Law

Title 42 Welfare

Wyoming · 42 · statute

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Contents: 141 provisions
  1. 42-1-101. Definitions; generally.
  2. 42-1-102. Conflict with federal laws.
  3. 42-2-101. Short title.
  4. 42-2-102. Definitions.
  5. 42-2-103. Provision of assistance and services; duties of
  6. 42-2-104. Personal opportunities with employment
  7. 42-2-105. Application for assistance and services; investigation of applicant.
  8. 42-2-106. Approval or disapproval of application;
  9. 42-2-107. Payment of assistance; custodian for incompetent recipients.
  10. 42-2-108. Continuous assistance to recipient changing
  11. 42-2-109. Review of assistance and services; termination or modification; notice to department of change in assets.
  12. 42-2-110. Administrative and judicial review.
  13. 42-2-111. Prohibited disclosure and use of records; penalty; judicial discovery.
  14. 42-2-112. Misrepresentation; penalties; recovery, termination or modification of assistance and services.
  15. 42-2-113. Assignment or transfer of assistance and services; exemption from legal process.
  16. 42-2-114. Reimbursement of federal government.
  17. 42-2-115. Supplemental nutrition assistance program
  18. 42-2-201. Definitions.
  19. 42-2-202. Participation required; exemptions; disqualification of benefits.
  20. 42-2-203. Establishment of program; powers and duties of division.
  21. 42-2-301. Repealed by Laws 2015, ch. 54, § 2.
  22. 42-2-302. Repealed by Laws 2015, ch. 54, § 2.
  23. 42-2-303. Repealed by Laws 2015, ch. 54, § 2.
  24. 42-2-401. Definitions.
  25. 42-2-402. Transfers of assets affecting eligibility; exceptions; disclosures by applicants.
  26. 42-2-403. Trust transfers affecting eligibility for medical assistance.
  27. 42-2-404. Determination of transfer of asset.
  28. 42-2-405. Individuals with substantial home equity; disqualification.
  29. 42-2-501. Low income home energy assistance and weatherization program; funding.
  30. 42-3-101. Creation; deposits.
  31. 42-3-102. Administration.
  32. 42-3-103. Authorized expenditures.
  33. 42-4-101. Short title.
  34. 42-4-102. Definitions.
  35. 42-4-103. Authorized services and supplies.
  36. 42-4-104. Powers and duties of department of health; state Medicaid agent appointed by governor.
  37. 42-4-105. Repealed by Laws 1991, ch. 221, § 3.
  38. 42-4-106. Application for assistance; determination of
  39. 42-4-107. Uniform application throughout state; discrimination prohibited; pilot projects authorized.
  40. 42-4-108. Administrative hearings.
  41. 42-4-109. Renumbered and Repealed.
  42. 42-4-110. Charges for inpatient hospital services.
  43. 42-4-111. Providing or obtaining assistance by misrepresentation; penalties.
  44. 42-4-112. Confidentiality of records; penalty for disclosure; authorized disclosure.
  45. 42-4-113. Eligibility criteria; irrevocable burial trusts.
  46. 42-4-114. Cooperative agreements authorized.
  47. 42-4-115. Work incentives improvement option; purchase of services; eligibility criteria; definition.
  48. 42-4-116. Premium calculation.
  49. 42-4-117. End stage renal dialysis program; rulemaking; funding.
  50. 42-4-118. Prescription drug assistance program created;
  51. 42-4-119. Pharmacy plus program; eligibility criteria; rulemaking; termination of program.
  52. 42-4-120. Contracts for waiver services; authority of
  53. 42-4-121. Program of all-inclusive care for the elderly.
  54. 42-4-122. Cooperation with paternity determination.
  55. 42-4-123. Repealed by Laws 2019, ch. 189, § 2.
  56. 42-4-124. Clubhouse rehabilitation services.
  57. 42-4-201. Action against third party; notice; subrogation.
  58. 42-4-202. Third party liability; authority; enforcement; notice; costs.
  59. 42-4-203. Settlement between recipient and tortfeasor or insurer; lien not discharged; exceptions.
  60. 42-4-204. Department subrogated to right of recovery of
  61. 42-4-205. Insurance policy termination notification requirement.
  62. 42-4-206. Claims against estates.
  63. 42-4-207. Recovery of incorrect payments; recovery of correct payments; liens.
  64. 42-4-208. Recovery for cost of health care.
  65. 42-4-301. Short title.
  66. 42-4-302. Definitions.
  67. 42-4-303. Acts subjecting person to treble damages; costs and civil penalties; exceptions.
  68. 42-4-304. Investigations and prosecutions; powers of
  69. 42-4-305. Limitation of actions; retroactivity; burden of proof.
  70. 42-4-306. Remedies under other laws; liberality of construction; joint and several liability.
  71. 42-4-401. Short title.
  72. 42-4-402. Definitions.
  73. 42-4-403. Medicaid fraud control unit created; duties.
  74. 42-4-404. Access to records.
  75. 42-4-405. Reporting to unit.
  76. 42-4-406. Fraud and false statements; criminal penalty.
  77. 42-4-407. Kickbacks, bribes, undisclosed payments,
  78. 42-4-408. Failure to maintain records; destruction of records; penalty.
  79. 42-4-409. Aggregation of claims in certain cases.
  80. 42-4-410. Suspension or exclusion as provider.
  81. 42-4-411. Provisions of act not exclusive remedies.
  82. 42-4-412. Rules.
  83. 42-5-101. Provision of information and services; refusal to accept.
  84. 42-5-102. Statutory interpretation.
  85. 42-6-101. Short title.
  86. 42-6-102. Definitions.
  87. 42-6-103. Rulemaking; guidance.
  88. 42-6-104. Alternative long term care home pilot programs authorized.
  89. 42-6-105. Adult foster care homes; licensure; suspension or revocation.
  90. 42-6-106. Home and community based waiver program expanded; requirements.
  91. 42-6-107. Assisted living expansion; reimbursement increase.
  92. 42-6-108. Adult day care.
  93. 42-6-109. Aging and disability resource centers.
  94. 42-7-101. Short title.
  95. 42-7-102. Definitions.
  96. 42-7-103. Wyoming long-term care partnership program established.
  97. 42-7-104. Administration.
  98. 42-8-101. Short title.
  99. 42-8-102. Definitions.
  100. 42-8-103. Nursing care facility assessment account.
  101. 42-8-104. Assessments.
  102. 42-8-105. Approval of state plan.
  103. 42-8-106. Multiple facilities.
  104. 42-8-107. Penalties for failure to pay assessment.
  105. 42-8-108. Quarterly adjustment payments.
  106. 42-8-109. Discontinuation of the assessment and quarterly adjustment payments.
  107. 42-9-101. Short title.
  108. 42-9-102. Definitions.
  109. 42-9-103. Private hospital assessment account.
  110. 42-9-104. Assessments.
  111. 42-9-105. Penalties for failure to pay assessment.
  112. 42-9-106. Quarterly adjustment payments.
  113. 42-9-107. Discontinuation of the assessment and quarterly adjustment payments.
  114. 42-9-108. Approval of state plan; rulemaking.
  115. 42-9-109. Multiple facilities.
  116. 42-10-101. Definitions.
  117. 42-10-102. Enhanced identity authentication process.
  118. 42-10-103. Enhanced eligibility verification process.
  119. 42-10-104. Case review process.
  120. 42-10-105. Referral of cases for investigation.
  121. 42-10-106. Report.
  122. 42-10-107. Rulemaking authority.
  123. 42-10-108. Prohibition on self-attestation. Note: this section is effective as of 1/1/2027.
  124. 42-10-109. Residency verification; monthly address checks;
  125. 42-10-110. Retroactive medicaid eligibility; rulemaking; reporting. Note: this section is effective as of 1/1/2027.
  126. 42-10-201. Prohibition on waiver of work requirements and exemptions. Note: this section is effective as of 1/1/2027.
  127. 42-11-101. Short title.
  128. 42-11-102. Definitions.
  129. 42-11-103. Private ground ambulance service provider assessment account.
  130. 42-11-104. Assessments.
  131. 42-11-105. Penalties for failure to pay assessment.
  132. 42-11-106. Payments to private ground ambulance service providers.
  133. 42-11-107. Discontinuation of the assessment and payments.
  134. 42-11-108. Approval of state plan; rulemaking.
  135. 42-11-109. Multiple ambulance services.
  136. 42-12-101. Definition of citizens who are eligible for
  137. 42-12-102. Verification of citizenship or eligible alien status. Note: this section is effective as of 1/1/2027.
  138. 42-12-103. Referral of illegal aliens to law enforcement.
  139. 42-12-104. Counting of ineligible alien income in
  140. 42-12-105. Reasonable opportunity periods for noncitizens
  141. 42-12-106. Citizenship data collection and presumptive

