Wyoming Administrative Code
Agency 048 - Health, Department of
Sub-Agency 0037 - Medicaid
Chapter 24 - WYOMING HOSPITAL REIMBURSEMENT SYSTEM
Section 24-17 - Reconsideration

(a) Request for reconsideration. A provider may request that the Department reconsider a decision to recover overpayments pursuant to Section 8, a decision to recover excess payments pursuant to Section 12, or the computation of disproportionate share payments pursuant to section 9. Such request must be mailed to the Department by certified mail within twenty days of the date the facility receives notice pursuant to subsections B(c), 9(f) or 12(e). The request must state with specificity the reasons for the request. Failure to provide such a statement shall result in the dismissal of the request with prejudice. The reconsideration shall be limited to whether the Department has complied with the provisions of this rule.

(b) Reconsideration. The Department shall review the decision and send written notice, by certified mail, to the provider of its final decision within forty-five days after receipt of the request for reconsideration. The Department may request additional information from the provider as part of the reconsideration process.

(c) Administrative hearing. A provider may request an administrative hearing regarding the final decision pursuant to Chapter I of these rules by mailing by certified mail or personally delivering a request for hearing to the Department within twenty days of the date the provider receives notice of the final decision.

(d) Failure to request reconsideration. A provider which fails to request reconsideration pursuant to this section may not subsequently request an administrative hearing regarding the decision to recover overpayments pursuant to Chapter I.

(e) A provider may not request reconsideration or an administrative hearing regarding a denial or reduction of payment or recovery of overpayments or excess payments caused by a change in the reimbursement methodology or any change in state or federal law.