048-46 Wyo. Code R. § 46-7
(a) All waiver services specified in the individualized plan of care shall be based on the participant's assessed needs; meet the service definition(s); be considered medically or functionally necessary; align with the participant's preferences for services, supports, and providers; and be prioritized based on the availability of funding in the participant's budget.
(b) Services shall have prior authorization before provided to a participant.
(c) Waiver services shall assist the participant in acquiring, retaining, and improving the skills necessary so the individual can function with as much independence as possible, exercise choice and self-management, and participate in the rights and responsibilities of community membership.
(d) The approved individualized plan of care shall reflect the services and actual units that providers agree to provide over the plan year. The approved individualized plan of care shall also include details regarding the specific support, the settings, times of day, and the specific activities requiring more support than others.
(e) Providers shall not serve children under age 18 and adults at the same time unless prior authorized in writing by the Division.
(f) Waiver services shall not be used to duplicate the same service or a similar service that is available to the participant through one of the following programs:
(g) Participants may request an exemption from subsection (f) by submitting a third party liability form as part of the participant's annual individualized plan of care. This form shall document that the service is not available through another program or agency to meet the individual participant's assessed needs. Exemptions may be granted at the direction of the Division.
(h) Routine transportation for activities provided during the service is included in the reimbursement rate for the service regardless of the number of trips. The provider shall not charge a participant separately for transportation during these waiver activities unless the special activity is outside of the participant's community or normal routine.
(i) Participants receiving residential habilitation services may receive up to an average of thirty-five (35) hours of day services per week which include: Adult Day, Community Integration, Companion, and Prevocational services.
(j) Waiver services are outlined in the Comprehensive and Supports Waiver Service Index, which is incorporated by reference.
048-46 Wyo. Code R. § 46-7
Adopted, Eff. 6/21/2017.
Amended, Eff. 7/26/2018.