Wyo. Code R. 048-0053-6
State Hospital
Chapter 6: Designated Hospitals
Effective Date: 04/04/2017 to Current
Rule Type: Current Rules & Regulations
Reference Number: 048.0053.6.04042017
This Chapter is promulgated by the Department of Health (“the Department”) pursuant to the Involuntary Commitment Act (“the Act”), at Wyo. Stat. Ann. §§ 25-10-101 through -305, and the Wyoming Administrative Procedure Act at Wyo. Stat. Ann. §§ 16-3-101 through -115.
(a) These rules have been adopted to establish definitions applicable to Chapter 7, Standards for the Designation of Hospitals pursuant to Wyo. Stat. Ann. § 25-10-104 and Chapter 8, Standards for the Reimbursement of Designated Hospitals or Other Treatment Providers pursuant to Wyo. Stat. Ann. § 25-10-112.
(b) The Department may issue manuals or bulletins to interpret the provisions of these rules, which reflect the policies contained in these rules and regulations. The provisions contained in manuals or bulletins shall be subordinate to the provisions of these rules and regulations.
(a) Terminology. Except as otherwise specified, the terminology used in these rules is the standard terminology used in the industry, and has the standard meaning used in accounting, healthcare, Medicaid and Medicare.
(b) The incorporation by reference of any external standard is intended to be the incorporation of that standard as it is in effect on the effective date of this Chapter of these rules and regulations.
The following definitions shall apply in the interpretation and enforcement of Chapters 6, 7, and 8 of these rules:
(a) “CARF Accreditation” means accreditation according to the Commission on Accreditation of Rehabilitation Facilities.
(b) “Centers for Medicare and Medicaid (CMS) Certification” means the state survey agency has determined that a healthcare entity has been determined to meet the Social Security Act’s provider or supplier definitions, and is in compliance with standards required by Federal regulations.
(c) “Claims” means the process of billing the allowable cost of services under the Act to the Department or responsible county pursuant to Wyo. Stat. Ann. § 25-10-112.
(d) “CMS 1500” means the billing claim form for healthcare services approved by the Centers for Medicaid and Medicare Services, which is used by physicians (formerly the HCFA 1500).
“Department” means the Wyoming Department of Health.
(f) “Designated Hospital” means a general hospital or psychiatric treatment hospital or unit that provides care to an individual detained under Wyo. Stat. Ann. §§ 25-10-109 through -110.1, which is under an agreement with the Department and bills the Department or the responsible county for the costs of care under the Act.
“Directed Outpatient Commitment” means as defined at Wyo. Stat. Ann. § 25-10-110.1.
“Emergency Detention” means the detention of a person pursuant to Wyo. Stat. Ann. § 25-10-109.
(i) “Inpatient psychiatric treatment” means the medical diagnosis, treatment and care of persons with mental illness requiring hospitalization which is provided under the direction of a licensed, board certified psychiatrist, directed at reducing the risk, symptoms and impact of the psychiatric disorder.
(j) “Involuntary hospitalization” means the hospitalization of a person against his will under Wyo. Stat. Ann. § 25-10-110, at the Wyoming State Hospital or at a designated hospital or treatment provider under agreement with the Department to provide inpatient psychiatric treatment.
“JCAHO” means the Joint Commission for the Accreditation of Healthcare Organizations.
(l) “Medicaid” means medical assistance and services provided pursuant to Title XIX of the Social Security Act or the Wyoming Medical Assistance and Services Act, at Wyo. Stat. Ann. §§ 42-4-101, et seq.
(m) “Medically necessary” means items and services which may be justified as reasonable, necessary, or appropriate, based on evidence-based clinical standards of care, as measured by the Level of Care Utilization System (LOCUS) tool.
(n) “Medical Records” means all documents in the possession of or subject to the control of the designated hospital, which describe the patient’s psychiatric assessments, diagnosis, condition or treatment.
(o) “Treatment Provider” or “treatment center” means a community mental health center under contract or agreement with the Department to provide outpatient or residential treatment to persons with mental illness or substance use disorders.
(p) “Universal billing claim form” means the national standardized form used by hospitals and other healthcare facilities or treatment providers which summarizes the allowable costs for services provided by the hospital or other treatment provider.
(q) “Utilization Review” means the process of comparing requests for medical services to guidelines deemed appropriate for such services.
(a) The order in which the provisions of this Chapter appear is not to be construed to mean that any provision is more or less important than any other provision.
(b) The text of this Chapter shall control the titles of its various provisions.
When promulgated, this Chapter supersedes all prior rules or policy statements issued by the Department, including manuals or bulletins, which are inconsistent with this Chapter.
If any portion of this Chapter is found to be invalid or unenforceable, the remainder shall continue in full force and effect.