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
Professional Services Supplemental Payments (PSSP) Medicare-Equivalent Average Commercial Rate (ACR) Ratios Update
April 20, 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 4, Page 37 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 decrease is ($2,250,000) in FFY 2027 and ($3,000,000) in FFY 2028. The corresponding federal share decrease is ($1,125,000) in FFY 2027 and ($1,500,000) in FFY 2028.
Rationale for the Change
This update is necessary to incorporate the most recent commercial rate data submitted by Wyoming-licensed PSSP program participants 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/2026/04/PSSP-ACR-Update-DRAFT.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
Long Term Care Home Equity Limit Increase
April 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 Supplement 15 to Attachment 2.6-A, Disqualification for Long-Term Care Assistance for Individuals with Substantial Home Equity. The proposed amendment increases the home equity limit for individuals applying for Wyoming Medicaid long-term care services to $1,000,000. The current home equity limit is $752,000, which reflects the minimum amount permitted under federal regulations. This proposed change aligns with a provision of the One Big Beautiful Bill Act, effective January 1, 2028.
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 revises the home equity limit used in determining eligibility for long-term care services to reflect updated thresholds within federal parameters. The proposed change also aligns Wyoming Medicaid policy with forthcoming federal limits under the One Big Beautiful Bill Act.
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
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
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Page Updated 02/18/2026