Section 16-8 - Random Sample and Extrapolation (a) Determination to use sampling. The determination to use sampling shall be within the Department's discretion.
(b) Sampling methods. The Department shall adhere to the following standards in using sampling: - (i) Samples shall be selected using a method which ensures that each claim in the universe to be sampled has an equal and independent chance of being chosen for the sample;
- (ii) Samples shall be selected only from claims within a time period which coincides with the period under investigation and from which recovery may be made;
- (iii) The sampling method, including the size of the sample, the selection of the samples and any extrapolation from the results of the sample, shall be in accordance with Department approved statistical procedures in accordance with Generally Accepted Auditing Standards (GAAS) and Statement on Accounting Standards (SAS); and
- (iv) Samples shall be selected at the ninety-five percent (95%) confidence level.
(c) Notice of intent to extrapolate. The Department shall notify the provider of its intent to use extrapolation. The notice shall include: - (i) The nature of the claims;
- (ii) The number of claims; and
- (iii) The method to be used in extrapolating from the sample.
(d) Effect of extrapolation results. The amount of overpayments determined pursuant to extrapolation shall be refutably presumed to be correct. The provider may rebut the presumption by providing, at the provider's expense, an audit using GAAS or SAS, or by demonstrating that the method used by the Department failed to comply with the requirements of this Section.
048-16 Wyo. Code R. § 16-8