How to start a hospice in Wyoming

Wyoming requires a Hospice program license (health care facility license) from Wyoming Department of Health, Aging Division, Healthcare Licensing and Surveys to operate a hospice. Fee: Licensure fee per HLS Chapter 1 (Licensure Fees). The 2016 rule text lists hospice at $100, assessed at least annually; revised license (name, location or bed change) $50. Current amounts may differ.

License required

Yes

License

Hospice program license (health care facility license)

Issuing agency

Wyoming Department of Health, Aging Division, Healthcare Licensing and Surveys

Fee

Licensure fee per HLS Chapter 1 (Licensure Fees). The 2016 rule text lists hospice at $100, assessed at least annually; revised license (name, location or bed change) $50. Current amounts may differ.

Renewal

Every year · Licenses run from issuance through the following June 30 and are renewed annually.

Insurance and bonds

Fidelity bond of no less than $5,000, augmented in relation to the number of employees.

Medicare certification

Medicare certification is separate from the state license (state survey or CMS-approved accreditor). CMS imposed a nationwide 6-month moratorium on new Medicare hospice enrollments (including new practice locations) effective 2026-05-13, extendable in 6-month increments; applications received by the Medicare contractor before that date are still processed, accreditation cannot be used for deemed-status entry during the moratorium, and a hospice undergoing a non-exempt ownership change within 36 months of enrollment must re-enroll as new and is therefore blocked. The federal notice leaves Medicaid/CHIP hospice moratoria to each state.

Regulation

Wyoming Department of Health HLS Rules, Chapter 10 (Hospice) and Chapter 1 (Licensure Fees); Health Care Facilities and Health Services Act

1. Submit the license application form with the required fee
2. Provide proof of a fidelity bond (at least $5,000, increased with staff count)
3. Submit policies: DFS central registry checks for manager and staff, personnel, org chart, grievances, records confidentiality, employee health, advance directives, patient rights, admission criteria, quality improvement, hospice day care (if any), emergency preparedness
4. Pass the initial licensure survey; renewal surveys are periodic

Program

Wyoming Medicaid and Kid Care CHIP (Wyoming Department of Health, Division of Healthcare Financing, Office of Medicaid)

Enrollment portal

Discover Your Provider (DyP) provider enrollment portal, run by HHS Technology Group (HTG)

Fiscal agent

CNSI (operates the Benefits Management System claims processing); provider enrollment is contracted to HHS Technology Group (HTG)

Application fee

Under the federal rule (42 CFR 455.460), institutional providers pay the CMS application fee when they first enroll, re-enroll or revalidate. The fee is $750 for calendar year 2026. Individual physicians and non-physician practitioners do not pay it. A fee already paid to Medicare or to another state's Medicaid program counts. WDH's enrollment page does not list a separate state fee.

Fingerprinting

WDH says enrolling under a taxonomy considered high-risk can add steps, and a provider specialist will reach out. Under federal rules (42 CFR 455.434 and 455.450), the state places provider types in 'limited', 'moderate' or 'high' risk levels. High-risk providers, and anyone who owns 5% or more of one, must submit fingerprints for a criminal background check.

Site visit

Under federal rule (42 CFR 455.432), the state must visit moderate- and high-risk providers before and after enrollment. Every enrolled provider must allow unannounced on-site inspections. WDH's enrollment page does not describe a separate state site visit process.

Revalidation

Federal rule (42 CFR 455.414) requires the state to revalidate every enrolled provider at least once every 5 years. After an April 2026 CMS request, WDH sent CMS a two-year off-cycle revalidation plan on June 5, 2026. Under an August 17, 2026 notice, high-risk providers must revalidate in the DyP portal by October 31, 2026. Every enrolled provider must also report an NPI by then; providers without one are treated as high risk. Missing the deadline means payment suspension, then termination on February 1, 2027.

Full Wyoming Medicaid enrollment guide →

CON program

No

Wyoming certificate of need details →

State minimum wage

$7.25 an hour

Effective

2009-07-24

Scheduled increases

No scheduled change found in the official sources reviewed.

HCBS 80/20 rule

Federal baseline: 42 CFR 441.302(k) requires the state to show that each provider spends at least 80% of Medicaid payments for homemaker, home health aide and personal care services under 1915(c) waivers on direct care worker pay and benefits. Compliance starts 2030-07-09 (for managed care, the first rating period starting on or after that date); annual payment-adequacy reporting under 441.311(e) starts 2028-07-09. A state may set a lower share for state-defined small providers and exempt providers facing hardship, each only through a public notice-and-comment process. The eCFR text has not changed since 2024-07-09. No state-published 80/20 implementation step (small-provider criteria, hardship exemption or reporting guidance) was found for this state in the official sources reviewed.

Hospice agencies (community based) — active organization NPIs (NPPES)

51 (as of Sep 13, 2026)

Medicare-certified hospices (CMS Care Compare)

21 (as of Aug 19, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

59,335 (as of Jun 1, 2026)

All Wyoming Hospice Medicaid rates, ranked →