048-4 Wyo. Code R. §§ 4-2 - Filing Complaints

(a) If an entity or individual has exhausted a provider's established client grievance procedure and is not satisfied with the resolution, the entity or individual may file a complaint with the Department.

(b) A complaint filed with the Department must be in writing. The complaint must be filed within one (1) year of the alleged violation and must provide the following information:

(i) The name, address and telephone number of the complaining party;

(ii) The party, individual, or agency the complaint is against; and

(iii) A clear and complete statement of the alleged violation of the law, order, rule, or standard, together with the facts which give the Department a clear and full understanding of the nature of the alleged violation.

(c) The Department shall confirm with the complainant and provider that the complaint was originally filed with the provider, with an unsatisfactory resolution for the complainant. The Department shall refer an individual or entity to the provider if the complaint was not originally filed with the provider.

(d) The Department shall ensure that complaints are properly evaluated, documented, acknowledged, and handled in a timely and appropriate manner, to include notification by the Department to the complainant and the provider in writing within ten (10) business days of the receipt of a complaint. If the nature of the complaint is not related to certification or contracting requirements, the Department shall refer the complainant to the appropriate authority, if any, including Wyoming Medicaid, the Wyoming Mental Health Professions Licensing Board, or an ombudsman program.

Notes

048-4 Wyo. Code R. §§ 4-2

Adopted, Eff. 4/9/2020.