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Wyoming Medicaid Rules, Chapter 34 — Home and Community Based Services Community Choices Waiver Program (Wyo. Code R. 048.0037.34)

WyomingregulationWyoming Department of Health, Division of Healthcare Financing

What this rule requires your agency to do

  • 1Providers shall submit verification that they have met all applicable certification renewal requirements forty-five (45) calendar days prior to their certification expiration date (Section 8(j)).(Wyoming Medicaid Rules, Chapter 34 — Home and Community Based Services Community Choices Waiver Program (Wyo. Code R. 048.0037.34))
  • 2After assuring the health and safety of the participant, a provider shall immediately report critical incidents (suspected abuse, neglect, self-neglect, abandonment, exploitation, intimidation, sexual abuse, and unexpected death) to the Department, the participant's case manager, and legal guardian (Section 15(b)).(Wyoming Medicaid Rules, Chapter 34 — Home and Community Based Services Community Choices Waiver Program (Wyo. Code R. 048.0037.34))
  • 3A provider shall report non-critical incidents (serious injury, elopement, seclusion, unscheduled medical/behavioral admissions and ER visits during service, use of restraint, unauthorized restrictive interventions, other deaths) within three (3) business days (Section 15(c)).(Wyoming Medicaid Rules, Chapter 34 — Home and Community Based Services Community Choices Waiver Program (Wyo. Code R. 048.0037.34))
  • 4A provider delivering a waiver service requiring electronic visit verification shall utilize the Department's EVV system or another compliant EVV system that connects to and interacts with the Department's EVV system for integration and billing (Section 20(e)).(Wyoming Medicaid Rules, Chapter 34 — Home and Community Based Services Community Choices Waiver Program (Wyo. Code R. 048.0037.34))
  • 5A provider shall document for each service the location, date, start and end times, initial or signature of the staff member, and a detailed description of services, and shall make service documentation available to the case manager by the tenth (10th) business day of the following month (Section 20(a), (g)).(Wyoming Medicaid Rules, Chapter 34 — Home and Community Based Services Community Choices Waiver Program (Wyo. Code R. 048.0037.34))
  • 6The Department shall not pay CCW funds to any individual or entity providing services to a participant unless the individual or entity is party to a fully executed provider agreement and is enrolled as a Medicaid provider and certified as a CCW provider (Section 8(a)).(Wyoming Medicaid Rules, Chapter 34 — Home and Community Based Services Community Choices Waiver Program (Wyo. Code R. 048.0037.34))
  • 7A CCW provider shall notify the participant and the Department in writing thirty (30) calendar days prior to ending services with the participant (Section 9(g)).(Wyoming Medicaid Rules, Chapter 34 — Home and Community Based Services Community Choices Waiver Program (Wyo. Code R. 048.0037.34))
  • 8All CCW providers, associated staff members, and adult volunteers with unsupervised access to participants shall complete a background screening including a DFS Central Registry screening, HHS-OIG Exclusions Database search, national name/SSN-based criminal history screening, and DOJ National Sex Offender Public Website search, and shall complete a full subsequent screening every five (5) years (Section 10(a), (d), (i)).(Wyoming Medicaid Rules, Chapter 34 — Home and Community Based Services Community Choices Waiver Program (Wyo. Code R. 048.0037.34))

Applies to: CCW-certified providers (including home care/personal support agencies), case management agencies, participant-directed employers, waiver participants

This chapter governs the Community Choices Waiver program, establishing eligibility, provider certification and decertification, background screening, training, covered services, participant rights, HCBS settings standards, case management, participant direction, EVV-linked service documentation, and incident reporting requirements.

Regulatory information, not legal advice — always confirm against the cited official source. Verification reduces error; it does not certify compliance.