Wyoming Administrative Code
Agency 048 - Health, Department of
Sub-Agency 0037 - Medicaid
Chapter 30 - REIMBURSEMENT OF INPATIENT HOSPITAL SERVICES
Section 30-4 - Definitions

(a) "All Patients Refined Diagnosis Related Groups (APR DRGs)." A classification system that classifies inpatient services based on their reason for admission, severity of illness, risk of mortality, and resources used during treatment.

(b) "Extraordinary circumstances." A catastrophic occurrence, beyond the control of a hospital, which results in substantially higher costs. An "extraordinary circumstance" includes, but is not limited to fire, earthquakes, floods, or other natural disasters.

(c) "Participating Providers." All in-state Wyoming providers and out-of state providers that are currently enrolled in the Wyoming Medicaid program and/or Wyoming Medicaid providers that received at least eight-hundred thousand dollars ($800,000) in cumulative Wyoming Medicaid payments for inpatient services during state fiscal years 20152017.

(d) "Present on Admission." A patient's health condition as defined by a diagnosis code that was identified at the time of a patient's admission to a hospital.

(e) "Rehabilitation Services." Covered services furnished to an individual with a primary diagnosis for rehabilitation therapy.