Proposed changes to this act

No one has proposed a change to this act yet.

141 provisions

42-4-411. Provisions of act not exclusive remedies.

The provisions of this act shall not be exclusive and do not preclude the use of any other criminal or civil remedy as authorized by law.

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42-4-412. Rules.

The attorney general, in consultation with the department of health, may adopt rules to implement W.S. 42-4-401 through 42-4-409 and 42-4-411.

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42-5-101. Provision of information and services; refusal to accept.

(a) The department of health may provide and pay for family planning and birth control information and services including interviews with trained personnel, distribution of literature, referral to a licensed physician for consultation, examination, tests, medical treatment and prescription and to the extent prescribed, the distribution of rhythm charts, drugs, medical preparation, contraceptive devices and similar products, to any person who may benefit from this information and these services. Information and services shall be provided in a language understood by the recipient. (b) Any medical service shall be performed by a licensed physician. (c) The right to receive public assistance and social services or any other public benefit shall not be affected by a refusal to accept family planning and birth control services. Each person offered family planning and birth control services shall be advised of this subsection both orally and in writing. (d) Any person may refuse to accept the duty of offering family planning and birth control services to the extent the duty is contrary to his personal or religious beliefs. The refusal shall not be grounds for: (i) Any disciplinary action; (ii) Dismissal; (iii) Any departmental transfer; (iv) Any other discrimination in employment; (v) Suspension from employment; or (vi) Any loss in pay or other benefits.

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42-5-102. Statutory interpretation.

(a) Nothing in W.S. 42-5-101 shall be interpreted to: (i) Interfere with a person's religious beliefs; (ii) In any way abridge the right to accept or refuse family planning and birth control services; (iii) Impose practices offensive to a person's moral standards; or (iv) Restrict self-determination in the procreation of children.

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42-6-101. Short title.

This act shall be known and may be cited as the "Wyoming Long Term Care Choices Act".

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42-6-102. Definitions.

(a) As used in this act: (i) "Adult foster care" means care in a home licensed as an adult foster home and care provided to a resident of the home while temporarily away from the adult foster home; (ii) "Adult foster care home" means any family home or facility in which residential care is provided in a homelike environment for five (5) or fewer adults who are not related to the provider by blood, marriage or adoption, except in special circumstances. "Adult foster care home" does not include any residential facility otherwise licensed or funded by the state of Wyoming. The homes shall be regulated in accordance with W.S. 35-2-901 through 35-2-913 and this act which shall govern in case of conflict; (iii) "Alternative eldercare home" means a facility and program which: (A) Provides services and care at the highest level required by a resident and as permitted under the applicable facility; (B) Shall be licensed as a health care facility pursuant to W.S. 35-2-901 through 35-2-913; (C) Creates communities that allow long-term residents to develop lasting relationships with other residents and staff; (D) Maintains residences as units independent from each other; (E) Provides, at a minimum, a private bedroom and bathroom for each resident; (F) Provides services to Medicaid supported residents at the Medicaid reimbursement rates; (G) Maintains all common spaces within the house, including secured exterior space, accessible and open to all residents during waking hours; (H) Provides an office space for a nurse within each house; (J) Provides a common area in each house including a seating area; (K) Provides public and staff bathroom facilities; (M) Creates a residential home environment in all aspects, using residential materials and designs appropriate to the style of the community; (N) Is committed to a restraint free environment; (O) Implements a culture of learning and participation by the residents and honors the elder hood stage of life. (iv) "Assisted living facility" means as defined in W.S. 35-2-901(a)(xxii); (v) "Department" means the department of health; (vi) "Home medical testing" means medical testing designed to be done in the home of the person being tested by a person who is not a licensed health care professional and includes but is not limited to testing done using a home blood pressure monitor or a home diabetes management blood sugar monitor; (vii) "Long term care assessment" means a form and an assessment process conforming with relevant federal regulations and designed to measure the abilities and disabilities of a person in the activities of daily living to determine the person's need for long term care. As of January 1, 2007 the department of health form LT-101 entitled "Assessment of Medical Necessity for Long Term Care" and the assessment needed to complete it shall be the long term care assessment; (viii) "Medicaid" means the program administered by the state pursuant to the Wyoming Medical Assistance and Services Act and this act and partly funded by the federal government pursuant to Title XIX of the federal Social Security Act; (ix) "Nursing home" means a nursing care facility as defined in W.S. 35-2-901(a)(xvi) and licensed pursuant to Wyoming Statutes, article 9, chapter 2, title 35; (x) "Residential care" means the provision of room and board and services that assist the resident in activities of daily living including but not limited to bathing, dressing, grooming, eating, medication management, incontinence care, home medical testing, money management or recreation; (xi) "This act" means W.S. 42-6-101 through 42-6-109.

