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Wyoming - Adult Companion Services — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-10

In Wyoming, Adult Companion Services are not offered as a distinct, standalone service under the state's Medicaid Home and Community-Based Services (HCBS) waivers. Instead, non-medical supervision and socialization that allow an adult to remain safely in the community are typically provided under the broader umbrella of Adult Day Services or Personal Care services, funded primarily through the Community Choices Waiver (CCW) or the Developmental Disabilities (DD) waivers (Supports and Comprehensive Waivers). The Wyoming Department of Health (WDH), Division of Healthcare Financing (DHCF) oversees the certification of these providers.

To become an approved provider for these equivalent services, applicants must first request access to the Wyoming Health Provider (WHP) portal, complete all required training and background screenings, and submit a complete certification application within 90 days. Following DHCF certification, providers must enroll as Wyoming Medicaid providers and sign a Provider Agreement, which must be renewed every five years.

1. Service Definition and Scope

Because Wyoming does not define "Adult Companion Services" as a separate waiver service, providers seeking to offer non-medical supervision and socialization must apply to provide Adult Day Services or Personal Care. Under the Community Choices Waiver (CCW) and DD waivers, these services are designed to ensure the health and safety of participants while fostering community integration and socialization.

Adult Day Services can be provided by independent individuals or agencies (such as certified Adult Day Services agencies or eligible Senior Centers). The scope includes supervision, socialization, and assistance with activities of daily living in a community-based setting, ensuring participants can safely remain in their communities.

2. Regulatory and Oversight Agencies

The primary oversight body for HCBS waiver services in Wyoming is the Wyoming Department of Health (WDH), Division of Healthcare Financing (DHCF). DHCF is responsible for initial provider certification, ongoing compliance monitoring, and Medicaid enrollment.

For agency providers, particularly those operating as Home Health Agencies or Adult Day Care facilities, the WDH Aging Division may also be involved in facility licensure and employee qualification verification during initial and periodic surveys.

3. Gatekeeping Prerequisites: Who Can Even Apply

Wyoming does not currently impose closed networks, moratoria, or Certificate of Need (CON) requirements for HCBS waiver providers. However, there are strict structural prerequisites before an application can be submitted.

Applicants must first request and be granted access to the Wyoming Health Provider (WHP) portal. Furthermore, the state explicitly requires that all training and multi-step background screenings be completed before requesting or submitting the certification application. If an agency operates as a Senior Center, it must be determined eligible in accordance with W.S. 9-2-1201(a)(iii).

4. Licensure and Certification Requirements

Providers must attain and maintain certification from the DHCF to provide waiver services. DHCF initially certifies a new agency or independent provider for one year. Renewal of certification is conducted at least once every three years.

If the provider operates a facility-based Adult Day Care, it must be licensed by the WDH Aging Division. Providers must also adhere to the HCBS Settings Final Rule, ensuring participant choice, privacy, and community integration, as codified in Wyoming Medicaid Rules Chapters 44-46 (for DD waivers) and Chapter 34 (for CCW).

5. Medicaid Provider Enrollment

After receiving HCBS certification from DHCF, providers must enroll as Wyoming Medicaid Providers. This is a separate step from certification and is completed through the Provider Enrollment, Screening, and Monitoring (PRESM) system.

During enrollment, applicants must select the correct PRESM Provider Type and sign the Wyoming Medicaid Provider Agreement. This enrollment and agreement must be renewed every five years.

6. Staffing, Training and Background Checks

Wyoming requires a multi-step background screening process for all HCBS providers and their staff. This screening must be successfully passed before the certification application is submitted.

Providers must also complete state-mandated initial training requirements before being certified. DHCF provides ongoing training through bi-monthly support calls covering topics like the HCBS settings requirements, participant rights, and person-centered planning.

7. Documentation, Policies and Records

Providers must maintain comprehensive policies and procedures that align with Wyoming Medicaid Rules. A critical requirement is having a formal complaint and grievance process, which must be documented and explained to participants.

For providers that own or control residential settings, lease agreements must be reviewed by the state to ensure compliance with Wyoming housing laws (e.g., W.S. 1-21-1001 to -1016). All application files uploaded to the WHP portal must follow strict file naming conventions.

8. Billing, Rates and Claims

Billing for waiver services is conducted through the Wyoming Medicaid MMIS. Providers must be fully enrolled and have an active Provider Agreement to submit claims.

Rates for Adult Day Services and Personal Care are established by the WDH based on periodic rate studies (such as the CCW Rate Study). Providers must bill according to the procedure codes and modifiers specified in the CCW or DD Provider Manuals.

9. Approval Sequence and Timeline

The approval process begins with requesting WHP portal access (up to 48 hours). The applicant then completes all training and background checks before starting the application.

Once the application is started in the WHP portal, it must be submitted within 90 days; otherwise, it is automatically canceled and the applicant must start over. After DHCF approves the certification, the provider completes Medicaid enrollment in PRESM.

10. Common Denials and Survey Findings

Applications are frequently canceled because they are not submitted within the strict 90-day window in the WHP portal. Failure to rename files according to the required naming conventions can also delay or reject an application.

During surveys or ongoing monitoring, common compliance issues include failing to adhere to the HCBS Settings Final Rule (e.g., lack of participant choice or privacy) and failing to maintain current background checks or required training documentation.

11. Key Contacts and Resources

The Wyoming Department of Health, Division of Healthcare Financing is the primary contact for HCBS provider certification and waiver questions. Credentialing specialists are available to assist with the application process.

Providers should utilize the WHP portal for certification applications and the PRESM system for Medicaid enrollment.

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