048-52 Wyo. Code R. §§ 52-9 - Documentation Requirements

(a) A provider must maintain all records necessary to fully disclose the nature, quality, amount, and medical necessity of services billed to a client currently receiving Medicaid services. Payment for services billed to Wyoming Medicaid that are not substantiated in the client's records are subject to recoupment. Documentation must be retained for at least six years from the date of payment or until ongoing audit issues are resolved, whichever is longer, as detailed in Wyoming Medicaid Rules Chapter 3.

(b) For services covered under this Chapter, complete copies of the client's IEP or IFSP must be maintained as part of the participating district's records. The records must clearly indicate that the school-based services are required by the client's IEP or IFSP.

(c) As part of the participating district's required records, the client's file must include:

(i) The IEP or the IFSP;

(ii) An evaluation performed by the provider, or the annual and current present level of performance;

(iii) Treatment notes describing the IEP or IFSP goals and objectives specific to each client met by their school-based services;

(iv) Billing information recorded in units of time, as specified in Wyoming Medicaid Rules Chapter 3; and,

(v) A copy of the signed consent form from a parent or legal guardian.

Notes

048-52 Wyo. Code R. §§ 52-9

Amended, Eff. 10/12/2022.