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42-6-103. Rulemaking; guidance.

The department is authorized to promulgate rules and regulations to implement this act. The rules and regulations shall seek to implement the objectives of this act by expanding the long term care system to one emphasizing consumer choice and home, home like and community based care alternatives.

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42-6-104. Alternative long term care home pilot programs authorized.

(a) Three (3) pilot program grants are authorized to study the feasibility of innovation in long term care facilities. Eligible recipients shall include cities, counties and any entity planning for long term care needs or providing long term care including private nonprofit and private for profit entities. The department shall solicit proposals for the grants through a request for proposals developed in consultation with the advisory council on aging. The department, in consultation with the council, shall select the recipients from the proposals received. The department shall negotiate any specific provisions of the grant award needed and shall administer the grants. In selecting the recipients, the council shall: (i) Consider the extent to which the proposal moves the staff of the facility to a more patient centered culture; (ii) Consider one (1) project to reconfigure an existing nursing home to achieve a resident-centered cultural change; (iii) Fund one (1) study relating to the creation of an alternative eldercare home, as defined in W.S. 42-6-102(a)(iii), provided that an acceptable project proposal is received in response to the request for proposals; (iv) Fund one (1) study relating to the creation of an alternative eldercare home, as defined in W.S. 42-6-102(a)(iii), which shall require that the home: (A) Maintains residences as units independent from other facilities such that there is no physical connection or shared roof structures between houses; (B) Provides a secured exterior patio or garden with covered seating for each house accessible by all residents including those with wheelchairs and assistive devices; (C) Provides for locked storage of hazardous materials and control of kitchen access during high traffic periods of meal preparation and clean-up; (D) Provides a den in each house to accommodate television viewing and limited overnight guests; (E) Implements a self-managed work team approach to in-house and clinical support staffing. Each house shall have its own core in-house staffing that is specific and dedicated to a single house; (F) Uses a home base facility for the clinical support team members that is outside and separate from the house; and (G) Maintains a lift free environment by providing ceiling lifts in each resident's bedroom and bathroom. (v) Consider the extent to which there is a market for the proposed facility or the extent to which people in need of long term care are likely to choose the proposed facility; and (vi) Consider the extent to which the proposed pilot project will determine the effectiveness of its approach to elder care in a timely manner. (b) Each grant proposal shall include plans for a local or applicant match of twenty-five percent (25%) of the grant amount. (c) For applicants that have completed any appropriate needs study or market study, the grant funding may be used for design and development of the facility and the organization which will operate it. If this is done, the grant recipient shall agree to accept Medicaid clients in the facility without discrimination. (d) The department is directed to work with grant recipients in the development of rules and regulations which are compatible with the culture of the homes and which will assure appropriate licensure for the care provided and the needs of the elder residents. The department shall inform the joint labor, health and social services interim committee if legislation is needed to authorize any necessary rules and regulations. (e) As a condition of receiving the grants, each grantee shall agree to provide training and reports to other parties in the state interested in innovative long term care approaches.

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42-6-105. Adult foster care homes; licensure; suspension or revocation.

(a) The department may initiate and license an adult foster care pilot project subject to the following: (i) The applicant shall pay a one-time fee of one hundred dollars ($100.00) which shall be deposited in the general fund; (ii) The department, a public health nurse or other employee of a local department of health shall complete an inspection of the proposed adult foster care home; (iii) The proposed home shall comply with all state and local building, sanitation, utility, fire and zoning codes applicable to single family dwellings; (iv) Repealed by Laws 2015, ch. 176, § 2. (v) Repealed by Laws 2015, ch. 176, § 2. (vi) The pilot program shall consist of no more than ten (10) adult foster care homes. At least three (3) of the homes shall be in counties with a population of thirty thousand (30,000) or less. (b) The department may, after notice and opportunity for hearing, revoke or suspend any license issued pursuant to this section, may prohibit a facility from accepting new resident clients, may place conditions on the continuation of a license, or may require a facility to take specified remedial actions within a specified time, if: (i) There is a threat to the health, safety or welfare of any resident client; (ii) There is credible evidence of abuse, neglect or exploitation of any resident client; (iii) The facility is not operated in compliance with this act or any rules and regulations promulgated pursuant to this act. (c) If, in the professional judgment of the state health officer, there is a clear and present threat to the health or safety of a resident client, the state health officer may close an adult foster care home and transfer the residents to another place. The department shall also initiate proceedings pursuant to subsection (b) of this section within three (3) working days. (d) The department shall complete a criminal records check on any individual employed by adult foster care homes and on any individual, other than a resident client or a resident client's spouse, who at the time of licensure is expected to live in the adult foster care home or who, after licensure, lives or comes to live in the adult foster care home. The department may refuse to license a facility or prohibit the individual from living in the facility if he has been convicted of a felony indicating he may abuse a resident or steal from a resident. (e) The department shall promulgate rules and regulations consistent with this act to govern the pilot project. (f) Repealed by Laws 2015, ch. 59, § 2.

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42-6-106. Home and community based waiver program expanded; requirements.

(a) Repealed By Laws 2013, Ch. 117, § 2. (b) The department is authorized to increase the provider reimbursement levels by an amount up to three dollars ($3.00) per hour for hourly services or seventeen and six-tenths percent (17.6%) above the prevailing rate for nonhourly services as of December 1, 2006. The department shall report to the joint labor, health and social services interim committee by November 1, 2007 the extent to which reimbursement improvements and any other changes made have improved the availability of home health care services and any additional remedies that may be needed. The length of the report shall not exceed one thousand (1,000) words plus any appropriate charts and graphs. Additional reports may be made from time to time as the need arises. (c) The department shall set goals for expanding the number of Medicaid home and community based clients in self directed budget options and shall report progress toward those goals to the joint labor, health and social services interim committee no later than November 1, 2007, November 1, 2008 and November 1, 2009. The department shall allow these options to be managed by persons designated to do so in advanced health care directives. (d) Consistent with approved budgets, the department shall make available a pool of state funds to meet transitional needs of clients moving from a more restrictive to a less restrictive environment in circumstances where Medicaid funds are not available due to federal restrictions. If sufficient funds are available, these state funds may also be used to meet short term needs of clients seeking to avoid placements in more restrictive environments. The department shall govern the expenditure of these funds though contracts, policies and rules and regulations as needed.

