206-14 Wyo. Code R. §§ 14-6 - Rate Setting Process

(a) When appropriate, the Department shall pay a daily tuition rate to each provider facility to reimburse allowable education costs as determined by the Department. The education daily tuition rates are calculated in part on the audited and reported annual financial statement and cost report survey from each facility.

(b) The Department shall calculate in-state education daily tuition rate of existing facilities using the following components:

(i) Each facility submits annual audited financial statement and cost report survey;

(ii) The data is normalized for each facility's cost report survey to adjust for differences in fiscal year vs. calendar year reporting;

(iii) Administrative costs are analyzed and a median allowable value is determined for each facility peer group;

(iv) Administrative costs exceeding the median are excluded;

(v) Allowable education costs will be divided by the actual reported educational days for each facility;

(vi) The base tuition rate is adjusted for inflation to determine allowable daily tuition rate for each facility;

(vii) The Department, after reviewing and accepting the calculated allowable daily tuition rates, will notify facilities of their approved rates on or before July 1 of each school year.

(c) New in-state facilities commencing operations after the annual rate setting period ends will have a temporary rate set that is equal to the average of the respective Wyoming instate peer group. This rate shall be recalculated after the facility participates for the first time in the annual rate setting process outlined in Section 6(a) of these rules.

(d) Out-of-state education daily tuition rates for both new and existing out-of-state facilities are determined as follows:

(i) If the state's governing education body sets a provider rate, the Department will pay that rate. It is the provider's responsibility to notify the Department of its state's rate and any changes to it; or

(ii) The facility rate will be the average of its Wyoming peer group rate. It will follow the procedure for determining in-state rates set forth in Section 6(a) of these rules.

(e) Related and supplemental services rates are paid at the current Medicaid rates or at rates determined by the Department using the Bureau of Labor Statistics market data.

(f) The mileage rate for transportation reimbursement is that authorized by the Wyoming Governor.

(g) All claims must be submitted for payment within one (1) year of services provided.

Notes

206-14 Wyo. Code R. §§ 14-6

Amended, Eff. 7/25/2019.