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
Wyoming Nursing Home Reimbursement System
June 18th, 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).
Wyoming submitted this SPA to CMS on September 22, 2025, following notice, provider communication, and stakeholder engagement conducted over a period of approximately two years prior to implementation of the Patient-Driven Payment Model (PDPM). This additional notice is being provided to maintain a complete public and tribal notice record and to preserve the State’s ability to resubmit the SPA, if necessary, with an effective date supported by this notice.
Nature of the Proposed Change
The proposed amendment is to transition the nursing home reimbursement methodology from the Resource Utilization Group (RUG) system to the Patient Driven Payment Methodology (PDPM).
Estimated Fiscal Impact
The estimated total expenditure impact of transitioning from the RUG methodology to the PDPM methodology is $0. This amendment is cost neutral and is not expected to result in an increase or decrease in annual aggregate expenditures.
Rationale for the Change
In the August 2018 Medicare final rule, CMS announced that the RUG-IV case-mix classification model under the Medicare skilled nursing facility (SNF) prospective payment system (PPS) would be replaced with the PDPM case-mix classification model beginning October 1, 2019. In October 2023, CMS stopped supporting RUG-IV case-mix on federally required assessments. Due to this change, Wyoming Medicaid must transition from the RUG-IV payment methodology to PDPM.
Proposed Effective Date
Should re-submission of this SPA be required, the proposed effective date will be July 1, 2026, contingent upon CMS approval.
Public Review and Comment
Copies of this proposed amendment are available for public review at the Wyoming Department of Health, Division of Healthcare Financing. Interested parties from all counties may request copies, ask questions, or submit comments by contacting Amy Guimond. No public hearings have been scheduled for this State Plan Amendment. To provide comment or to obtain a copy of the proposed State Plan Amendment, contact:
Amy Guimond
Wyoming Department of Health
122 West 25th Street, 4th Floor West
Cheyenne, WY 82002
Phone: 307-777-7473
Email: amy.guimond@wyo.gov
Public and Tribal Notice
Wyoming Department of Health, Medicaid
Proposed Amendment to the Wyoming Medicaid State Plan
Fee Schedule Effective Dates Update
June 4th, 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 proposes to update the Introduction page to Attachment 4.19 of the Wyoming Medicaid State Plan to reflect fee schedule updates effective July 1, 2026. The Introduction page, which is pending CMS approval as of the date of this notice, identifies the effective dates for state-developed fee schedule rates and directs providers and the public to the agency’s published fee schedules.
Estimated Fiscal Impact
The estimated total expenditure increase is $3,386,213 in FFY 2026 and $13,544,850 in FFY 2027. The corresponding federal share increase is $1,693,106 in FFY 2026 and $6,772,425 in FFY 2027.
Rationale for the Change
This update is necessary to align the Wyoming Medicaid State Plan with the agency’s fee schedules effective July 1, 2026, and to reflect legislatively approved Medicaid rate changes implemented through those fee schedules.
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 for public review, 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:
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
Public and Tribal Notice
Wyoming Department of Health, Medicaid
Proposed Amendment to the Wyoming Medicaid State Plan
Coverage of Freestanding Birth Centers
May 13th, 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
Wyoming Medicaid proposes to amend Attachment 3.1-A, Page 12, Freestanding Birth Center Services, and adopt a new Attachment 4.19-B page for Freestanding Birth Center Services. This amendment is being submitted to authorize coverage and payment for freestanding birth center services in accordance with recently enacted state law requiring Wyoming Medicaid coverage for this facility type.
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 adds freestanding birth center services to the Medicaid State Plan in accordance with state law.
Proposed Effective Date
The proposed effective date of this amendment is July 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 05/13/2026