048-31 Wyo. Code R. § 31-8

Current through April 27, 2019
Section 31-8 - Medicaid allowable payment for specialty services

(a) The Department shall reimburse specialty services through selective contracting with qualified providers. Except as otherwise provided in this Section, only providers that enter a contract with the Department shall be reimbursed for providing specialty services.

(b) All-inclusive rate. Providers of specialty services shall not receive Medicaid reimbursement for furnishing specialty services in addition to the contract rate.

(c) Services that require prior authorization or admission certification. The Division may, as part of the selective contracting process, require prior authorization or admission certification as a prerequisite to Medicaid payment. Failure to obtain prior authorization or admission certification shall result in the denial of Medicaid payment.

048-31 Wyo. Code R. § 31-8