Public Notices, Regulatory Documents, and Reports

NOTICE OF INTENT TO RENEW
Comprehensive and Support Waiver Programs

Public Comment is Now Closed 

Draft Supports Waiver Agreement

Draft Comprehensive Waiver Agreement

Summary of Proposed Changes

Appendix D: Original Model – Waiver Service Rates

Draft Comprehensive and Supports Waiver Service Index

Draft Comprehensive and Supports Waiver Fee Schedule

PUBLIC NOTICE

Intent to Adopt Amended Rule
Wyoming Department of Health

Public notice is hereby given that the Wyoming Department of Health proposes to adopt the following Rule pursuant to its statutory authority in Wyoming Statutes §§ 42-4-101 through -124.

Wyoming Medicaid Rule Chapter 34
Home and Community Based Services
Community Choices Waiver Program

Chapter 34 applies to and governs the Home and Community Based Services, Community Choices Waiver Program (CCW), including eligibility, provider enrollment and participation, covered services, participant rights and safeguards, home and community based settings, critical incident reporting and participant driven services. The Rule also covers CCW service authorization, reimbursement and documentation standards.

The proposed amendment to Chapter 34 is intended to clarify and further explain CCW’s participant application, eligibility, reserved capacity and waiting list procedures, provider qualifications, participation standards, certification, decertification, and reinstatement processes. The proposed amendment outlines the provider background screening criteria and procedures, establishes CCW training requirements for delivery of services, and also adds the service categories covered by the CCW program.

The proposed amendment clarifies and explains CCW participants’ rights and safeguards, provider incident reporting and handling of complaints, and the criteria and standards for all home and community-based settings. The proposed amendment establishes the case management and service planning requirements and the procedures and criteria for participant direction of CCW services. The proposed amendment is intended to simplify the CCW payment and submission of claims procedures, and to establish the electronic visit verification documentation standards. Lastly, the proposed amendment generally updates the incorporation by reference sections and formatting to comply with current requirements.

To provide public comment or obtain a copy of this Amended Rule, contact:

Matthew Crandall, Policy and Communications Unit Manager
Division of Healthcare Financing, Medicaid
Wyoming Department of Health
122 W. 25th Street, 4 West
Cheyenne, WY 82002
(307) 777-7366
matthew.crandall2@wyo.gov

The Amended Rule can also be viewed online at the Public Notices, Regulatory Documents, and Reports of the HCBS website page, under the Chapter 34 Public comment toggle.

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 Wyoming Departments of Health welcomes all comments and suggestions on the proposed Amended Rule. Any person may urge the Agency not to adopt this Amended Rule and may request that the Agency state its reasons for overruling the consideration urged against adoption. Written comments must be submitted to the above address no later than 5:00 p.m. on October 9, 2023.

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, adoption of this Amended Rule. Requests must be submitted to the above addresses. If requested, the statement will be issued by the Department within thirty (30) days after the Agency action.

Dated this 15th day of August, 2023.

Stefan Johansson, Director
Wyoming Department of Health

Chapter 34

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Dear Comprehensive or Supports Waiver Participant:

During the 2023 General Session of the Wyoming Legislature, the Wyoming Legislature passed House Enrolled Act 0037, the budget bill that includes two provider reimbursement rate increases that affect the Comprehensive and Supports Waiver (DD Waiver) providers. 

 The first increase applies to DD Waiver agency providers, which are defined as providers that designate wages and employ staff members other than themselves.  These providers must legally report employee earnings to the Internal Revenue Service.   Agency rates will align with the rates identified in Appendix D – Original Model – Waiver Service Rates, of the Comprehensive and Supports Waivers SFY 2023 Provider Rate Study.  Please note that rates for independent providers will be held harmless and will not be decreased to align with this Appendix.

An additional increase to all provider reimbursement rates is also included in the waiver amendments.  The increase applies to all DD Waiver providers, and is over and above the increase for agency providers.  All provider rates that are paid based on a billing unit, regardless of provider type, will be increased by approximately 2%.

Due to the overall 2% increase of all provider rates, your individual budget amount (IBA) will increase.  If you receive services from an agency provider, you may see an increase to your IBA that is over and above the 2%.  The 2% increase is available to you for any modifications you would like to make to your individualized plan of care (IPC), but  IBA increases associated with agency rates can only be used for these specific services, meaning that you will not be able to modify your IPC to use the increase for a different service once your IBA has changed.

Your IBA will be adjusted if you choose a different provider type.  For example, if you receive one of these services from an agency as of December 1st, and select an independent provider on January 1st, your IBA will be adjusted down to account for the independent provider rate.  If you receive one of these services from an independent provider as of December 1st, and select an agency provider on January 1st, your IBA will be adjusted up to account for the agency provider rate.  Your IBA will be reflective of the number of service units that are currently on your IPC, so your purchasing power for these services will remain the same.

 Please work with your case manager and plan of care team to account for these changes in your IBAs during your next annual plan renewal meeting.  No other action is required from you at this time.  For additional information on these rate changes, please refer to the Frequently Asked Questions for the October 2023 Provider Rate Increase.  This document, as well as the updated Comprehensive and Supports Waiver Service Index and fee schedule, will be available at https://health.wyo.gov/healthcarefin/hcbs/servicesandrates/ beginning October 1, 2023