Wyoming Administrative Code
Agency 048 - Health, Department of
Sub-Agency 0037 - Medicaid
Chapter 3 - PROVIDER ENROLLMENT AND PARTICIPATION, PRE-AUTHORIZATION, PAYMENT AND SUBMISSION OF CLAIMS BY PROVIDERS
Section 3-4 - Provider Qualifications
Universal Citation: WY Code of Rules 3-4
Current through September 21, 2024
(a) The Department shall establish qualifications for individuals or entities to enroll as a provider of Medicaid covered services consistent with state and federal law.
(b) To qualify for enrollment as a provider of covered Medicaid services, an individual or entity shall, at a minimum, satisfy the following criteria:
(i)
Meet applicable licensing and certification standards found in Wyoming statutes
and rules, or in the statutes and regulations of the state in which the
provider is located, or in the statutes and regulations of the state in which
the services are provided. If applicable, a provider shall comply with Medicare
certification standards;
(ii) Not
be excluded from participation in federally funded health care programs by the
U.S. Department of Health and Human Services, Office of Inspector General;
and,
(iii) Be assigned a National
Provider Identifier (NPI) number by the National Plan and Provider Enumeration
System, as applicable.
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