053-10 Wyo. Code R. § 10-17

Current through April 27, 2019

Section 10-17 - Nursing Services

(a) Private Nursing or Nursing Home Care. Medical and hospital care includes nursing home care and necessary private nursing including non-professional home nursing services.

• (i) Nursing home care and home nursing services shall be paid only if prescribed in advance by the primary treating health care provider, who explains in detail the need and states the expected period of time such services will be required.

(b) Home nursing services shall be paid for a maximum of 12 hours per day per provider.

(c) Home nursing services required beyond 12 consecutive months shall be reviewed by the Division every 12 months thereafter to determine continued medical necessity.

(d) Disclaimer of Employment. Persons performing nursing services in the home of an injured worker are not employees of the State of Wyoming. The home nursing care provider or the provider's employer shall retain all responsibility for the payment of any and all federal income tax, state or federal unemployment insurance, state or federal social security premiums, and workers' compensation premiums that may be due.

(e) Initial prescriptions for home nursing services written after October 1, 1996, the following will apply:

• (i) only independent Medicare/Medicaid certified agencies may provide in-home nursing care;

• (ii) only Certified Nurses Assistants, Licensed Practical Nurses, Licensed Vocational Nurses or Registered Nurses working for a Medicare/Medicaid certified agency can provide in-home nursing care;

• (iii) if the injured worker's residence is not within a 50 mile radius of a Medicare/Medicaid certified agency, the Division may approve other alternatives. Any such arrangement must have prior approval from the Division.

053-10 Wyo. Code R. § 10-17

Amended, Eff. 8/24/2017.