048-27 Wyo. Code R. §§ 27-4 - Provider Participation and Enrollment
(a) A provider that
requests Medicaid reimbursement for services furnished to a participant shall
meet the provider participation requirements of Chapter 3 and
42 C.F.R. §
460.200.
(b) A provider desiring the designation of
PACE provider must complete and submit an application to CMS that describes how
the applying organization meets all the requirements in 42 C.F.R. § 460.
(i) The application shall be competed in
collaboration with the Department in accordance with CMS PACE application
guidelines at www.cms.gov.
(ii)
Upon completion of the application the applying organization shall submit it
for review by the Department.
(iii)
The Department shall review the PACE application to ensure compliance to State
rules and regulations.
(iv) Once
the Department has verified that the application adheres to State requirements
for PACE, the application shall be submitted by the Department to CMS review
and approval.
(A) CMS evaluates PACE program
provider applications in accordance with CMS PACE application guidelines. The
evaluation will include an on-site-review at the provider's place of business
by CMS and Department representatives.
(B) CMS provides notification of
determination based on timelines outlined in 42 C.F.R. § 460
(v) Upon approval of the
application, CMS, the Department, and the PACE provider shall sign a three-way
Program Agreement authorizing the PACE provider to market and engage in
enrollment activities, pursuant to 42 C.F.R. § 460, Subpart C.
(c) PACE provider employees and
contractors who provide direct contact services to PACE participants shall meet
the qualifications defined in 42 C.F.R. § 460.
Notes
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