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42-6-107. Assisted living expansion; reimbursement increase.

The department shall seek federal approval to increase the number of allowed slots in the assisted living Medicaid waiver from one hundred forty-six (146) to one hundred sixty-eight (168) slots.

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42-6-108. Adult day care.

The department shall investigate adult day care providers in Wyoming with respect to access, rates, administration of rules and regulations and their impact on providers and clients, and shall report its findings to the joint labor, health and social services interim committee and to the advisory council on aging. The report shall not exceed two thousand (2,000) words in length plus appropriate charts and graphs.

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42-6-109. Aging and disability resource centers.

(a) The department is authorized, using competitive grants and contracts, to fund a statewide network of aging and disability resource centers. (b) Locations of the aging and disability resource centers shall be determined by the department of health, aging division. In selecting locations for aging and disability resource centers, the department of health, aging division, shall require a degree of local community funding, which may include in kind contributions, for a center. (c) The purpose of each center shall be to create a single, coordinated system of information and assistance for all persons seeking long term support. Each center shall assist eligible persons in making informed decisions about health care access and long term care service and support options and shall serve as a referral agency to the long term care support system. Centers shall provide information and assistance to individuals needing either public or private resources, professionals seeking assistance on behalf of their clients and individuals planning for their future long term care needs. (d) Repealed by Laws 2015, ch. 59, § 2.

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42-7-101. Short title.

This act may be cited as the "Wyoming Long-Term Care Partnership Program Act.

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42-7-102. Definitions.

(a) As used in this act: (i) "Agency" means the department of health; (ii) "Asset disregard" means, with respect to qualification for state Medicaid benefits, the disregard of any assets or resources in an amount equal to the insurance benefit payments that are made to or on behalf of an individual who is a beneficiary under a qualified long-term care insurance partnership policy; (iii) "Department" means the department of insurance; (iv) "Medicaid" means the program administered by the state pursuant to the Wyoming Medical Assistance and Services Act and this act and partly funded by the federal government pursuant to title XIX of the federal Social Security Act; (v) "Qualified long-term care insurance partnership policy" means a policy that meets all of the following requirements: (A) The policy covers an insured who was a resident of Wyoming when coverage first became effective under the policy; (B) The policy is a qualified long-term care insurance policy as defined in section 7702B(b) of the Internal Revenue Code of 1986 issued not earlier than the effective date of the state plan amendment; (C) The director of the department certifies that the policy meets the model regulations and requirements of the national association of insurance commissioners model specified in paragraph (5) of title VI, section 6021 of the federal Deficit Reduction Act of 2005; and (D) If the policy is sold to an individual who: (I) Has not attained age sixty-one (61) as of the date of purchase, the policy provides compound annual inflation protection; (II) Has attained age sixty-one (61) but has not attained age seventy-six (76) as of such date, the policy provides some level of inflation protection; or (III) Has attained age seventy-six (76) as of such date, the policy may, but is not required to, provide some level of inflation protection. (vi) "State plan amendment" means a state Medicaid plan amendment made with the approval of the federal department of health and human services that provides for the disregard of any assets or resources in an amount equal to the insurance benefit payments that are made to or on behalf of an individual who is a beneficiary under a qualified long-term care insurance partnership policy.

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42-7-103. Wyoming long-term care partnership program established.

(a) In accordance with title VI, section 6021 of the federal Deficit Reduction Act of 2005, there shall be established the Wyoming long-term care partnership program, to be administered by the agency with the assistance of the department, to provide incentives for individuals to insure against the costs of providing for their long-term care needs by creating a mechanism for individuals to qualify for coverage of the cost of their long-term care needs under Medicaid without first being required to substantially exhaust their resources. (b) The agency shall: (i) Before January 1, 2010, or as soon thereafter as possible, make application to the federal department of health and human services for a state plan amendment to establish that, if an individual is a beneficiary of a long-term care partnership program certified policy, the total assets an individual owns and may retain under Medicaid and still qualify for benefits under Medicaid at the time the individual applies for long-term care benefits are increased by one dollar ($1.00) for each one dollar ($1.00) of benefit paid out under the individual's long-term care partnership program certified insurance policy; (ii) Provide information and technical assistance to the department on the department's role in assuring that any individual who sells a qualified long-term care insurance partnership policy receives training and demonstrates evidence of an understanding of such policies and how they relate to other public and private coverage of long-term care. (c) The department may not impose any requirement affecting the terms of benefits of a policy under the partnership program unless the department imposes such requirement on long-term care insurance policies without regard to whether the policy is covered under the partnership or is offered in connection with such a partnership. (d) The issuers of qualified long-term care partnership policies in Wyoming shall provide regular reports to the secretary of the federal department of health and human services, in accordance with federal regulations. (e) Reciprocity between the program and other state programs shall be subject to the following: (i) Any individual who has purchased a partnership policy in any participating state, who has received benefits under the policy and who applies for Medicaid in a participating state other than the one in which the policy was issued shall receive an asset disregard in an equal dollar amount to the benefits received under the policy; (ii) The asset disregard procedure and calculation shall be the same for every individual with a partnership policy who applies for Medicaid in the participating state, without regard to whether the policy was purchased in another state or the date the policy was purchased; (iii) An amount equal to the benefits received under the partnership policy shall be exempt from Medicaid estate recovery provisions; and (iv) If a person moves from the state in which the person's partnership policy was issued, later applies for Medicaid in another participating state and is determined to be eligible using a partnership asset disregard, the partnership asset disregard shall not be revoked upon eligibility redetermination should the state subsequently decide to become exempt from the reciprocity agreement.

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42-7-104. Administration.

(a) The agency and the department are authorized to adopt rules to implement and administer the provisions of this act. (b) The agency and department shall comply with all federal rules developed in accordance with title VI, section 6021 of the federal Deficit Reduction Act of 2005, regarding data reporting, reciprocity with other states that develop long-term care insurance partnership programs, and any other matters, and shall have the authority to adopt regulations relative to the provisions of any federal rules and their administration.

