048-16 Wyo. Code R. § 16-22

Current through April 27, 2019

Section 16-22 - Suspending or Withholding Payments Pending Reconsideration or Administrative Hearing

(a) The Department may suspend a provider or withhold all payments for services furnished by a provider pending reconsideration or administrative hearing if the State Medicaid Agent or his or her designee determines in writing and notifies the provider that:

• (i) There is a substantial likelihood the Department will prevail in an action to recover overpayments;

• (ii) There is a substantial likelihood the provider's pattern or practice which prompted the investigation will continue; or

• (iii) There is reasonable cause to doubt the provider's financial ability to refund any overpayments.

(b) The decision to suspend or withhold payments pursuant to this section may be subject to an administrative hearing pursuant to Chapter 4.

048-16 Wyo. Code R. § 16-22