services - a government authority operating within Wisconsin. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form F-10142?
A: Form F-10142 is a document used to notify the termination of Medicaid waiver eligibility for a Community Waiver Participant in Wisconsin.

Q: Who uses Form F-10142?
A: Form F-10142 is used by the Wisconsin Medicaid program to notify individuals of the termination of their Medicaid waiver eligibility.

Q: What is a Community Waiver Participant?
A: A Community Waiver Participant is an individual who receives Medicaid services through a waiver program that allows them to receive care in their community instead of in a facility.

Q: What does it mean when someone's Medicaid waiver eligibility is terminated?
A: When someone's Medicaid waiver eligibility is terminated, it means they are no longer eligible to receive services through the waiver program.

Q: Why would someone's Medicaid waiver eligibility be terminated?
A: There are several reasons why someone's Medicaid waiver eligibility may be terminated, such as no longer meeting the eligibility criteria or failure to comply with program requirements.

Q: What should a person do if their Medicaid waiver eligibility is terminated?
A: If someone's Medicaid waiver eligibility is terminated, they should contact the Wisconsin Medicaid program to inquire about their options and possible next steps.

Q: Is there an appeal process for the termination of Medicaid waiver eligibility?
A: Yes, there is an appeal process available for individuals whose Medicaid waiver eligibility is terminated. They have the right to request a fair hearing to contest the termination decision.

ADVERTISEMENT

Form Details:

  • Released on July 1, 2008;
  • The latest edition provided by the Wisconsin Department of Health Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form F-10142 by clicking the link below or browse more documents and templates provided by the Wisconsin Department of Health Services.

Download Form F-10142 Interagency Notification of Termination of Medicaid Waiver Eligibility for a Community Waiver Participant - Wisconsin

4.5 of 5 (26 votes)
  • Form F-10142 Interagency Notification of Termination of Medicaid Waiver Eligibility for a Community Waiver Participant - Wisconsin, Page 1
ADVERTISEMENT