Wyoming Administrative Code
Agency 048 - Health, Department of
Sub-Agency 0037 - Medicaid
Chapter 43 - ACQUIRED BRAIN INJURY HOME AND COMMUNITY BASED WAIVER
Section 43-23 - Audits

(a) The Division or the Centers for Medicare and Medicaid Services may audit a provider's financial records, medical records, or employment records, at any time to determine whether the provider has received excess payments or overpayments.

(b) The Division or the Centers for Medicare and Medicaid Services may perform audits through employees, agents, or through a third party. Audits shall be performed in accordance with generally accepted auditing standards.

(c) Disallowance. The Division shall recover excess payments or overpayments pursuant to Section 22 of this Chapter.

(d) Reporting audit results. If at anytime during a financial audit or a medical audit, the Division discovers evidence suggesting fraud or abuse by a provider, that evidence, in addition to the Division's final audit report regarding that provider, shall be referred to the Medicaid Fraud Control Unit.

(e) The Division shall share the results of the audit with the provider before excess payments or overpayments are recovered. However, nothing in this section shall abrogate the rights of the State to recover excess payments or overpayments in accordance with Chapter 16 or Chapter 39.