Public Notices, Regulatory Documents, and Reports

PUBLIC NOTICE

April 13, 2021

PUBLIC NOTICE TO AMEND THE COMPREHENSIVE AND SUPPORTS WAIVERS TO IMPLEMENT HIGH NEEDS MODEL RATE INCREASE

Notice is hereby given to the public that the Wyoming Department of Health, Division of Healthcare Financing (Division) intends to submit an application to amend the Supports and Comprehensive Medicaid Waiver programs to the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS).

The Supports and Comprehensive Waiver programs provide eligible individuals with a developmental or intellectual disability, or an acquired brain injury, a community-based alternative to the care provided in an institution. The proposed amendments will reflect the increase in specific service reimbursement rates for agency providers, as identified in Senate Enrolled Act 12 adopted during the 2022 Wyoming State Legislative Session (https://wyoleg.gov/2022/Enroll/SF0001.pdf). The proposed amendments will also add an individual and agency provider type definition for any affected services. The amendment applications will have a proposed effective date of September 1, 2022.

Proposed Waiver Amendment – Comprehensive – Submitted to CMS 5/17/2022

Proposed Waiver Amendment – Supports – Submitted to CMS on 5/17/2022

Summary of Proposed Changes

High-Needs Model Rate Increase Frequently Asked Questions (FAQ)

Summary of Public Comment

Draft Fee Schedule of Proposed Rates

Draft DD Waiver Service Index

PUBLIC NOTICE
October 10, 2021

CHANGES TO STATEWIDE METHODS AND STANDARDS FOR SETTING PROVIDER PAYMENT RATES FOR THE COMPREHENSIVE AND SUPPORTS WAIVERS

This notice of changes in statewide methods and standards for setting payment rates is provided in accordance with the provisions of 42 CFR § 447.205.  The Wyoming Department of Health, Division of Healthcare Financing (Division) proposes and seeks public comment on the following changes:

Implementation of Supports and Comprehensive Waiver provider payment rate methodology as established in the Guidehouse report entitled Comprehensive and Supports Waivers SFY2023 Provider Rate Study.

In 2008, the Department of Health was required by state statute (W.S. 42-4-120 (g)) to establish a cost-informed reimbursement system to pay providers of services and supplies under home and community based waiver programs for persons with developmental disabilities or acquired brain injury. This state statute also required that rates be rebased at least once every four (4) years, but not more than once in any two (2) year period. 

The proposed rate methodology uses an independent rate build-up approach based on cost and wage data from providers and other state and national data sources. The independent rate build-up methodology comprises direct care and indirect care components and uses assumptions about types of employees; wage rates; benefits; program support and administration costs; supervisor span of control; staffing patterns; and direct care work productivity factors. The anticipated increase to the annual aggregate expenditures is approximately $9,458,515. 

The Centers for Medicare and Medicaid Services (CMS) approved applications to amend the rate determination methods described in Appendix I-2 of the Supports and Comprehensive Waivers.  The Comprehensive and Supports Waivers SFY 2023 Provider Rate Study report is available under the Statistics and Reports section of this webpage.

Public comment on these proposed changes closed on Tuesday, November 9, 2021.  Amendments have been approved by CMS.

PUBLIC NOTICE

February 28, 2021

CHANGES TO STATEWIDE METHODS AND STANDARDS FOR SETTING PROVIDER PAYMENT RATES

Public notice is hereby given that the Wyoming Department of Health, Division of Healthcare Financing (the Division) intends to change the methods and standards for setting payment rates for services rendered under the Community Choices Waiver (CCW) program. This notice is provided consistent with the requirements at 42 CFR §447.205.

The Division conducted a study and updated the CCW program’s reimbursement methodology in preparation of its application to renew the program for another five-year waiver period. The revised CCW rate model primarily employs a cost factor build-up approach to identify and calculate the reasonable and necessary direct and indirect provider costs associated with waiver service delivery. The Division’s rate model then combines the estimated cost factors to calculate the maximum allowable reimbursement rate for each waiver service. The CCW rate model’s net impact on annual program expenditures is estimated at $950,000, or 2.5%.

The Community Choice Waiver SFY 2022 Provider Rate Study report is available under the Statistics and Reports section of this webpage.

CCW Rate Change Implementation Frequently Asked Questions (FAQs)

Service Plan Modifications for CCW Rate Changes Frequently Asked Questions (FAQs) 

Responses to CCW Case Manager Rate Change Questions