048-11 Wyo. Code R. § 11-6

Current through April 27, 2019
Section 11-6 - Provider participation and responsibilities

(a) Compliance with Chapter 3. An individual or entity that wishes to receive Medicaid funds for medical supplies, durable medical equipment or prosthetic devices furnished to a recipient must meet the requirements of Chapter 3.

(b) Eligible providers.

  • (i) A pharmacy; or
  • (ii) A non-pharmacy that has a current, valid business license as required by the laws of the State of Wyoming or the State where the business is located.

(c) Provider Responsibilities. Providers shall be responsible for the delivery of the prescribed durable medical equipment, prosthetic device, or supplies. After delivery, if an item is determined to be inappropriate or incorrect, the provider is responsible for retrieving the durable medical equipment or supplies within five (5) working days after being notified of the problem by the client or the Department. Claims for items known to be awaiting pickup by the provider cannot be billed to the Medicaid program. If billing occurs prior to notice that pickup is necessary, the provider shall submit an adjustment with in twenty (20) working days following the date of pickup. Providers shall be responsible for confirmation of continued need for disposable supplies by contact with the client or client's caretaker prior to shipment of supplies. Continued need shall be confirmed by a current prescription which contains a statement of length of need.

(d) Compliance with 42 CFR 424.57. An individual or entity which wishes to receive Medicaid funds for services must meet the requirements to be a DMEPOS (durable medical equipment, prosthetics, orthotics, and supplies) supplier and must follow the procedures and comply with the standards as set forth in 42 CFR 424.57, except that the term "Medicaid" shall replace the term "Medicare," and "Department" shall replace "CMS".

048-11 Wyo. Code R. § 11-6

Amended, Eff. 2/8/2017.