If the service recipient needs more service hours authorized than the waiver service definitions allow, is there an appeal process?
Service hours in excess of the limits specified in the approved waiver document are considered non-covered. Federal matching funds would not be available to pay for services in excess of the limits specified. The service appeals process described in Chapter 2 of the Provider Manual applies anytime a service is requested and denied. Generally, non-covered services are not authorized via the appeals process.
