Wyoming Administrative Code
Agency 048 - Health, Department of
Sub-Agency 0037 - Medicaid
Chapter 8 - INPATIENT HOSPITAL ADMISSION CERTIFICATION
Section 8-8 - Medical Necessity Criteria
Universal Citation: WY Code of Rules 8-8
Current through September 21, 2024
(a) The Department shall, in consultation with appropriate medical and other health care professionals, develop criteria to determine the medical necessity and appropriateness of inpatient hospital services. The criteria shall reflect prevailing norms of medical practice.
(b) Admission certification shall be denied unless the request meets the medical necessity criteria.
(c) The medical necessity criteria may be obtained from the Department by written request.
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