Chapter 11 - Fiscal Provisions
CHAPTER 11 - FISCAL PROVISIONS
25-11-101. Definitions.
(a) As used in this chapter:
(i) "Actual cost" means the cost of providingtreatment or services for a resident in a state institution including minimumcosts, as set by the department having the direct authority and control of theinstitution, of maintaining the resident;
(ii) Repealed by Laws 1991, ch. 221, 3.
(iii) "Established charge" means that part of theactual cost for which the resident, the resident's estate and legallyresponsible persons are liable. The established charge may equal but notexceed the actual cost;
(iv) "Legally responsible person" means the resident,a responsible relative or the conservator of the resident's property as definedby W.S. 3-1-101(a)(iii);
(v) "Resident" means a patient or residentvoluntarily admitted or involuntarily committed to a state institution;
(vi) "Responsible relative" means a resident's spouseor a resident's parents if the resident is an unemancipated minor;
(vii) "State institution" means any institution intitle 25 under the direct authority and control of the department of health.
25-11-102. Department to adopt schedule of costs for services andtreatments; residents' accounts.
(a) The department of health shall promulgate on or beforeOctober 1 of each year a schedule of actual costs for services and treatmentrendered residents at each state institution under the direct authority and controlof the department.
(b) In determining actual costs the department may subtractfrom operation costs capital outlay and real property repair and maintenance todetermine the immediate benefit to the resident.
(c) An account for each resident shall record the actual costsand established charge for each month or fraction thereof. The establishedcharge shall be paid in the manner provided in this article and credited to theaccount of the resident.
25-11-103. Determining financial ability and established charges;special funds considered as part of resident's assets.
(a) Established charges shall be determined using a slidingscale promulgated by the department of health or the department of familyservices for each state institution under its direct authority and control. The sliding scale shall be based upon the ability of the resident or otherlegally responsible person to pay and shall be designed to provide that theresident or legally responsible person shall not be deprived of income necessaryto maintain a reasonable standard of living for that person and his dependents.
(b) Upon completion of a resident questionnaire form providedby the department, the director of the department shall determine theestablished charge to be assessed in each case using the sliding scalepromulgated by the department. Any payor may protest his established chargethrough the head of the institution to the department exercising directauthority and control over the institution if still dissatisfied. Thedepartment may affirm the established charge or set a different establishedcharge. The decision of the department may be appealed pursuant to the WyomingAdministrative Procedure Act.
(c) Any available income and special funds, including but notlimited to hospitalization insurance, social security benefits, disabilitycompensation, pensions, retirement benefits and veterans' benefits shall beconsidered part of the total assets of a resident in determining an establishedcharge.
(d) Nothing in this chapter limits any obligation created bylaw or contract for third parties to pay for services provided to a residentadmitted to a state institution.
25-11-104. Reimbursement of general fund for payments.
Paymentsfor services provided to a resident admitted to a state institution eithervoluntarily or involuntarily shall be reimbursed to the state general fund.
25-11-105. Limitation on liability of responsible relatives; liabilityof relatives, patient and estate after release or death; exception.
(a) The liability of a parent or spouse of a resident forpayment of established charges shall not exceed two (2) years of cumulativecare at the state institution. Voluntary payments for care in excess of thetwo (2) year limitation may be accepted. This section does not limit theobligation, created by contract or law, of third party payments for resident ortemporary services.
(b) Subject to the limitation in subsection (a) of thissection, the resident, his estate and other legally responsible persons areliable after release of the resident for the payment of any unpaid establishedcharge. If a resident or a released resident dies, his estate is liable forall unpaid established charges unless the department exercising directauthority and control over the institution determines that no claim or a lesserclaim should be filed against the estate due to the need for support from theproceeds of the estate of the legal dependents of the resident who are thebeneficiaries of his estate.
25-11-106. Billings; assignment of insurance; collection or waiver ofarrearages.
(a) The department of health shall establish proceduresrequiring state institutions under its direct authority and control to providemonthly billings to each resident of the state institution and to each legallyresponsible person. Billings under this subsection for the state hospital shallprovide for an itemization, including at a minimum, the daily establishedcharge.
(b) The department shall obtain an assignment of benefits fromany resident under its care and supervision who has insurance that may coverservices provided.
(c) An account for established charges which is not paid withinninety (90) days after the end of the month in which the charges accrue is inarrears and shall be referred to the respective department for collection. Thedepartment may contract with a private person or agency for collection ofaccounts under this subsection.
(d) The department may adjust, compromise or waive collectionof charges from the legally responsible person if the department determinesthat the person is without financial means or that collection would constitutea hardship. If the department decides to waive collection of charges, nofuture billing will be sent to a resident or legally responsible person.
25-11-107. State to bear costs of those unable to pay.
Ifa resident or legally responsible person has no available assets at the time ofor during the resident's stay at a state institution to pay an establishedcharge, all costs of treatment and transportation shall be borne by the state.
25-11-108. Department to promulgate rules; forms.
Thedepartment of health shall promulgate reasonable rules and regulations andshall approve and provide forms necessary to carry out the purposes of thischapter.