048-9 Wyo. Code R. § 9-14

Current through April 27, 2019

Section 9-14 - Copayment

(a) Outpatient hospital services. Except as provided in subsection (b), a recipient must pay a $6.00 copayment for each outpatient hospital visit.

(b) Exceptions. The following recipients are exempt from the copayment provision of subsection (a):

(i) An individual seeking emergency services;

(ii) An individual seeking family planning services;

(iii) An individual under age 21;

(iv) A pregnant woman or a woman that seeks hospital services within six weeks after the delivery of her child;

(v) A resident of a nursing facility; and

(vi) A recipient that is also eligible for Medicare.

(c) Collection of copayment. Providers are responsible for collecting the copayment. The amount of the copayment shall be automatically deducted by the Department from the allowable Medic-aid payment, regardless of whether the copayment is actually paid.

(i) Prohibition or denial of services. A provider may not deny outpatient services to a recipient because of the recipient's inability to make the copayment.

(ii) Regular refusal to make copayment. A provider may refuse outpatient services, other than emergency services, to a recipient who regularly refuses to make copayments.

048-9 Wyo. Code R. § 9-14