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42-8-101. Short title.

This article shall be known and may be cited as the "Wyoming Nursing Care Facility Assessment Act."

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42-8-102. Definitions.

(a) As used in this article: (i) "Account" means the nursing care facility assessment account created under W.S. 42-8-103; (ii) "Department" means the department of health; (iii) "Fiscal year" means the twelve (12) month period beginning October 1 and ending September 30; (iv) "Medicaid" means as defined in W.S. 42-7-102(a)(iv); (v) "Medicare resident day" means a resident day funded by the Medicare program, a Medicare advantage or special needs plan or by the Medicare hospice program; (vi) "Net patient service revenue" means gross inpatient revenues from services provided to nursing care facility patients less reductions from gross inpatient revenue resulting from an inability to collect payment of charges. Inpatient care revenue excludes nonpatient care revenue such as beauty and barber, vending income, interest and contributions, revenues from the sale of meals and all outpatient revenues. Reductions from gross revenue includes bad debts, contractual adjustments, uncompensated care, discounts and adjustments and other revenue deductions; (vii) "Nursing care facility" means a facility providing nursing care, but does not include a facility solely providing assisted living care, a facility solely providing rehabilitative services or a facility solely providing a combination of assisted living care and rehabilitative services; (viii) "Resident day" means a calendar day of care provided to a nursing facility resident, including the day of admission and excluding the day of discharge, provided that one (1) resident day shall be deemed to exist when admission and discharge occur on the same day; (ix) "Upper payment limit" means the limitation established pursuant to 42 C.F.R. 447.272 that disallows federal matching funds when state Medicaid agencies pay certain classes of nursing care facilities an aggregate amount for services furnished by that class of nursing care facilities that would exceed the amount that would be paid under Medicare payment principles.

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42-8-103. Nursing care facility assessment account.

(a) The nursing care facility assessment account is created. (b) The state treasurer shall invest amounts deposited within the account in accordance with law, and all investment earnings shall be credited back to the account. (c) The account shall consist of: (i) Amounts collected or received by the department from nursing care facility assessments under this article; (ii) All federal matching funds received by the department as a result of expenditures made by the department attributable to the account; (iii) Any interest or penalties levied in conjunction with the administration of this article. (d) The account is created for the purpose of receiving funds as specified in this section. Collected assessment funds shall be used to secure federal matching funds available through the state Medicaid plan, which shall be used to make Medicaid payments for nursing care facility services which exceed the amount of nursing care facility Medicaid rates, in the aggregate, as calculated in accordance with the approved state Medicaid plan in effect on October 1, 2010. The fund shall be used exclusively for the following purposes: (i) To pay administrative expenses incurred by the department or its agent in performing the activities authorized by this article, provided that such expenses shall not exceed a total of one percent (1%) of the aggregate assessment funds collected in the fiscal year; (ii) To increase nursing care facility payments to fund covered services to Medicaid beneficiaries within Medicare upper payment limits, as negotiated with the department. The upper payment limit for private nursing care facilities, state government-owned facilities and nonstate government-owned nursing facilities shall be calculated by the department using the higher of the cost-based or prospective payment system approach in accordance with the provisions of 42 C.F.R. 447.272; (iii) To repay the federal government any excess payments made to nursing facilities if the state plan, after approval by the federal centers for Medicare and Medicaid services, is subsequently disapproved for any reason and after the state has appealed. Nursing care facilities shall refund the excess payments to the assessment account. The department shall return the excess payments to the federal government and nursing care facility providers in the same proportion as the original financing. Individual nursing care facilities shall be reimbursed based on the proportion of the individual nursing care facility's assessment to the total assessment paid by nursing care facilities. If a nursing care facility is unable to refund payments as provided in this paragraph, the department shall develop a payment plan and deduct amounts from future Medicaid payments. The department shall refund the federal government for the federal portion of those overpayments; or (iv) To make quarterly adjustment payments as provided in W.S. 42-8-108.

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42-8-104. Assessments.

(a) Each nursing care facility shall pay the nursing care facility assessment to the account in accordance with this article. (b) The aggregated amount of assessments for all nursing facilities during a fiscal year shall be the lesser of the amount necessary to fund the provisions of this article or the maximum amount that may be assessed pursuant to the indirect guarantee threshold as established pursuant to 42 C.F.R. 433.68(f)(3)(i). The department shall determine the assessment rate prospectively for the applicable fiscal year on a per-resident-day basis, exclusive of Medicare resident days. The per-resident-day assessment rate shall be uniform. The department shall promulgate rules for facility reporting of non-Medicare resident days and for payment of the assessment. (c) The department shall collect, and each nursing care facility shall pay, the assessment under this section on a quarterly basis. The initial payment shall be due not later than forty-five (45) days after the state plan has been approved by the federal centers for Medicare and Medicaid services unless a later date is set by the department. Subsequent payments are due not later than forty-five (45) days after the end of each calendar quarter. (d) Nursing care facility operators may increase their charges to incorporate the cost of paying the assessment under this section, but shall not create a separate line-item charge on the bill reflecting the assessment.

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42-8-105. Approval of state plan.

(a) The department shall seek necessary federal approval in the form of state plan amendments in order to implement the provisions of this article. (b) The department shall adopt rules and regulations necessary to implement the provisions of this article or obtain approval of the state plan amendments.

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42-8-106. Multiple facilities.

If a person conducts, operates or maintains more than one (1) nursing care facility licensed by the department, the person shall pay the assessment for each nursing care facility separately.

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42-8-107. Penalties for failure to pay assessment.

(a) If a nursing care facility fails to pay an assessment when due under this article, there shall be added to the assessment a penalty equal to five percent (5%) of the amount of the assessment that was not paid when due. The penalty under this section may be waived by the department for good cause. Any payments after a penalty is assessed under this section shall be credited first to unpaid assessment amounts rather than to penalty or interest amounts, beginning with the most delinquent installment. (b) In addition to the penalty under subsection (a) of this section, the department may implement any of the following remedies for failure of a nursing care facility to pay its assessment when due under this article: (i) Withhold any medical assistance reimbursement payments until the assessment is paid; (ii) Suspend or revoke the nursing care facility's license; or (iii) Develop a plan that requires the nursing care facility to pay any delinquent assessment in installments.

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42-8-108. Quarterly adjustment payments.

