048-45 Wyo. Code R. § 45-36

Current through April 27, 2019
Section 45-36 - Recertification of Providers

(a) The Division shall notify providers in writing that their certification is expiring at least 90 calendar days prior to the certification expiration date. The letter shall detail the requirements the provider must meet to be recertified.

(b) Providers who require an on-site visit shall request recertification from the Division at least 60 calendar days prior to their certification expiration date. Providers who do not require an on-site visit shall submit verification that they have met all applicable requirements to the Division at least 45 calendar days prior to their certification expiration date.

  • (i) If a provider fails to notify the Division requesting recertification or fails to submit requirements to the Division at least 45 calendar days prior to the certification expiration date, the Division shall notify the provider in writing of the expiration of the certification and grant the provider 15 business days to meet the recertification requirements.
    • (A) If the provider does not meet the recertification requirements within the 15 business days of the date of the letter from the Division, the provider's certification shall expire and the provider shall need to reapply to the Division to become a certified provider.
    • (B) Providers shall be notified in writing that their certification has expired by certified letter.

(c) The Division shall review providers' certification requirements and shall complete a written report, including a statement of recommendations, within 30 calendar days. The Division may:

  • (i) Approve the certification for a period of up to two years.
  • (ii) Approve the certification for a period of one year with recommendations that identify deficiencies that affect the health, safety, welfare, rights or habilitation of participants.
  • (iii) Approve the certification for a period of less than a year with recommendations that identify deficiencies that seriously affect the health, safety, welfare, rights, or habilitation of participants or for providers who have failed to comply with the rules and standards applicable to the services they are providing.

(d) The provider shall submit a quality improvement plan for each recommendation made in the written report.

  • (i) The quality improvement plan shall include action steps, responsible parties, and dates of completion for each recommendation.
    • (A) For recommendations that identify deficiencies that relate to health, safety, welfare, or rights of participants, the provider shall submit the quality improvement plan to the Division within 15 business days of date of the report.
    • (B) For all other recommendations, the provider shall submit the quality improvement plan to the Division within 30 calendar days of receipt of the written report from the Division.
  • (ii) If the quality improvement plan is not received by the Division within the required timeframe, the Division shall notify the provider in writing that the Division may impose probation, a monitor, or revoke the provider's certification pursuant to Section 36 and Section 37 of this Chapter unless the Division receives the quality improvement plan.

(e) The Division shall notify the provider in writing within 30 calendar days after receipt of the provider's quality improvement plan regarding the approval of the plan.

  • (i) If the quality improvement plan is not approved, the provider shall receive notification in writing of the reasons for the disapproval and will be required to submit a revised plan within 10 business days of receipt of the written disapproval from the Division.
  • (ii) If the second quality improvement plan is not approved, the provider shall have 15 calendar days from notification of the disapproval to submit an acceptable plan or the Division may impose probation, a monitor, or revoke the provider's certification pursuant to Section 36 and Section 37 of this Chapter.

(f) The Division shall complete appropriate follow-up monitoring to assure that the actions identified in the provider's quality improvement plan have been completed within the specified time frame.

048-45 Wyo. Code R. § 45-36