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

Universal Citation: WY Code of Rules 45-25

Current through September 21, 2024

(a) Providers that are certified in Adult Day, Case Management, Community Living, Community Support, Companion, or Supported Employment Services shall receive and maintain national accreditation in the accreditation areas specific to the service being provided if the services listed in this subsection and delivered by the provider collectively equal or exceed $150,000 per calendar year.

(b) Providers shall obtain accreditation in the area applicable to each service within eighteen (18) months of qualifying under this provision. The eighteen (18) month clock begins on the date the accreditation criteria are met.

(c) Provider accreditation options include the Council on Quality and Leadership (CQL) and CARF International. Regardless of the accreditation attained, all references to accredited providers in this rule apply to the provider.

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

(e) 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.

(f) 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.

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