Ch. 12, § 6. Prior Authorization

(a) All home health services require prior authorization. (b) To request prior authorization, a provider must submit completed prior authorization forms specified by the Department, including a plan of treatment that includes a statement by a practitioner that the requested home health services are appropriate and medically necessary. (i) At least once every sixty days, a practitioner must review the plan of treatment to determine if it is still appropriate and medically necessary, and, if it is, sign and date the plan again and resubmit it to the Department. (ii) All new home health orders must be accompanied by documentation of a face-to-face visit between the client and the ordering practitioner within the ninety days prior to the start of home health services. (iii) If a client is eligible for both Medicare and Wyoming Medicaid, the client's ordering practitioner must provide documentation that shows the client is not home-bound and would not qualify for home health services under the client's Medicare benefits.