048-15 Wyo. Code R. §§ 15-9 - Prior Authorization

(a) Services that require prior authorization.

(i) The Department may designate ambulance services that require prior authorization.

(ii) In designating services that require prior authorization, the Department shall consider the:

(A) Cost of the service;

(B) Potential for over-utilization of the service; and

(C) Availability of lower cost alternatives.

(b) The Department may disseminate a list of ambulance services that require prior authorization to providers through manuals or bulletins.

(c) The failure to obtain prior authorization shall result in denial of Medicaid payment for the service.

Notes

048-15 Wyo. Code R. §§ 15-9

Amended, Eff. 2/8/2017. Amended, Eff. 5/14/2018.