Section 27-4 - Provider Participation and Enrollment (a) A provider that requests Medicaid reimbursement for services furnished to a participant shall meet the provider participation requirements of Chapter 3 and 42 C.F.R. § 460.200.
(b) A provider desiring the designation of PACE provider must complete and submit an application to CMS that describes how the applying organization meets all the requirements in 42 C.F.R. § 460. - (i) The application shall be competed in collaboration with the Department in accordance with CMS PACE application guidelines at www.cms.gov.
- (ii) Upon completion of the application the applying organization shall submit it for review by the Department.
- (iii) The Department shall review the PACE application to ensure compliance to State rules and regulations.
- (iv) Once the Department has verified that the application adheres to State requirements for PACE, the application shall be submitted by the Department to CMS review and approval.
- (A) CMS evaluates PACE program provider applications in accordance with CMS PACE application guidelines. The evaluation will include an on-site-review at the provider's place of business by CMS and Department representatives.
- (B) CMS provides notification of determination based on timelines outlined in 42 C.F.R. § 460
- (v) Upon approval of the application, CMS, the Department, and the PACE provider shall sign a three-way Program Agreement authorizing the PACE provider to market and engage in enrollment activities, pursuant to 42 C.F.R. § 460, Subpart C.
(c) PACE provider employees and contractors who provide direct contact services to PACE participants shall meet the qualifications defined in 42 C.F.R. § 460.
048-27 Wyo. Code R. § 27-4