(a) Each nursing facility is eligible for quarterly adjustments as provided in this section. (b) The department shall determine the number of days that nursing care facility services were paid for by the Wyoming medical assistance program for the applicable annual cost report. That number of days shall be utilized by the department to determine the nursing care facility adjustment payment. Adjustment payments shall be paid by the department on a quarterly basis to reimburse covered Medicaid expenditures in the aggregate within the upper payment limit. Each quarterly payment shall be made not later than thirty (30) days after the end of the calendar quarter with the initial adjustment payment due not later than thirty (30) days after the approval by the federal centers for Medicare and Medicaid services of the state's plan reflecting facility adjustment payments.

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42-8-109. Discontinuation of the assessment and quarterly adjustment payments.

(a) The assessment imposed by this article shall be discontinued if: (i) The state plan amendment reflecting the quarterly nursing care facility adjustment payments under W.S. 42-8-108 is not approved by the federal centers for Medicare and Medicaid services. The department may modify the rate adjustment provisions as necessary to obtain the federal centers for Medicare and Medicaid services approval if such changes do not exceed the authority and purposes of this article; (ii) The department reduces rates to a level less than the rates effective on October 1, 2010 plus revenue increases from the account, including matches by federal financial participation; (iii) The department or any other state agency attempts to utilize the money in the account for any use other than permitted by this article; (iv) If federal financial participation to match assessments under this article becomes unavailable under federal law. In such case, the department shall terminate the imposition of assessments beginning on the date the federal statutory, regulatory or interpretive change takes effect. (b) If collection of the assessment is discontinued as provided in this section, quarterly adjustment payments shall be discontinued and any amount in the account shall be returned to the nursing care facility from which the assessment was collected on the same basis as it was collected.

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42-9-101. Short title.

This chapter shall be known and may be cited as the "Wyoming Private Hospital Assessment Act."

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42-9-102. Definitions.

(a) As used in this chapter: (i) "Account" means the private hospital assessment account created by W.S. 42-9-103; (ii) "Department" means the department of health; (iii) "Fiscal year" means the twelve (12) month period beginning October 1 and ending September 30; (iv) "Medicaid" means the medical assistance program established by title XIX of the federal Social Security Act and administered in this state by the department pursuant to the Wyoming Medical Assistance and Services Act; (v) "Medicare cost report" means the annual hospital cost report as determined by the centers for medicare and medicaid services and as reported to the health care cost report information system; (vi) "Net hospital patient revenue" means gross hospital revenue as reported on the most recently filed medicare cost report, excluding estimated nonhospital ancillary revenue, multiplied by the hospital’s ratio of total net to gross revenue. The department shall establish a procedure to reconcile filed cost report information with information from the settled cost report. If a hospital does not file a medicaid cost report, the department shall establish a procedure to determine what the hospital would have reported as net patient hospital revenue if the hospital had filed a medicaid cost report; (vii) "Private hospital" means those institutions licensed by the department as hospitals which are not owned or operated by the state or any city, town, county, special district or other political subdivision of the state or local government; (viii) "Quarterly adjustment payment" means the payment made to private hospitals pursuant to W.S. 42-9-106; (ix) "Upper payment limit" means the applicable limitation established pursuant to 42 C.F.R. 447.272, 42 C.F.R. 447.321 or as otherwise established by the centers for medicare and medicaid services; (x) "Upper payment limit gap" means the amount calculated annually by the department constituting the difference between the applicable upper payment limit and medicaid payments made subject to that limit in a fiscal year, excluding any quarterly adjustment payments authorized by this chapter; (xi) "Hospital services" means inpatient, outpatient and other services provided by a private hospital or by practitioners employed by, under contract with or in affiliation with a hospital-affiliated professional service provider group. Hospital services for purposes of this act include services provided in a psychiatric residential treatment facility owned, operated by or affiliated with a private hospital.

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42-9-103. Private hospital assessment account.

(a) The private hospital assessment account is created. (b) The state treasurer shall invest amounts deposited within the account in accordance with law and all investment earnings shall be credited back to the account. Funds in the account are continuously appropriated to the department for the purposes specified in this section. (c) The account shall consist of: (i) Amounts collected or received by the department from private hospital assessments under this chapter; (ii) All federal matching funds received by the department as a result of expenditures made by the department pursuant to this chapter. (d) The account shall be used exclusively for the following purposes: (i) To pay administrative expenses incurred by the department or its agent in performing the activities authorized by this chapter, provided that these expenses shall not exceed a total of three percent (3%) of the aggregate assessment funds collected in the fiscal year; (ii) To secure federal matching funds available through the state medicaid plan as approved pursuant to W.S. 42-9-108, which shall be used to make quarterly adjustment payments as provided by this chapter; (iii) To repay to the federal government any excess payments received or made to private hospitals if the state plan, after approval by the centers for medicare and medicaid services, is subsequently disapproved for any reason and after the state has exhausted all appeals. Private hospitals shall refund any excess payments to the assessment account. If a private hospital is unable to refund payments as provided in this paragraph, the department shall develop a payment plan to recoup deficient payments and accordingly deduct amounts from future medicaid payments. The department shall refund the federal government for the federal portion of those overpayments; (iv) To refund assessments paid by private hospitals for quarterly adjustment payments which were earned but not paid by the department, but only after the payments authorized by paragraphs (i) and (iii) of this section have been made.

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42-9-104. Assessments.

(a) Each private hospital shall pay a private hospital assessment to the department in accordance with this section. Hospitals owned or operated by the state or any city, town, county, special district or other political subdivision of the state or local government shall not be required to pay the assessment required by this section. (b) The assessment due under this section shall be imposed each fiscal year in an amount calculated as a uniform percentage of each hospital's net patient revenue. The assessment rate shall be determined by the department on a prospective basis and shall be based on the percentage of net hospital patient revenue needed to generate an amount not to exceed the nonfederal portion of the upper payment limit gap plus the fee authorized by W.S. 42-9-103(d)(i). In no event shall the assessment rate: (i) Exceed the indirect guarantee threshold amount established by 42 C.F.R. 433.68(f)(3)(i) or other federal law; (ii) Exceed two percent (2%) of a hospital's net patient revenue for the first fiscal year in which the hospital is assessed; (iii) Increase by more than one percent (1%) of a hospital's net patient revenue for each fiscal year following the first fiscal year in which the hospital is assessed without further approval by the legislature. (c) Unless otherwise determined by the department, the department shall collect and each private hospital shall pay the assessment required by this section on a quarterly basis, each payment constituting twenty-five percent (25%) of the annual assessment determined by the department. The initial payment shall be due not later than forty-five (45) days after the state plan has been approved by the centers for medicare and medicaid services unless a later date is set by the department. Subsequent payments are due not later than forty-five (45) days after the end of each calendar quarter unless a later date is set by the department. (d) If a private hospital ceases to operate as a hospital or for any reason ceases to be subject to the assessment imposed under this chapter, the assessment for the fiscal year in which the cessation occurs shall be adjusted by multiplying the annual assessment by a fraction, the numerator of which is the number of days in the year during which the hospital is subject to the assessment and the denominator of which is three hundred sixty-five (365). Immediately upon ceasing to operate as a hospital, or otherwise ceasing to be subject to this chapter, the hospital shall pay the assessment for each quarter as adjusted, to the extent not previously paid.

