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.
Public Notices for Pending State Plan Amendments
Public Notices for Pending Waiver Amendments
Proposed State Plan Amendments
Table of Contents
Section 1 - Single State Agency Organization
This section provides information regarding the State’s designation of the Wyoming Medicaid Single State Agency, the authority under which it operates and a description of the organization, statewide operation and the State Medical Care Advisory Committee.
Section 2 - Coverage and Eligibility
This section outlines coverage and eligibility conditions for Wyoming Medicaid such as the categories of eligible persons and the levels of income, resources and assets required to assess financial eligibility for the various programs and groups.
Section 3 - Services: General Provisions
This section provides information on amount, duration and scope of Wyoming Medicaid services including coordination with Medicare Part B, services for elderly or those in institutions for mental disease, special requirements for sterilization procedures, Medicaid for Medicare cost sharing for qualified Medicare beneficiaries, and ambulatory prenatal care for pregnant women during the presumptive eligibility period.
Section 4 - General Program Administration
This section provides information on general program administration, quality and utilization control and provider reimbursement. It also includes sections on hearing for applicants and recipients, fraud detection, facility surveys and inspections and the appeals process.
4.17 Liens and Recoveries
4.19 Payment for Services
4.23 Use of Contracts
4.11-A Standards for Institutions
4.19-C Payments for Reserved Beds
Section 5 - Personnel Administration
This section details the standards for personnel administration in the Medicaid program and provides assurances the State is in compliance with Federal Regulations regarding personnel administration standards and training.
Section 6 - Financial Administration
This section provides assurances the State is in compliance with Federal Regulations regarding fiscal policies and accountability, cost allocation and financial participation.
6.2 Cost Allocation
Section 7 - General Provisions
This section covers additional federal requirements such as State Plan amendments, nondiscrimination and the Governor’s review.
7.1 Plan Amendments