Medical trauma care.

WORKING DRAFT

ORIGINAL SENATE

FILE

NO.
0077

ENROLLED ACT NO. 70, SENATE

FIFTY-EIGHTH LEGISLATURE OF THE STATE OF WYOMING
2005 GENERAL SESSION

AN ACT relating to hospitals; providing for payments to hospitals for unreimbursed trauma care, as specified; requiring reports; authorizing a position; providing appropriations; and providing for an effective date.

Be It Enacted by the Legislature of the State of Wyoming:

Section 1.

(a)

As used in this act:

(i)

"Acute care hospital" means a hospital licensed in Wyoming pursuant to W.S. 35
‑
2
‑
901 through 35
‑
2
‑
911 and which provides acute patient care;

(ii)

"Department" means the Wyoming department of health;

(iii)

"Incident" means an admission, both inpatient and outpatient, involving traumatic care for an individual patient within a one (1) year period to a single hospital. Admissions of the same patient for causes not directly related to an earlier admission shall be considered a separate incident;

(iv)

"Trauma care services" means services to p
atients with at least one (1) injury diagnosis code, using the International Classification of Diseases, 9
th
Edition, from 800.0 through 904, 925 through 929, 940 through 959.9, and 994.7, plus

at least one (1) of the following:

(A)

Hospitalization for one (1) calendar day;

(B)

Admission to the intensive care unit or monitored bed unit;

(C)

Cardiac or respiratory arrest on route to the hospital or emergency room;

(D)

Dead on arrival at the facility;

(E)

Transfer from or to another acute care hospital;

(F)

Admission directly from the emergency room to the operating room;

(G)

Trauma team activation;

(H)

Meets prehospital triage criteria.

(b)

Acute care hospitals shall be reimbursed on a per incident basis, subject to the following:

(i)

There is compliance with the reporting requirements of the Wyoming trauma care program registry before the request for reimbursement;

(ii)

Reimbursement shall be available for costs incurred after June 30, 2005 and before July 1, 2006;

(iii)

Requests for reimbursement may be submitted to the health department for payment only after one hundred eighty (180) days have elapsed from the date the bill for the services rendered was sent to the patient or his representative.

(c)

The department shall promulgate rules and regulations to administer this program on behalf of the state of Wyoming. The rules and regulations shall include provisions for:

(i)

Ensuring that reimbursements do not exceed the appropriated funds;

(ii)

Limiting reimbursement to the necessary support of the poor;

(iii)

Preventing duplication from this appropriation and insurance;

(iv)

Reimbursing hospitals for trauma service costs.

(d)

The department may contract with a fiscal agent to make the actual payments and conduct any necessary audits of reimbursement requests. Reimbursement requests shall be made in a form and manner prescribed by the department. The department or its agent on its behalf may request any documentation it deems necessary to support any request for reimbursement.

(e)

The department shall not reimburse any one (1) acute care hospital in a cumulative amount greater than twenty-five percent (25%) of the appropriation in section 2 of this act. However, if the department reasonably concludes as of May 31, 2006, that the appropriation will not be fully expended, the remaining funds may be used to reimburse hospitals on a pro rata basis above the twenty-five percent (25%) limit of this subsection, subject to the requirements of subsection (b) of this section.

Section 2.
There is appropriated to the department of health two million five hundred thousand dollars ($2,500,000.00) from the general fund for the program set forth in section 1 of this act and fifty thousand dollars ($50,000.00) from the general fund to administer the program. One (1) position is authorized for the department to administer the program created by this act.

Section 3.

On or before December 1, 2005, the department of health shall report to the joint appropriations and the joint labor, health and social services interim committees on the status of the program including costs of services and how funds have been expended.

Section 4.
This act is effective immediately upon co
m
pletion of all acts necessary for a bill to become law as provided by Article 4, Section 8 of the Wyoming Constit
u
tion.

(END)

Speaker of the House

President of the Senate

Governor

TIME APPROVED: _________

DATE APPROVED: _________

I hereby certify that this act originated in the Senate.

Chief Clerk

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