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42-9-105. Penalties for failure to pay assessment.

(a) If a private hospital fails to pay an assessment due under this chapter, there shall be added to the assessment a penalty equal to five percent (5%) of the amount of the assessment that was not paid when due. The penalty under this section may be waived by the department for good cause. Any payments made after a penalty is assessed under this section shall be credited first to unpaid assessment amounts rather than to penalty amounts, beginning with the most delinquent installment. (b) In addition to the penalty under subsection (a) of this section, the department may implement any of the following remedies for failure of a private hospital to pay its assessment when due under this chapter: (i) Withhold any medicaid payments, including any quarterly adjustment payments, until the assessment is paid; or (ii) Develop a plan that requires the private hospital to pay any delinquent assessment in installments.

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42-9-106. Quarterly adjustment payments.

(a) To preserve the quality and improve access to private hospital services, the department shall make quarterly adjustment payments as set forth in this section. (b) Each private hospital that pays assessments under this chapter and is eligible to receive medicaid payments shall be eligible to receive quarterly adjustment payments as provided in this section. The department shall distribute quarterly adjustment payments in an amount up to but not to exceed the applicable upper payment limit gap. The department shall establish a uniform methodology by which to distribute quarterly adjustment payments in compliance with applicable federal and state medicaid laws and regulations. (c) Quarterly adjustment payments shall not be used to offset any other payment by medicaid for hospital services to medicaid beneficiaries, including without limitation any fee-for-service, per diem, private hospital inpatient adjustment or cost settlement payment. (d) No private hospital shall be guaranteed, expressly or otherwise, that any quarterly adjustment payment will equal or exceed the amount of the private hospital assessments due under this chapter. (e) Monies made available by this chapter shall not be used to replace other general revenues appropriated and funded by the legislature or other revenues used to support medicaid.

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42-9-107. Discontinuation of the assessment and quarterly adjustment payments.

(a) The assessment imposed by this chapter shall be discontinued if: (i) The state plan amendment reflecting the quarterly adjustment payments authorized by this chapter is not approved by the centers for medicare and medicaid services. The department may modify the quarterly adjustment payment provisions as necessary to obtain the centers for medicare and medicaid services approval if the changes do not exceed the authority and purposes of this chapter; (ii) Federal financial participation to match assessments under this chapter becomes unavailable under federal law. In this event, the department shall terminate the imposition of assessments beginning on the date the federal statutory, regulatory or interpretive change takes effect. (b) If collection of the assessment is discontinued as provided in this section, quarterly adjustment payments shall be discontinued and, after payment of all amounts under W.S. 42-9-103(d)(i) and (iii), any assessments remaining in the account shall be returned to the private hospitals from which the assessments were collected on the same basis as they were collected.

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42-9-108. Approval of state plan; rulemaking.

(a) The department shall seek necessary federal approval in the form of state plan amendments in order to continue to implement the provisions of this chapter. The department shall be deemed to satisfy this requirement by seeking approval for the operation of an upper payment limit program that provides for quarterly adjustment payments. While seeking federal approval under this subsection, the department may modify payment or qualification provisions as necessary to obtain the Centers for Medicare and Medicaid Services approval if the changes do not exceed the authority and purposes of this chapter. (b) The department shall adopt rules and regulations necessary to implement the provisions of this chapter and to obtain approval of the state plan amendments.

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42-9-109. Multiple facilities.

If a person conducts, operates or maintains more than one (1) private hospital licensed by the department, the person shall pay the assessment for each private hospital separately.

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42-10-101. Definitions.

(a) As used in this chapter: (i) "Identity information" includes the name, alias, date of birth, address, social security number and other related information of an applicant for or recipient of a public welfare benefit; (ii) "Public welfare benefit" means as provided in W.S. 42-2-102(a)(vii).

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42-10-102. Enhanced identity authentication process.

Prior to awarding any public welfare benefit the department may require an applicant to complete an identity authentication process that confirms the applicant owns the identity presented in the application. The identity authentication process under this section shall consist of financial or personal questions related to the applicant. The authentication process shall be available for applicant interviews in person or by telephone.

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42-10-103. Enhanced eligibility verification process.

