048-8 Wyo. Code R. § 8-7

Current through April 27, 2019

Section 8-7 - Continued Stay Review for Emergency Admissions

(a) Notice to Department. A hospital shall request a continued stay review of an emergency admission which results in the provision of inpatient hospital services which require an admission certification.

(b) Review by Department. The Department shall conduct a continued stay review of any emergency admission which results in the provision of inpatient hospital services to a client.

(c) Medicaid payments. There shall be no Medicaid payments to any provider of inpatient hospital services except to the extent that the continued stay review results in an admission certification. Medicaid payments for inpatient hospital services shall be pursuant to State Plan Amendment, Attachment 4.19a, Part 1.

(d) Procedures for continued stay review. The hospital shall:

• (i) Notify the Department of the admission and provide the information required in Sections 9(b) and (c) of this Chapter by the end of the next working day after the admission. Notification shall be in writing as required by the Department.

• (ii) Failure to timely request a continued stay review shall result in the denial of Medicaid payment for inpatient services furnished to the client before the date of the request.

048-8 Wyo. Code R. § 8-7

Amended, Eff. 1/6/2015.