Intent to Amend Chapters 44, 45, and 46 of the Department of Health's Medicaid Rules
Public notice is hereby given that the Wyoming Department of Health (Department) proposes to amend the following rules addressing the Supports and Comprehensive Waivers pursuant to its statutory authority in Wyoming Statute § 9-2-102 and the Wyoming Medical Assistance and Services Act at Wyoming Statutes §§ 42-4-101 through -121.
- Wyoming Medicaid Rules – Chapter 44 – Environmental Modifications, Specialized Equipment, and Self-Directed Goods for Medicaid Home and Community Based Waiver Services;
- Wyoming Medicaid Rules – Chapter 45 – DD Waiver Provider Standards, Certification, and Sanctions; and
- Wyoming Medicaid Rules – Chapter 46 – Medicaid Supports and Comprehensive Waivers.
All chapters are amended to align with federal requirements, state statute, Division of Healthcare Financing practice, and the Supports and Comprehensive Waiver agreements, which have been approved by the Centers for Medicare and Medicaid Services. All chapters reflect overall language clean up and clarification.
Chapter 44 outlines the specific requirements of environmental modifications, specialized equipment, and self-directed goods and services. This amendment changes the name of the chapter and removes Sections 9 and 10, which refer to “Self-directed Goods.” This service has been eliminated from the Supports and Comprehensive Waivers.
Chapter 45 governs certification of providers under the Supports and Comprehensive Waivers. It describes waiver provider standards, participant rights, and certification and sanction requirements. Although the list is not exhaustive, key modifications are described below:
- Section 4 – Rights of Participants Receiving Services – clarifies participant rights and establishes additional plan of care team requirements if the right to be free from restraint is limited.
- Section 10 – Individualized Plan of Care – revises the timeframe a case manager has to provide notice of the plan of care meeting to at least twenty (20) calendar days prior to the meeting.
- Section 13 – Home and Community Based Standards for Waiver Services – outlines additional requirements of waiver providers related to site inspections, emergency plans, and remote monitoring.
- Section 14 – Background Check Requirements – updates background screening requirements for waiver providers.
- Section 17 – Positive Behavior Supports – establishes additional situations in which a positive behavior support plan shall be reviewed.
- Section 18 – Restraint Standards – establishes additional provider training requirements in the event an injury occurs as a result of a restraint.
- Section 25 – Additional Standards for Providers that Require National Accreditation – updates provider obligations to obtain national accreditation.
Chapter 46 replaces Emergency Chapter 46 and addresses Supports and Comprehensive Waiver requirements, including assessment, eligibility, cost limits, and emergency services. It establishes a person-centered approach to determine participant support needs in the individualized plan of care. Although the list is not exhaustive, key modifications are described below:
- All sections subsequent to Section 3 have been renumbered.
- Section 4 (previously Section 5) – Assessment and Eligibility – changes title to Eligibility Requirements. Rearranges and simplifies section to make the flow of the eligibility process more understandable.
- New Sections added to make the eligibility process more understandable.
- Section 5 – Loss of Eligibility
- Section 6 – Institutional Level of Care Requirements
- Section 7 – Clinical Eligibility Diagnoses
- Section 8 – Inventory for Client and Agency Planning Assessment
- Section 15 (previously Section 13) – Extraordinary Care Committee – modifies requirements for Extraordinary Care Committee reviews.
As required by Wyoming Statute § 16-3-103(a)(i)(G), these proposed rules meet minimum substantive state statutory requirements
To obtain a copy of these Rules, visit https://health.wyo.gov/
Shirley Pratt, Policy Analyst
Wyoming Department of Health
6101 Yellowstone Road, Suite 220
Cheyenne, WY 82002
A public hearing will be held if requested by 25 persons, by a governmental subdivision, or by an association having not less than 25 members.
The Department welcomes all comments on the proposed amended rules. Any person may urge the Department not to amend these rules and may request that the Department state its reasons for overruling the consideration urged against the amendment. Written comments must be submitted to the above address no later than 5PM on November 1, 2019.
Interested parties may request a statement of the Department’s position regarding each comment and the action taken as a result of the comments prior to, or within thirty (30) days after, Department action. Requests must be submitted to the above address. If requested, the statement will be issued by the Department within thirty (30) days after Department action.
Department of Health Medicaid Rules Governing the Comprehensive and Supports Waiver Programs
Chapter 44 – Environmental Modifications, Specialized Equipment, and Self Directed Goods – Effective 7.26.2018
Chapter 45 – DD Waiver Provider Standards, Certification, and Sanctions – Effective 7.26.2018
Emergency Chapter 46 – Medicaid Supports and Comprehensive Waivers – Extended 8.27.2019
To review other Medicaid Chapters, visit https://rules.wyo.gov/.
- Select Current Rules
- Select Health, Department of (048)
- Select Medicaid (0037)
- Select the Chapter you wish to review
Policies Governing the Wyoming Departing of Health, Developmental Disabilities Section