The State Plan is a contract between a State and the Federal government, enabling the delivery of health care. It ensures that a State abides by Federal rules and gets FFP. The State Plan sets out groups to be covered, services provided and limitations, reimbursement methodologies, and administrative requirements.
To view the process on getting a State Plan Amendment approved click on the flow chart link.
Region 8 Medicaid SPA Process Flow Chart
Public Notices for Pending State Plan Amendments
Public and Tribal Notice
Wyoming Department of Health, Medicaid
Proposed Amendment to the Wyoming Medicaid State Plan
Ground Ambulance Medicare-Equivalent Average Commercial Rate (ACR) Ratios Update
February 18, 2026
Public and tribal notice is hereby given that the Wyoming Department of Health intends to submit a State Plan Amendment (SPA) to the United States Department of Health and Human Services, Centers for Medicare & Medicaid Services (CMS).
Nature of the Proposed Change
This amendment updates the provider-specific Medicare-Equivalent ACR ratios listed in Attachment 4.19-B, Part 1, Addendum 5 of the Wyoming Medicaid State Plan. These ratios are used to calculate each provider’s Upper Payment Limit (UPL) under the existing CMS-approved methodology. This SPA does not revise methodology, policy, services, or eligibility in any way. Only the numerical ACR ratios are being updated to reflect the most recent submitted commercial rate data.
Estimated Fiscal Impact
The estimated total expenditure increase is $225,000 in FFY 2027 and $300,000 in FFY 2028. The corresponding federal share is $112,500 in FFY 2027 and $150,000 in FFY 2028.
Rationale for the Change
This update is necessary to incorporate the most recent commercial rate data submitted by Wyoming-licensed ground ambulance providers and to maintain compliance with the CMS-approved Upper Payment Limit methodology.
Proposed Effective Date
The proposed effective date of this amendment is July 1, 2026, contingent upon CMS approval.
Public Review and Comment
Copies of this proposed amendment are available at https://health.wyo.gov/wp-content/uploads/2026/02/Ground-Ambulance-ACR-Update-DRAFT-State-Plan-Page.pdf for public review, or by contacting the Wyoming Department of Health, Division of Healthcare Financing. To provide comment or to obtain a copy of the proposed State Plan Amendment, contact:
Sara Pino
Wyoming Department of Health
122 West 25th Street, 4th Floor West
Cheyenne, WY 82002
Phone: 307-777-7473
Email: Sara.Pino3@wyo.gov
Public and Tribal Notice
Wyoming Department of Health, Medicaid
Proposed Amendment to the Wyoming Medicaid State Plan
Fee Schedule Frontispiece
December 19, 2025
Public and tribal notice is hereby given that the Wyoming Department of Health intends to submit a State Plan Amendment (SPA) to the United States Department of Health and Human Services, Centers for Medicare & Medicaid Services (CMS).
Nature of the Proposed Change
Wyoming Medicaid proposes to adopt a single consolidated “Fee Schedule Frontispiece” within Section 4 of the Wyoming Medicaid State Plan. This frontispiece will serve as the authoritative index listing all Medicaid fee schedules, their effective dates, and the public URLs where those schedules are posted. This change does not change reimbursement methodologies; does not add, remove, or modify covered services; and does not impact member eligibility or benefits. As part of this change, existing State Plan pages that currently contain embedded fee schedule links or effective dates will be updated to reference the new frontispiece instead.
Estimated Fiscal Impact
This amendment is anticipated to be cost neutral and is not expected to result in any change to aggregate Medicaid expenditures.
Rationale for the Change
This amendment is proposed to establish a centralized and authoritative reference for all Wyoming Medicaid fee schedules, and ensure all references to fee schedules are accurate and current. A background and summary of this proposed amendment can be viewed at: https://health.wyo.gov/wp-content/uploads/2025/12/Proposal-for-Implementation-of-Fee-Schedule-Frontispiece-in-State-Plan.pdf
Proposed Effective Date
The proposed effective date of this amendment is January 1, 2026, contingent upon CMS approval.
Public Review and Comment
Copies of the Wyoming Medicaid State Plan will be available for public review at the Wyoming Department of Health, Division of Healthcare Financing. To provide comment or to obtain a copy of the proposed State Plan Amendment, contact:
Denzel Clifton
Wyoming Department of Health
122 West 25th Street, 4th Floor West
Cheyenne, WY 82002
Phone: 307-777-2554
Email: Denzel.Clifton1@wyo.gov
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Page Updated 02/18/2026