Wyoming Medicaid Rules, Chapter 45 — DD Waiver Provider Standards, Certification, and Sanctions (Wyo. Code R. 048.0037.45)

What this rule requires your agency to do

• 1All individual waiver providers, subcontractors, and provider employees offering direct services shall be 18 or older, be certified by the Division, maintain current CPR and First Aid certification, have email/internet access to a Division portal, and, if assisting with medications, maintain a current Division medication assistance training certificate (Section 5(a)).(Wyoming Medicaid Rules, Chapter 45 — DD Waiver Provider Standards, Certification, and Sanctions (Wyo. Code R. 048.0037.45))
• 2The provider shall make service documentation for services rendered available to the case manager each month by the tenth (10th) business day of the following month, including reporting zero units when no services were delivered (Section 8(n)).(Wyoming Medicaid Rules, Chapter 45 — DD Waiver Provider Standards, Certification, and Sanctions (Wyo. Code R. 048.0037.45))
• 3Providers shall report suspected abuse, neglect, exploitation, intimidation, abandonment, sexual abuse, and death immediately to the Division, DFS, Protection & Advocacy, the case manager, legally authorized representatives, and law enforcement; restraint use, seclusion, serious injury, elopement, police involvement, and unscheduled ER/hospital visits within one (1) business day; and specified medication errors within three (3) business days (Section 20(a)-(c)).(Wyoming Medicaid Rules, Chapter 45 — DD Waiver Provider Standards, Certification, and Sanctions (Wyo. Code R. 048.0037.45))
• 4A provider terminating services with a participant shall notify the participant and the Division in writing at least thirty (30) calendar days before ending services; failure to serve during that period is abandonment and may result in decertification (Section 22(b)).(Wyoming Medicaid Rules, Chapter 45 — DD Waiver Provider Standards, Certification, and Sanctions (Wyo. Code R. 048.0037.45))
• 5A case management agency and any managing employee shall not own, operate, be employed by, or have a financial interest in or relationship with any other entity providing services to a participant (conflict-free case management) (Section 5(b)(ii)(D)(III)).(Wyoming Medicaid Rules, Chapter 45 — DD Waiver Provider Standards, Certification, and Sanctions (Wyo. Code R. 048.0037.45))
• 6All persons providing waiver services or with unsupervised access to participants shall complete and pass background screening (DFS Central Registry, OIG Exclusions Database, and state/national fingerprinted criminal history check), with subsequent screenings every five (5) years and monthly OIG checks for owners/managing employees (Section 14(a), (e), (n)).(Wyoming Medicaid Rules, Chapter 45 — DD Waiver Provider Standards, Certification, and Sanctions (Wyo. Code R. 048.0037.45))
• 7Providers shall complete all required documentation, including required signatures, before or at the time a claim is submitted; documentation prepared after claim submission is prohibited and Medicaid funds shall be withheld or recovered (Section 8(b)).(Wyoming Medicaid Rules, Chapter 45 — DD Waiver Provider Standards, Certification, and Sanctions (Wyo. Code R. 048.0037.45))
• 8Case managers must hold a qualifying Master's, Bachelor's (plus 1 year experience), or Associate's degree (plus 4 years experience), obtain and maintain their own NPI, and provide evidence of eight (8) hours of continuing education each certification year (Section 5(b)(ii)(A)-(C)).(Wyoming Medicaid Rules, Chapter 45 — DD Waiver Provider Standards, Certification, and Sanctions (Wyo. Code R. 048.0037.45))