Statutes, codes, and regulations
Wyoming Administrative Code
Agency 048 - Health, Department ofSubagency 0037 - Medicaid
Chapter 45 - DD WAIVER PROVIDER STANDARDS, CERTIFICATION, AND SANCTIONS
Section 45-25 - Additional Standards for Providers that Require National Accreditation

048-45 Wyo. Code R. § 45-25

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Current through April 27, 2019
Section 45-25 - Additional Standards for Providers that Require National Accreditation

(a) Providers who are certified in Residential Services, Supported Living, Community Integration, Adult Day Services, Prevocational, or any Supported Employment Service shall receive and maintain national accreditation in the accreditation areas specific to the service being provided if:

  • (i) The provider is on the individualized plan of care for three (3) or more participants; and
  • (ii) The provider's total income for all billed waiver services equals or exceeds $125,000 collectively per calendar year.
  • (iii) Providers shall obtain accreditation in the area applicable to each service within eighteen (18) months of qualifying under this provision.

(b) Provider accreditation options include Commission on Quality and Leadership (CQL) or Commission on Accreditation of Rehabilitation Facilities (CARF). Regardless of the accreditation attained, all references to accredited providers in this rule apply to the provider.

(c) The Division shall decertify a provider who fails to obtain or maintain accreditation.

(d) If a provider fails to obtain or maintain accreditation, a transition plan shall be implemented for each participant who is leaving the provider's services.

  • (i) Each waiver participant shall be relocated to a different provider within ninety (90) days of the date the Division receives confirmation that the provider did not receive accreditation. If a provider fails to obtain or maintain accreditation, the Division shall complete an immediate site survey and onsite assessment.
  • (ii) The provider's decertification date shall begin ninety (90) days from the date of written notice from the accrediting entity that the provider did not receive accreditation.

(e) An accredited provider shall submit all national accreditation report documents to the Division within thirty (30) days of receiving the report documents from the accrediting entity.

048-45 Wyo. Code R. § 45-25

Amended, Eff. 6/21/2017.

Amended, Eff. 7/26/2018.