Statutes, codes, and regulations
Wyoming Administrative Code
Agency 048 - Health, Department ofSubagency 0037 - Medicaid
Chapter 4 - MEDICAID ADMINISTRATIVE HEARINGS
Section 4-9 - Clients Maintaining Services Pending Appeal

048-4 Wyo. Code R. § 4-9

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Current through April 27, 2019
Section 4-9 - Clients Maintaining Services Pending Appeal

(a) If the Department mails the notice as required pursuant to subsection 6(a) of this Chapter, and the client requests a hearing before the effective date of the action, the Department may not terminate or reduce services until the final decision is rendered after the hearing unless:

  • (i) It is determined at the hearing that the sole issue is one of federal or state law or policy; and
  • (ii) The Department promptly informs the client in writing that services are to be terminated or reduced pending the final decision.

(b) If the adverse action is affirmed, the Department may institute recovery procedures against the client to recoup the cost of any services furnished to the client, to the extent they were furnished solely by reason of this section, and may recover any overpayments made to a provider.

(c) The Department shall reinstate and continue services until a decision is rendered if the action resulted from other than the application of federal or state law or policy pursuant to 42 C.F.R. § 431.231(c)(3).

048-4 Wyo. Code R. § 4-9