Wyoming Administrative Code
Agency 048 - Health, Department of
Sub-Agency 0037 - Medicaid
Chapter 8 - INPATIENT HOSPITAL ADMISSION CERTIFICATION
Section 8-4 - General Provisions

(a) General methodology. The Department shall review designated admissions and proposed admissions for inpatient hospital services to ensure the appropriateness and medical necessity of such services.

(b) The failure to comply with this Chapter shall result in the denial of certification and, if appropriate, recovery of Medicaid payments. A provider may not bill a client if there has been a denial of certification or recovery of Medicaid payments.