048-30 Wyo. Code R. § 30-25
(a) Field audits. The Department or HCFA may perform a field audit of a provider at any time to determine the accuracy and reasonableness of cost reports, the accuracy of cost settlements or whether the hospital has received excess payments.
(b) Desk reviews. The Department or HCFA may perform a desk review of a provider at any time to determine the accuracy and reasonableness of cost reports, the accuracy of cost settlements or whether the hospital has received excess payments.
(c) The Department or HCFA may perform field audits or desk reviews through employees, agents, or through a third party. Audits shall be performed in accordance with GAAS.
(d) Disallowances. If a field audit or desk review discloses nonallowable costs, overpayments or excess payments, the Department shall recover any excess payments pursuant to Section 28.
(e) Notice of excess payments. After determining that a provider has received excess payments, the Department shall send written notice to the provider, by certified mail, return receipt requested, stating the amount of the excess payments, the basis for the determination of excess payments and the providers right to request reconsideration of that determination pursuant to Section 29. The reconsideration shall be limited to whether the Department has complied with the provisions of this Chapter.
(f) Recovery of excess payments. A provider must reimburse the Department for excess payments within thirty days after the provider receives written notice from the Department pursuant to subsection (e), even if the provider has requested reconsideration or an administrative hearing regarding the determination of excess payments. If the provider fails to timely repay excess payments, the Department shall recover the excess payments pursuant to Section 28.
(g) Reporting audit results. If at anytime during a financial audit or a medical audit, HCF discovers evidence suggesting fraud or abuse by a provider, that evidence, in addition to HCFs final audit report regarding that provider, shall be referred to the Medicaid Fraud Control Unit of the Wyoming Attorney General's Office.
048-30 Wyo. Code R. § 30-25