Wyoming Administrative Code
Agency 048 - Health, Department of
Sub-Agency 0053 - State Hospital
Chapter 6 - DESIGNATED HOSPITALS
Section 6-4 - Definitions

(a) "CARF Accreditation" means accreditation according to the Commission on Accreditation of Rehabilitation Facilities.

(b) "Centers for Medicare and Medicaid (CMS) Certification" means the state survey agency has determined that a healthcare entity has been determined to meet the Social Security Act's provider or supplier definitions, and is in compliance with standards required by Federal regulations.

(c) "Claims" means the process of billing the allowable cost of services under the Act to the Department or responsible county pursuant to Wyo. Stat. Ann. § 25-10-112.

(d) "CMS 1500" means the billing claim form for healthcare services approved by the Centers for Medicaid and Medicare Services, which is used by physicians (formerly the HCFA 1500).

(e) "Department" means the Wyoming Department of Health.

(f) "Designated Hospital" means a general hospital or psychiatric treatment hospital or unit that provides care to an individual detained under Wyo. Stat. Ann. §§ 25-10-109 through -110.1, which is under an agreement with the Department and bills the Department or the responsible county for the costs of care under the Act.

(g) "Directed Outpatient Commitment" means as defined at Wyo. Stat. Ann. § 25-10-110.1.

(h) "Emergency Detention" means the detention of a person pursuant to Wyo. Stat. Ann. § 25-10-109.

(i) "Inpatient psychiatric treatment" means the medical diagnosis, treatment and care of persons with mental illness requiring hospitalization which is provided under the direction of a licensed, board certified psychiatrist, directed at reducing the risk, symptoms and impact of the psychiatric disorder.

(j) "Involuntary hospitalization" means the hospitalization of a person against his will under Wyo. Stat. Ann. § 25-10-110, at the Wyoming State Hospital or at a designated hospital or treatment provider under agreement with the Department to provide inpatient psychiatric treatment.

(k) "JCAHO" means the Joint Commission for the Accreditation of Healthcare Organizations.

(l) "Medicaid" means medical assistance and services provided pursuant to Title XIX of the Social Security Act or the Wyoming Medical Assistance and Services Act, at Wyo. Stat. Ann. §§ 42-4-101, et seq.

(m) "Medically necessary" means items and services which may be justified as reasonable, necessary, or appropriate, based on evidence-based clinical standards of care, as measured by the Level of Care Utilization System (LOCUS) tool.

(n) "Medical Records" means all documents in the possession of or subject to the control of the designated hospital, which describe the patient's psychiatric assessments, diagnosis, condition or treatment.

(o) "Treatment Provider" or "treatment center" means a community mental health center under contract or agreement with the Department to provide outpatient or residential treatment to persons with mental illness or substance use disorders.

(p) "Universal billing claim form" means the national standardized form used by hospitals and other healthcare facilities or treatment providers which summarizes the allowable costs for services provided by the hospital or other treatment provider.

(q) "Utilization Review" means the process of comparing requests for medical services to guidelines deemed appropriate for such services.