Wyoming - Medical Supply Service — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-10

The Wyoming Department of Health (WDH) Home and Community-Based Services (HCBS) Section certifies Medical Supply Service providers to deliver durable medical equipment and disposable supplies under the Community Choices Waiver (CCW), Supports Waiver, and Comprehensive Waiver. Providers must first secure Medicare DMEPOS accreditation and enrollment before applying for Wyoming Medicaid certification, as the state relies on federal accreditation standards in lieu of a distinct state-level DME license.

Approval requires completing a multi-step background screening and submitting a certification application through the Wyoming Health Provider (WHP) portal within 90 days of initiation. Once certified by the HCBS Section, the entity must complete the final Medicaid provider enrollment through the Discover Your Provider (DyP) system to receive a Wyoming Medicaid Pay-to provider ID.

1. Service Definition and Scope

Medical Supply Services under Wyoming's HCBS waivers encompass the provision, fitting, and servicing of durable medical equipment (DME) and disposable medical supplies that are not covered by the Medicaid State Plan. These items must be specified in the participant's individualized service plan to increase independence or ensure health and welfare.

The service is designed to fill gaps left by traditional Medicaid, meaning waiver funds can only be authorized when all other funding streams have been exhausted or denied.

• Covered Items: Devices, controls, or appliances that enable participants to perceive, control, or communicate with their environment.
• Disposable Supplies: Items necessary for life support or to address physical conditions, excluding standard first aid items.
• Exclusions: Items covered under the standard Wyoming Medicaid State Plan must be billed there first; waiver funds are the payer of last resort.
• Service Limits: Subject to individual budget allocations under the Supports Waiver or specific caps defined in the CCW.

2. Regulatory and Oversight Agencies

The Wyoming Department of Health (WDH) Division of Healthcare Financing oversees all Medicaid operations, with specific waiver management delegated to the HCBS Section. Provider enrollment is managed through a contracted vendor system.

Claims and billing are handled by a separate fiscal agent operating the state's Medicaid management information system.

• Wyoming Department of Health (WDH): Administers the Medicaid program (https://health.wyo.gov).
• WDH HCBS Section: Manages waiver certification and policy for CCW and DD Waivers (https://health.wyo.gov/healthcarefin/hcbs/).
• HHS Technology Group (HTG): Operates the Discover Your Provider (DyP) Medicaid enrollment portal (https://wyoming.dyp.cloud/).
• CNSI / Acentra Health: Operates the Benefits Management System and Services (BMS) for claims processing (http://www.wyomingmedicaid.com).

3. Gatekeeping Prerequisites: Who Can Even Apply

Wyoming does not issue a state-level DME license. Instead, the state requires federal Medicare DMEPOS accreditation as the primary structural precondition for Medicaid enrollment as a medical supplier.

Without active Medicare enrollment and accreditation from a recognized national body, the state will not process a Medicaid enrollment application for this taxonomy.

• Medicare Enrollment: Applicants must be actively enrolled as a Medicare DMEPOS supplier.
• DMEPOS Accreditation: Must hold current accreditation from a CMS-approved accrediting organization (e.g., ACHC, BOC, TJC).
• Physical Location: Must maintain a physical business location accessible to the public and state inspectors.
• NPI Requirement: Must possess a Type 2 National Provider Identifier (NPI) specific to the DME/Medical Supply taxonomy.

4. Licensure and Certification Requirements

Because Wyoming lacks a specific state DME license, providers must obtain HCBS Certification directly from the WDH HCBS Section. This process verifies business standing, background checks, and waiver-specific training.

The certification process is entirely digital and requires strict adherence to document formatting and submission timelines.

• WHP Portal Access: Providers must request access to the Wyoming Health Provider (WHP) portal to initiate the certification application.
• Application Window: The HCBS certification application must be submitted within 90 days of initiation, or it is automatically canceled.
• Business Registration: Must provide proof of registration and good standing with the Wyoming Secretary of State.
• Liability Insurance: Must maintain and submit proof of general and professional liability insurance.

5. Medicaid Provider Enrollment

After receiving HCBS certification, providers must enroll in the Wyoming Medicaid system using the Discover Your Provider (DyP) portal. This step generates the Pay-to provider ID necessary for billing.

The state contracts with HTG Technology Group to manage this portal and conduct final credential verifications.

