048-16 Wyo. Code R. §§ 16-17 - Conditions on Providers
(a) The Department
may place the following condition(s) on the provider's certification or
Medicaid enrollment:
(i) Requiring a
physician's or appropriate medical specialist's statement verifying the ability
to perform service duties as required;
(ii) Restricting the provider's certification
or participation to a specific service;
(iii) Restricting the provider's
certification or participation to a specific geographic area or location;
and
(iv) Requiring the provider to
deny new admissions.
(b)
The provider shall be notified via certified mail that a condition is being
place on their certification or participation and shall have fifteen (15)
business days to abate all areas of noncompliance that warrant the
condition(s), or to submit an acceptable corrective action/quality improvement
plan.
(i) If the provider fails to abate all
areas of noncompliance or submit an acceptable corrective action/quality
improvement plan within fifteen (15) business days of the notice, then the
condition(s) shall go into effect and continue until removed.
(A) If all areas of noncompliance are
successfully abated or an acceptable corrective action/quality improvement plan
is received by the Department, within fifteen (15) business days of receipt of
the notice then the condition(s) shall not be imposed.
(B) If the provider does not implement the
corrective action/quality improvement plan accepted by the Department, than the
provider shall be notified via certified mail that condition(s) shall be
effective immediately.
(ii) Once in place, a condition(s) shall not
be removed until the provider submits the following:
(A) Evidence that the areas of non-compliance
have been abated;
(B) An acceptable
corrective action/quality improvement plan and;
(C) Verification that the corrective
action/quality improvement plan has been implemented for each area of
non-compliance, within thirty (30) days of placement of the
condition.
(c) Failure to comply with this section may
result in revocation of the provider's certification or other applicable
adverse action.
Notes
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