048-41 Wyo. Code R. §§ 41-23 - Audits
(a) The Division or the Centers for Medicare
and Medicaid Services may audit a provider's financial records, medical
records, or employment records, at any time to determine whether the provider
has received excess payments or overpayments.
(b) The Division or the Centers for Medicare
and Medicaid Services may perform audits through employees, agents, or through
a third-party. Audits shall be performed in accordance
with generally accepted auditing standards.
(c) Disallowance. The Division shall recover
excess payments or overpayments pursuant to Section 22 of this
Chapter.
(d) Reporting audit
results. If at anytime during a financial audit or a medical audit, the
Division discovers evidence suggesting fraud or abuse by a provider, that
evidence, in addition to the Division's final audit report regarding that
provider, shall be referred to the Medicaid Fraud Control Unit.
(e) The Division shall share the results of
the audit with the provider before excess payments or overpayments are
recovered. However, nothing in this section shall abrogate the rights of the
State to recover excess payments or overpayments in accordance with Chapter 16
or Chapter 39.
Notes
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