• DyP Portal Registration: Create an account at https://wyoming.dyp.cloud/ and select the Medical Supply/DME application type.
• Provider Agreement: Electronically sign the Wyoming Medicaid Provider Agreement within the DyP system.
• W-9 Submission: Mail or upload a completed W-9 form to HTG Technology Group for payment processing.
• High-Risk Taxonomy Review: DME is often categorized as high-risk, triggering additional screening steps or site visits by a provider specialist.

6. Staffing, Training and Background Checks

Wyoming HCBS rules require all waiver providers, including medical supply business owners and key personnel, to pass comprehensive background screenings. Required training must be completed before requesting the application.

Personnel delivering or fitting equipment must also meet manufacturer-specific training standards.

• Background Screening: Multi-step background check required for owners and managing employees through the HCBS Section's designated process.
• Training Prerequisite: WDH recommends completing all required HCBS provider training modules before requesting portal access.
• OIG Exclusion Check: Monthly verification that no staff or owners appear on the federal OIG List of Excluded Individuals/Entities (LEIE).
• Delivery Staff Qualifications: Staff delivering or fitting equipment must be trained on the specific devices per manufacturer guidelines.

7. Documentation, Policies and Records

Medical Supply providers must maintain strict documentation linking the equipment provided to the participant's approved service plan. Records must be retained for state audit purposes.

Failure to maintain signed delivery tickets is a primary cause for Medicaid fund recoupment.

• Service Plan Alignment: Documentation must prove the supplied item matches the specifications in the participant's individualized service plan.
• Delivery Receipts: Must maintain signed delivery tickets or proof of receipt for all equipment and supplies furnished.
• Record Retention: All Medicaid and waiver-specific records must be kept for a minimum of six years.
• Incident Reporting: Must have policies to report critical incidents, such as equipment failure resulting in injury, to the HCBS Section.

8. Billing, Rates and Claims

Claims are processed through the Benefits Management System and Services (BMS). Medical Supply services are reimbursed based on the Wyoming Medicaid fee schedule or manually priced if no fee exists.

Providers must navigate prior authorization requirements for most waiver-funded supplies.

• Electronic Billing: Wyoming Medicaid only accepts electronic claims submissions via the BMS portal.
• Prior Authorization: Many DME items and waiver supplies require prior authorization from the HCBS Section or its utilization review contractor before delivery.
• Payer of Last Resort: Providers must bill Medicare or private insurance before billing the HCBS waiver.
• Fee Schedule: Rates are published on the Wyoming Medicaid website (http://www.wyomingmedicaid.com) under the Provider Fee Schedules section.

9. Approval Sequence and Timeline

The end-to-end process involves federal accreditation, state HCBS certification, and Medicaid enrollment. Timelines depend heavily on the provider's readiness and background check processing.

Delays in obtaining WHP portal access or completing background checks will extend the overall timeline.

• WHP Portal Approval: Allow up to 48 hours for the state to approve initial access to the WHP portal.
• Application Completion: Providers have exactly 90 days to submit the HCBS application once started.
• HCBS Review: The WDH HCBS Section typically reviews complete certification applications within 30 to 60 days.
• DyP Enrollment: Final Medicaid enrollment processing by HTG takes an additional 30 days after HCBS certification is granted.

10. Common Denials and Survey Findings

Applications are frequently delayed or denied due to administrative errors or failure to meet strict deadlines. Post-enrollment audits often target documentation deficiencies.

The state strictly enforces its 90-day application window for HCBS certification.

• 90-Day Expiration: Applications are automatically canceled if not fully submitted within the 90-day WHP portal window.
• Missing Accreditation: Denials occur if the applicant fails to upload current, valid Medicare DMEPOS accreditation.
• File Naming Errors: The WHP portal requires specific file naming conventions; improperly named uploads cause application rejection.
• Delivery Ticket Deficiencies: Auditors frequently recoup funds if delivery receipts lack participant signatures or date stamps.

11. Key Contacts and Resources

Providers should utilize the official WDH portals and contact the designated enrollment vendors for assistance. The HCBS Section handles waiver policy, while HTG handles the DyP system.

The Medicaid fiscal agent handles all post-enrollment billing inquiries.

• WDH HCBS Credentialing: [email protected] for waiver certification questions.
• Wyoming Health Provider (WHP) Portal: Access via https://health.wyo.gov/healthcarefin/hcbs/becomeaprovider.
• Provider Enrollment Call Center: 1-877-399-0121 or [email protected] for DyP portal issues.
• Wyoming Medicaid Provider Portal: http://www.wyomingmedicaid.com for claims, manuals, and fee schedules.

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