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During the Sixty-First Legislature of the State of Wyoming 2012 Budget Session, the Wyoming Legislature passed Original Senate File No. 0034, Enrolled Act No. 58, Senate (hereinafter SEA0058 or the Medicaid Options Study legislation) requiring the Wyoming Department of Health (WDH) to conduct a study into the Medicaid system. This legislation required the WDH to:

·  Analyze the cost drivers and identify other areas within the Medicaid program that may benefit from redesign;

·  Evaluate potential redesign of current Medicaid programs; and

·  Evaluate the design of Medicaid programs mandated by the Patient Protection and Affordable Care Act, P.L. 111-148, and the Health Care and Education Reconciliation Act of 2010, P.L. 111-152.

As a result of the legislation, the WDH completed a comprehensive study of the Wyoming Medicaid Program and Systems. During the study, the WDH used the best available data to identify what drives costs in Medicaid and developed recommendations for controlling theses costs. WDH identified 3 major areas within Wyoming Medicaid that could benefit from reform or redesign. These areas include:

·  Health care services;

·  Long term care services; and

·  Developmental disability and acquired brain injury services.

During the Sixty-Second Legislative Session, the Legislature passed Original Senate File No. 0060, Enrolled Act No. 82, which directed WDH to reform and redesign the Medicaid program.  With regards to the long term care services (Section 1. (a) (ii)), this includes repealing a cap on the number of participants in the home and community based waiver program; developing an assessment tool to replace the LT101; and redesigning the nursing facility reimbursements to reflect patient acuity, percentage of Medicaid occupancy, and regional economic factors.

The focus of this Long Term Services Redesign Project will be to assist the WDH in identifying options for reforming and redesigning the Medicaid long term care (LTC) services. The Medicaid LTC services include skilled nursing facility care, the Long Term Care Waiver, and the Assisted Living Facility Waiver. It also includes the hospital care needed by recipients in these programs. The initiative has been broken down by the WDH and the legislation into four (4) subprojects/workgroups, which include:

·  Project One: LT-101, Eligibility Assessment and Plan of Care Tool

·  Project Two: Nursing Home Reimbursement

    ·  Project Three: Remove Cap on LTC and ALF Waivers; HCBS Capacity Building and Barrier Identification

·  Project Four: Big Picture System Visioning, Redesign, and Rebalancing

Subpages (1): Advisory Group