Statutes, codes, and regulations
Wyoming Administrative Code
Agency 048 - Health, Department ofSubagency 0037 - Medicaid
Chapter 16 - PROGRAM INTEGRITY
Section 16-7 - Audits

048-16 Wyo. Code R. § 16-7

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Current through April 27, 2019
Section 16-7 - Audits

Nothing in this rule shall prohibit the Department from conducting audits of providers as required or permitted by federal or state laws or policies.

(a) The Department or CMS may audit a provider at any time to determine whether the provider has received overpayments.

(b) The Department or CMS may perform audits through employees, agents, or through a third party. Audits shall be performed in accordance with generally accepted auditing standards.

(c) Reporting audit results. If at any time during an audit the Department discovers evidence of an overpayment, that evidence may be referred to the MFCU.

(d) Provider self-audit.

  • (i) A provider may do a self-audit at any time. The Department may review or audit the provider's self-audit.
  • (ii) The Department may require a provider to conduct a self-audit if there is a reasonable belief that the provider has received overpayments.
  • (iii) If the provider should have notified the Department of any overpayments and did not provide notification within thirty (30) days of the completion of the self-audit, the Department has the option of imposing additional sanctions pursuant to Section 9 of this Chapter.

048-16 Wyo. Code R. § 16-7