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Post-payment Reviews, 048-0037-8 Wyo. Code R. § 13
Link to the law
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Current as of January 2019
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Post-Payment Reviews
Specifies the grounds on which the Department of Health may conduct post-payment reviews of hospitals that provide inpatient Medicaid services (e.g., compliance with Medicaid regulations, provision of medically necessary services, etc.). Authorizes the person evaluating the medical necessity of an admission to request additional information from a physician or hospital if needed to clarify a medical record. Requires the Department, upon determining that services were not medically necessary, to notify a provider that payment will be recovered.
Current as of January 2019
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