048-36 Wyo. Code R. §§ 36-6 - Reimbursable transportation expenses

(a) Ambulance transportation. Transportation in an ambulance is a covered service as specified in Chapter 15.

(b) Administrative transportation to and from a medical appointment is reimbursable if:

(i) The covered services furnished to the client at the medical appointment are medically necessary;

(ii) Transportation has been approved by the Department at least three working days in advance of the necessary transportation; and

(iii) The transportation is the least costly mode of transportation selected and approved by the Department pursuant to subsection (c).

(c) Selection and approval of administrative transportation.

(i) The Department shall be responsible for selecting and approving the mode of administrative transportation.

(ii) In selecting and approving transportation, the Department:

(A) May consider the following modes of transportation:

(I) Public transportation, including subsidized public transportation and the Wyoming Rural Transit Program;

(II) Private automobile;

(III) Taxi;

(IV) Bus;

(V) Shuttle services; and

(VI) Airline; and

(B) Shall select the least expensive and most appropriate mode of transportation reasonably available.

(iii) Per diem expenses. Per diem expenses are reimbursable to a client or a client's legal guardian if:

(A) The client receiving services is a client under age twenty-one; and

(B) The services to be received are covered services.

(d) Transportation to medical appointments outside Wyoming and within the Wyoming Medicaid Service Area (WMSA) is reimbursable if:

(i) The covered service is not available in the local trade area; and

(ii) The specified city within the WMSA is closer (in highway miles) than the nearest location within Wyoming where the service is available.

(e) Transportation to medical appointments outside the WMSA is not reimbursable unless:

(i) A person licensed to practice medicine, dentistry, psychiatry, osteopathy, or optometry has referred the client to a specified provider for covered services that are not available in the service area; and

(ii) The referral is in writing and the medical necessity of the referral is documented in the client's medical records.

Notes

048-36 Wyo. Code R. §§ 36-6

Amended, Eff. 6/14/2017.