048-31 Wyo. Code R. § 31-4
(a) "Admission" or "admitted." The act by which an individual is admitted to a hospital as an inpatient or an outpatient."Admission" or "admitted" does not include an individual that is transferred from one unit of a hospital to another unit in the hospital or to a distinct part hospital unit.
(b) "Admission certification." Admission certification as defined by Chapter 8, which is incorporated by this reference.
(c) "Certified." Approved by the survey agency as in compliance with applicable statutes and rules.
(d) "Chapter 1." Chapter 1, Rules for Medicaid Administrative Hearings, of the Wyoming Medicaid rules.
(e) "Chapter 3." Chapter 3, Provider Participation, of the Wyoming Medicaid Rules.
(f) "Chapter 4." Chapter 4, Third Party Liability, of the Wyoming Medicaid Rules.
(g) "Chapter 8." Chapter 8, Inpatient Admission Certification, of the Wyoming Medicaid Rules.
(h) "Chapter 9." Chapter 9, Hospital Services, of the Wyoming Medicaid Rules.
(i) "Chapter 30." Chapter 30, Level of Care Inpatient Hospital Reimbursement, of the Wyoming Medicaid Rules.
(j) "Claim." A request by a provider for Medicaid payment for covered services provided to a recipient.
(k) "Contract." A written agreement between a provider and the Department in which the provider agrees to provide specialty services pursuant to this Chapter.
(l) "Covered service." A health service or supply eligible for Medicaid reimbursement pursuant to the rules and policies of the Department.
(m) "Department." The Wyoming Department of Health, its agent, designee or successor.
(n) "Director." The Director of the Department or the Directors designee.
(o) "Division." The Division of Health Care Financing of the Department, its agent, designee or successor.
(p) "Emergency." The sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity (including pain) that referral or transfer of the individual to a contracting provider is impractical, and the absence of immediate medical attention could reasonably be expected to result in:
(q) "Enrolled." Enrolled as defined in Chapter 3, which definition is incorporated by this reference.
(r) "Excess payments." Medicaid funds received by a provider which exceed the Medicaid allowable payment established by the Department.
(s) "HCFA." The Health Care Financing Administration of the United States Department of Health and Human Services, its agent, designee or successor.
(t) "HHS." The United States Department of Health and Human Services, its agent, designee or successor.
(u) "Hospital." An institution that:
(v) "Inpatient." An "inpatient" as defined by 42 C.F.R. § 440.10, which is incorporated by this reference.
(w) "Inpatient hospital service." "Inpatient hospital services" as defined by 42 C.F.R. § 440.10, which is incorporated by this reference.
(x) "JCAHO." The Joint Commission on Accreditation of Healthcare Organizations.
(y) "Maintenance psychiatric services." Covered extended psychiatric services identified by revenue code 680.
(z) "Medicaid." Medical assistance and services provided pursuant to Title XIX of the Social Security Act and/or the Wyoming Medical Assistance and Services Act. "Medicaid" includes any successor or replacement program created by Congress and/or the Wyoming Legislature.
(aa) "Medical record." All documents, in whatever form, in the possession of or subject to the control of the hospital which describe the recipients diagnosis, condition or treatment, including, but not limited to, the plan of care for the recipient.
(bb) "Outpatient." An "outpatient" as defined by 42 C.F.R. § 440.2(a), which is incorporated by this reference.
(cc) "Outpatient hospital services." "Outpatient hospital services" as defined by 42 C.F.R. § 440.20(a), which is incorporated by this reference.
(dd) "Patient." An individual admitted to a hospital or other provider of inpatient or outpatient hospital services.
(ee) "Physician." A person licensed to practice medicine or osteopathy by the Wyoming State Board of Medical Examiners or a comparable agency in another state, or a person licensed to practice dentistry by the Wyoming Board of Dental Examiners or a comparable agency in another state.
(ff) "Prior authorized." Approval by the Division pursuant to Chapter 3, Section 9, which is incorporated by this reference.
(gg) "Provider." A provider as defined by Chapter 3, Section 3(y), which is incorporated by this reference.
(hh) "Readmission." The act by which an individual is:
(ii) "Recipient." A person who has been determined eligible for Medicaid.
(jj) "Services." Health services, medical supplies, or equipment.
(kk) "Specialty services." Services identified for selective contracting by the Department and approved by HCFA through appropriate waivers.
(ll) "Survey agency." The Health Facilities Survey, Certification and Licensure Office of the Department, its agent, designee or successor, or a comparable agency in another state.
(mm) "Third party liability." Third party liability as determined pursuant to Chapter 4, which is incorporated by this reference.
048-31 Wyo. Code R. § 31-4