Wyoming Administrative Code
Agency 048 - Health, Department of
Sub-Agency 0037 - Medicaid
Chapter 24 - WYOMING HOSPITAL REIMBURSEMENT SYSTEM
Section 24-11 - Record retention

Universal Citation: WY Code of Rules 24-11

Current through September 21, 2024

(a) Period of retention. A hospital which receives or has received Medicaid funds shall retain financial records for six (6) years following the date of submission of the applicable cost report to the Department. Such records may be maintained in hard-copy, on micro-fiche or micro-film.

(b) Record keeping requirements.

(i) Financial records. A provider must keep financial records in accordance with GAAP and maintain sufficient control and documentation to satisfy the requirements of this rule, including accommodating GAAS and reasonable requests by the Department for additional information. The provider must maintain adequate documentation for all line items on the cost report.

(ii) Medical records. A provider must maintain medical records.

(c) Availability of records. A provider shall make financial or medical records available upon request to representatives of the Department or the United States Department of Health and Human Services and pursuant to Chapter XVI, Medicaid Program Integrity.

(d) Refusal to produce records. The refusal of a provider to make financial or medical records available upon request pursuant to this section shall result in the immediate suspension of all Medicaid payments to the provider and all Medicaid payments under review shall be repaid to the Department within ten days after written request for such payment. The suspension of payments shall continue until the requested records are provided.

(e) Explanation of records. In the event of a field audit, the provider shall have available at the field audit location one or more knowledgeable persons who can explain the provider's financial records, the accounting and control system and cost report preparation, including attachments and allocations, to the auditors.

(f) Failure to maintain records. A provider unable to satisfy one or more of the requirements of this Section shall be given a written notice of deficiency and shall have sixty days after the date of the written notice to correct such deficiency. If, at the end of the sixty days, the Department determines that the deficiency has not been corrected, the Department shall withhold twenty-five percent (25%) of the providers claims for services provided on or after the sixtieth day. If, at the end of one hundred and twenty days after the mailing of the written notice of deficiency, the Department determines that the deficiency has not been corrected, the Department shall suspend all Medicaid payments for service provided after such date. The suspension of payments shall continue until the the Department determines that adequate records are being maintained. At such time, payments will be reinstated, without interest. This remedy does not affect the Departments right to withhold payments, terminate provider participation or invoke other remedies permitted by applicable statutes and rules.

(g) Out of state records. If a provider maintains financial or medical records out of state, the provider shall either transfer the records to an in-state location that is suitable for the Department to perform the field audit or reimburse the Department for reasonable costs, including travel, lodging and meals, incurred in performing the field audit in an out-of-state location.

Disclaimer: These regulations may not be the most recent version. Wyoming may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.