Developmental programs-cost based reimbursements.

WORKING DRAFT

ORIGINAL HOUSE

BILL

NO.
0052

ENROLLED ACT NO. 43, HOUSE OF REPRESENTATIVES

FIFTY-NINTH LEGISLATURE OF THE STATE OF
WYOMING
2008 BUDGET SESSION

AN ACT relating to Medicaid; authorizing a cost based payment system for providers of services and supplies under home and community based waiver programs for persons with developmental disabilities and acquired brain injury; granting rulemaking authority; providing an appropriation; and providing for an effective date.

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

Section 1.

W.S. 42
‑
4
‑
120 by creating a new subsection (g) is amended to read:

42
‑
4
‑
120.

Contracts for waiver services; authority of department; emergency case services; cost based payments.

(g)

The department shall establish by rule and regulation a cost based reimbursement system to pay providers of services and supplies under home and community based waiver programs for persons with developmental disabilities or acquired brain injury. The payment system shall:

(i)

Use information provided to the department, including but not limited to:

(A)

Provider cost data;

(B)

Provider claims data;

(C)

Participant needs assessment data;

(D)

Other relevant regional and national data
.

(ii)

Establish a new base period to be used in calculating reimbursement rates to providers for subsequent budget periods at least once every four (4) years but not more than once in any two (2) year period.
When a new base period is established, t
he department shall
submit a biennial or supplemental budget request
to adjust provider reimbursement rates based on the most current base period;

(iii)

Be developed following consultation with Wyoming developmental disability and acquired brain injury waiver program service providers, developmental disability waiver program clients and their families and an expert in cost based waiver program payment systems, which the department is authorized to retain by contract following competitive bidding;

(iv)

Be implemented for services and supplies provided under individual budget amounts established
on and
after July 1, 2008;

(v)

Be contingent upon approval by the center for Medicare and Medicaid services of the
United States
department of health and human services;

(vi)

Require service and supply providers to provide actual cost of service and supply data to the department and to submit to reasonable audits of the submitted data, if requested by the department.

Section 2.

There is appropriated three million eight hundred eighty-six thousand one hundred fifteen dollars ($3,886,115.00) from the general fund and three million eight hundred eighty-six thousand one hundred fifteen dollars ($3,886,115.00) from federal funds to the department of health. This appropriation shall be for the period beginning with the effective date of this act and ending June 30, 2010. This appropriation shall only be expended for the purpose of increases in payments to service providers under the cost based payment system created by this act, and is in addition to other amounts appropriated for home and community based waiver programs. Notwithstanding any other provision of law, this appropriation shall not be transferred or expended for any other purpose and any unexpended, unobligated funds remaining from this appropriation shall revert as provided by law on July 1, 2010. This appropriation shall be included in the department's 2011-2012 standard biennial budget request.

Section
3
.

This act is effective July 1, 2008.

(END)

Speaker of the House

President of the Senate

Governor

TIME APPROVED: _________

DATE APPROVED: _________

I hereby certify that this act originated in the House.

Chief Clerk

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