Wyoming Administrative Code
Agency 048 - Health, Department of
Sub-Agency 0037 - Medicaid
Chapter 24 - WYOMING HOSPITAL REIMBURSEMENT SYSTEM
Section 24-8 - Cost settlement

(a) Cost settlement methodology. Cost reports shall be cost settled by the Medicare intermediary using Medicare principles of cost reimbursement as modified by this Chapter and using data provided by the Department.

(b) TEFRA limits. A hospitals Medicaid allowable payment shall not exceed the TEFRA limits.

(c) Notice of Medicaid Program Reimbursement. The Department shall, within sixty days after receipt of the Notice of Program Reimbursement, send a Notice of Medicaid Program Reimbursement to the hospital.

(d) Repayment of overpayments. A hospital shall reimburse the Department for overpayments within thirty days after the date of the Notice of Medicaid Program Reimbursement, even if the provider has requested reconsideration or an administrative hearing regarding the determination of overpayments. If a hospital does not timely reimburse the Department, overpayments may be recovered pursuant to Section 14. Notice of overpayments must include the hospitals right to request reconsideration of the cost-settlement pursuant to Section 17. The reconsideration shall be limited to whether the Department has complied with the provisions of this rule.

(e) Payment of underpayments. The Department shall request the issuance of payment warrant to reimburse the hospital for underpayments within fifteen days after the date of the Notice of Medicaid Program Reimbursement.