(a) Prior to awarding any public welfare benefit, and on a quarterly basis after any benefit is awarded, the department shall, to the extent practicable, determine the following information as it relates to each applicant for or recipient of a public welfare benefit: Note: Effective 1/1/2027 this subsection will read as: (a) Prior to awarding any public welfare benefit, and at the intervals specified in this section after any benefit is awarded, the department shall, to the extent practicable, determine the following information as it relates to each applicant for or recipient of a public welfare benefit: (i) Earned and unearned income information maintained by the United States internal revenue service; (ii) Weekly, monthly or quarterly reports of income and unemployment insurance payment information maintained by the department of workforce services; (iii) Income information maintained by the United States social security administration; Note: Effective 1/1/2027 this paragraph will read as: (iii) Income information maintained by the United States social security administration, reviewed by the department at every application and recertification period; (iv) Immigration status information maintained by the United States citizenship and immigration services; Note: Effective 1/1/2027 this paragraph will read as: (iv) Immigration status information maintained by the United States citizenship and immigration services and verified through the SAVE online service or other acceptable documentation; (v) Death register information maintained by the United States social security administration; Note: Effective 1/1/2027 this paragraph will read as: (v) Death register information maintained by the United States social security administration, reviewed by the department not less than on a monthly basis; (vi) Prisoner information maintained by the United States social security administration; Note: Effective 1/1/2027 this paragraph will read as: (vi) Prisoner information maintained by the United States social security administration, reviewed by the department of family services at every application and recertification period; (vii) Public housing and section 8 housing assistance payment information; Note: Effective 1/1/2027 this paragraph will read as: (vii) Public housing and section 8 housing assistance payment information, reviewed by the department of family services at every application and recertification period; (viii) Fleeing felon, probation or parole violation information; Note: Effective 1/1/2027 this paragraph will read as: (viii) Fleeing felon, probation or parole violation information, reviewed by the department of family services at every application and recertification period; (ix) Wage reporting information maintained by states contiguous to Wyoming; (x) Beneficiary records and earnings information maintained by the United States social security administration in the beneficiary and earnings data exchange system; Note: Effective 1/1/2027 this paragraph will read as: (x) Beneficiary records and earnings information maintained by the United States social security administration in the beneficiary and earnings data exchange system, reviewed by the department at every application and recertification period; (xi) Earnings and pension information maintained by the United States social security administration in the beneficiary earnings exchange record system; Note: Effective 1/1/2027 this paragraph will read as: (xi) Earnings and pension information maintained by the United States social security administration in the beneficiary earnings exchange record system, reviewed by the department at every application and recertification period; (xii) Earnings and pension information maintained by the Wyoming retirement system; Note: Effective 1/1/2027 this paragraph will read as: (xii) Earnings and pension information maintained by the Wyoming retirement system, reviewed by the department of family services at every application and recertification period and by the department of health upon the receipt of applicable information from the Wyoming retirement system; (xiii) Employment information maintained by the department of workforce services; Note: Effective 1/1/2027 this paragraph will read as: (xiii) Employment information, reviewed by the department at every application and recertification period; (xiv) Employment information maintained by the United States department of health and human services in the national directory of new hires; Note: Effective 1/1/2027 this paragraph will read as: (xiv) Employment information maintained by the United States department of health and human services in the national directory of new hires, reviewed by the department of family services at every application and recertification period; (xv) Supplemental security income information maintained by the United States social security administration in the social security income state data exchange system; Note: Effective 1/1/2027 this paragraph will read as: (xv) Supplemental security income information maintained by the United States social security administration in the social security income state data exchange system, reviewed by the department at every application and recertification period; (xvi) Veterans' benefits information; (xvii) Child care services information maintained by the department; (xviii) Utility payment information maintained by the state under the low income home energy assistance program as provided in W.S. 42-2-501; (xix) Emergency utility payment information maintained by the state or local governmental entities; and (xx) Income and employment information maintained by the department and the United States department of health and human services office of child support enforcement. (b) The department is authorized to enter into agreements with third-party vendors to obtain the following information prior to awarding any public welfare benefit, and on a quarterly basis after any benefit is awarded: (i) Information on public welfare benefits received in other states maintained in any real time national database, including the national accuracy clearinghouse; (ii) A nationwide public records data source of physical asset ownership including real property, automobiles, watercraft, aircraft, luxury vehicles or any other vehicle; (iii) A nationwide public records data source of incarcerated individuals; (iv) A nationwide best available address and driver's license data source to verify individuals are residents of Wyoming; (v) A comprehensive public records database that identifies potential identity fraud or identity theft which can closely associate name, social security number, date of birth, phone and address information; or (vi) National and local financial institutions, in order to locate undisclosed depository accounts or verify account balances of disclosed accounts. (c) In addition to the records specified in subsections (a) and (b) of this section, the department may also consider information from any database or source which is substantially similar to or a successor of any record, database or information specified under this section. (d) On not less than a quarterly basis, the department of family services and department of health shall each make available on their public websites all of the following data from findings on noncompliance and fraud investigations, provided the data is presented in the aggregate and does not include confidential or personally identifying information: [NOTE: This subsection will be effective 1/1/2027.] (i) The total number of public benefit cases investigated for intentional program violations or fraud; (ii) The total number of public benefit cases referred to the attorney general's office for prosecution; (iii) Total improper payments and expenditures; (iv) Total monies received; (v) Aggregate data concerning improper payments and ineligible recipients as a percentage of those recipients investigated and reviewed.

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42-10-104. Case review process.

(a) If the department finds a discrepancy or change in circumstances as a result of the activities required by W.S. 42-10-102 or 42-10-103, the department shall review the case using the following procedures: (i) If the discrepancy or change in circumstances does not affect eligibility, the department shall take no further action; (ii) If the discrepancy or change in circumstances may affect eligibility, the department shall: (A) Promptly make a determination of the effect of the discrepancy or change in circumstances on the eligibility of the applicant or recipient; and (B) Provide written notice to the applicant or recipient describing in detail the circumstances of the discrepancy or change in circumstances, the manner in which the applicant or recipient may respond and the consequences of failing to take any action. The department shall give the applicant or recipient an opportunity to explain the discrepancy or change in circumstances. (iii) The applicant or recipient shall respond within ten (10) business days from the date of the written notice of the discrepancy or change in circumstances; (iv) If an applicant or recipient does not respond to a notice of a discrepancy or change in circumstances as provided in paragraph (ii) of this subsection and the department determines that the discrepancy or change in circumstances affects eligibility for a public welfare benefit, the department shall provide a written decision of the intent to deny, reduce the benefit or close the benefit case; (v) If an applicant or recipient responds to a notice of a discrepancy or change in circumstances as provided in paragraph (ii) of this subsection, the department shall investigate and make a determination of whether or not the discrepancy or change in circumstances has been resolved and determine the applicant's or recipient's eligibility for public welfare benefits. The decision of the department shall be provided to the applicant or recipient in writing; (vi) A written decision of the department under this section shall constitute a final decision of the department subject to judicial review as provided in W.S. 16-3-114.

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42-10-105. Referral of cases for investigation.

(a) After review of a discrepancy or change in circumstances under W.S. 42-10-104, if the department finds that there is inadequate documentation or upon reasonable suspicion that there is fraud, misrepresentation, identity theft or another violation of law the department shall: (i) Refer the case to the fraud and recovery unit for investigation, recovery of improper payments and collection of civil penalties, if applicable and, if appropriate, referral to prosecuting authorities for criminal prosecution; (ii) Refer the information to other agencies, divisions or departments as appropriate for review of eligibility in public programs. (b) To the extent the department encounters an individual enrolled in Medicaid who the department has reason to believe is not eligible for Medicaid, the department shall inform the individual and the Wyoming Medicaid program of the reason the department does not believe the individual is eligible.

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