Ch. 12, § 3. Definitions

Except as defined in this Section or as defined in Chapter 1, the terminology used in this Chapter is the standard terminology and has the standard meaning used in accounting, health care, Medicaid, and Medicare. (a) "Attending physician" m e a n s t he physician who prescribes home health services or reviews and certifies the plan of treatment. (b) "Encounter" refers to a documented interaction between a patient and a healthcare provider on a specific date of service, where all services are provided, regardless of the duration or number of interactions throughout that day. An exception to billing one encounter per day applies to services that cannot be provided at a single time due to medical necessity or specific practitioner orders regarding frequency or scheduling. (c) "Home health agency" an agency primarily engaged in arranging and directly providing nursing or other healthcare services to persons at their residence. (d) "Home health aide" means a person who is certified as a nursing assistant/nurse aide by the Wyoming State Board of Nursing, and employed by a home health agency. (e) "Home health aide service" m e a n s a covered service provided pursuant to a plan of treatment by a home health aide under the supervision of a registered nurse. (f) "Intermittent" m e a n s three or fewer encounters per day for home health aide services and skilled nursing services combined. (g) "Long-term custodial care" means care that has moved beyond the acute phase (has become clinically stable) and is expected to be needed for the rest of the client's life. (h) "Plan of treatment" m e a n s a plan prepared on CMS Form 485 or other form designated by the Department which is signed and dated by the client's practitioner, and which specifies the: (i) Client's diagnosis; (ii) Objectives of the plan; (iii) Client's prognosis; (iv) Covered services which are medically necessary for the implementation of the plan; and (v) Person or persons to provide such services or supplies. (i) "Practitioner" means attending physician, advanced practice registered nurse, physician's assistant or other licensed practitioner of the healing arts within the scope of their practice. (j) "Supplies" means medical supplies authorized for Medicaid payments under Wyo. Stat. § 42-4-103 and the Rules and Regulations for Medicaid.