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Wyoming Medicaid Rules, Chapter 46 - Medicaid Supports and Comprehensive Waivers (Sections 7, 8, 10)

WyomingregulationWyoming Department of Health, Division of Healthcare Financing (Medicaid)

What this rule requires your agency to do

  • 1The agency/Division must obtain Division approval before scheduling a psychological or neuropsychological evaluation triggered by a change in condition, and must perform a subsequent neuropsychological evaluation every five (5) years. (ch. 46, § 7(b))(Wyoming Medicaid Rules, Chapter 46 - Medicaid Supports and Comprehensive Waivers (Sections 7, 8, 10))
  • 2The agency/Division must ensure each participant receives a qualifying Inventory for Client and Agency Planning (ICAP) assessment score for the participant's age as a condition of waiver eligibility before waiver services are provided. (ch. 46, § 8)(ch. 46, § 8)
  • 3The provider must ensure the plan of care reflects the services and actual units that providers agree to provide over the plan year. (ch. 46, § 10(d))(Wyoming Medicaid Rules, Chapter 46 - Medicaid Supports and Comprehensive Waivers (Sections 7, 8, 10))
  • 4The provider must ensure the individualized plan of care is based on the participant's assessed needs, meets the service definitions, is medically or functionally necessary, and aligns with the participant's preferences for services, supports, and providers. (ch. 46, § 10(a))(Wyoming Medicaid Rules, Chapter 46 - Medicaid Supports and Comprehensive Waivers (Sections 7, 8, 10))
  • 5The agency/Division must reassess each participant for clinical eligibility at least annually, or more frequently when a change in circumstances requires a higher level of services or support to ensure the participant's health, safety, and welfare. (ch. 46, § 7(b))(Wyoming Medicaid Rules, Chapter 46 - Medicaid Supports and Comprehensive Waivers (Sections 7, 8, 10))
  • 6The Division's designee must administer the ICAP assessment and complete it every five (5) years, or more frequently at the Division's option, to verify continued waiver clinical eligibility. (ch. 46, § 8(b))(Wyoming Medicaid Rules, Chapter 46 - Medicaid Supports and Comprehensive Waivers (Sections 7, 8, 10))

Applies to: HCBS waiver services for individuals with intellectual/developmental disabilities, including personal-care-type in-home supports

Wyoming Medicaid Rules Chapter 46 governs the Supports and Comprehensive HCBS waivers. It conditions waiver eligibility on a qualifying ICAP assessment, requires reassessment of clinical eligibility at least annually (or more often on a change of circumstances), sets a five-year cycle for the ICAP and neuropsychological evaluations, and requires the individualized plan of care to be built on the participant's assessed needs.

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