Joe Manchin III
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| |STATE OF WEST VIRGINIA | |
| |DEPARTMENT OF HEALTH AND HUMAN RESOURCES | |
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|Bill J. Crouch | | Cynthia E. Beane |
|Cabinet Secretary | |Commissioner |
Kepro
CSEDW Program
1007 Bullitt Street, Suite 200
Charleston, WV 25301
Telephone: 1-844-304-7107 Fax: 1-866-473-2354
To: APPLICANT NAME
APPLICANT NAME
APPLICANT ADDRESS 1
APPLICANT ADDRESS 2
From: CSEDW Program Manager
WV Bureau for Medical Services
Date: DATE
Re: Initial Application Closure: Financial Eligibility Not Established
Our records indicate that you do not meet the financial eligibility requirements to be able to receive/enter the CSED waiver program.
This letter is to inform you that because you do not meet financial eligibility requirements, we have closed your application for consideration into the WV CSED Waiver Program. If you wish to pursue program consideration, you will need to reapply by completing another WV-BMS-CSED-1 Application Form and submitting it to KEPRO along with proof of financial eligibility from the Department of Health and Human Resources (DHHR).
Questions regarding the information contained in this letter may be directed to KEPRO by calling 1-844-304-7107 or via email at: wvcsedw@. Questions can also be mailed to: KEPRO 1007 Bullitt Street, Suite 200, Charleston, WV 25301.
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Bureau for Medical Services
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