reglab/housing_qa huggingface dataset:
WY Stat § 42-4-115 (2021)
2021 Wyoming Statutes|Title 42 - Welfare|Chapter 4 - Medical Assistance and Services|Article 1 - In General|Section 42-4-115 - Work Incentives Improvement Option; Purchase of Services; Eligibility Criteria; Definition.

42-4-115. Work incentives improvement option; purchase of services; eligibility criteria; definition.| (a) The department may amend the state plan for medical assistance and services developed under W.S. 42-4-104(a)(ii) to allow individuals with countable income not to exceed three hundred percent (300%) of the supplemental security income level to receive services authorized under W.S. 42-4-103(a), provided that:  (i) Repealed by Laws 2002, Ch. 31, § 2.  (ii) Repealed By Laws 2002, Ch. 31, § 2.  (iii) The individual is eligible to buy into the Wyoming Medical Assistance and Services Act under the federal Ticket to Work and Work Incentive Improvement Act of 1999 and subsequent similar federal enactments and the federal government is not restricted from paying its proportionate share of the individual's eligible medical expenses;  (iv) Provided that the individual's earnings do not exceed the level specified in section 201(a)(3) of the Federal Ticket to Work and Work Incentive Improvement Act of 1999; and  (v) The individual pays to the department a premium of seven and one-half percent (7.5%) of his total gross earnings from work and seven and one-half percent (7.5%) of his unearned income in excess of six hundred dollars ($600.00) per year, provided that:  (A) The total paid in premiums under this section does not exceed the yearly premium as calculated pursuant to W.S. 42-4-116; and  (B) The individual is not liable for more than the full premium calculated pursuant to W.S. 42-4-116.  (b) If the federal government does not allow a state plan amendment containing the expense limitations provided in paragraphs (a)(i) and (ii) of this section or provisions with similar fiscal effects, the state plan amendment authorized by this section shall not be implemented without specific legislative authorization.  (c) With respect to the premium received pursuant to subsection (a) of this section, the department shall deduct and forward to the federal government any amount owed under federal regulations. Any overpaid premium shall be refunded to the individual and the balance shall be deposited in the general fund. The sum of all amounts deposited under this section shall be reported in the biennial budget submissions to the joint appropriations interim committee as premium earned to offset the expenses of the program.  (d) Repealed by Laws 2015, ch. 54, § 2.  (e) Repealed by Laws 2002, Ch. 31, § 2.  (f) Repealed By Laws 2002, Ch. 31, § 2.
WY Stat § 42-4-116 (2021)
2021 Wyoming Statutes|Title 42 - Welfare|Chapter 4 - Medical Assistance and Services|Article 1 - In General|Section 42-4-116 - Premium Calculation.

42-4-116. Premium calculation.| (a) The calculation of premium for services under W.S. 42-4-115 shall be as follows:  (i) Determine the total expenses of the Medicaid program for the most recent state fiscal year and the total number of clients in the Medicaid program served in that period;  (ii) Deduct from the totals in paragraph (i) of this subsection the clients over the age of sixty-five (65) years and the expenses associated with those clients;  (iii) Divide the resulting expenses calculated pursuant to paragraph (ii) of this subsection by the clients remaining after the deduction pursuant to paragraph (ii) of this subsection. The result is the basic annual premium;  (iv) Add to the basic premium a risk factor of fifty percent (50%) of the basic premium to recover additional costs incurred by the population eligible to be served pursuant to W.S. 42-4-115; and  (v) The premium shall be the sum of the basic annual premium calculated pursuant to paragraph (iii) of this subsection and the risk factor calculated pursuant to paragraph (iv) of this subsection.
WY Stat § 42-4-117 (2021)
2021 Wyoming Statutes|Title 42 - Welfare|Chapter 4 - Medical Assistance and Services|Article 1 - In General|Section 42-4-117 - End Stage Renal Dialysis Program; Rulemaking; Funding.

42-4-117. End stage renal dialysis program; rulemaking; funding.| (a) Effective July 1, 2001, the department shall expand coverage for services authorized under W.S. 42-4-103(a)(xxiii) for qualified individuals in need of end stage renal dialysis to the extent funding is available.  (b) The department shall by rule and regulation establish reasonable limits on services and supplies authorized under this section, including establishing eligibility criteria for receipt of services. In establishing eligibility criteria, the department shall consider financial ability of the individual or his family to contribute to the services, severity of the illness, the critical need for the services and the ability of the program to meet the needs of the individual.
WY Stat § 42-4-122 (2021)
2021 Wyoming Statutes|Title 42 - Welfare|Chapter 4 - Medical Assistance and Services|Article 1 - In General|Section 42-4-122 - Cooperation With Paternity Determination.

42-4-122. Cooperation with paternity determination.| (a) Except as otherwise provided in subsection (b) of this section, as a condition of eligibility, or continuing eligibility, for medical assistance under this chapter, a person who receives medical assistance shall cooperate in good faith with the department to:  (i) Establish the paternity of a child, including any proceeding to adjudicate parentage that is held pursuant to W.S. 14-2-801 through 14-2-823;  (ii) Obtain a child support obligation payment or other payments or property to which the state may have a claim, including recovery of birth costs paid by medical assistance pursuant to W.S. 14-2-1001 through 14-2-1008.  (b) The following persons are not required to cooperate with the department pursuant to subsection (a) of this section:  (i) A person who is pregnant, or who has been pregnant within the preceding sixty (60) days;  (ii) A person who has good cause to not cooperate with the department, as determined by rule promulgated pursuant to W.S. 14-2-1008.
WY Stat § 42-4-124 (2021)
2021 Wyoming Statutes|Title 42 - Welfare|Chapter 4 - Medical Assistance and Services|Article 1 - In General|Section 42-4-124 - Clubhouse Rehabilitation Services.

42-4-124. Clubhouse rehabilitation services.| (a) The director of the department shall include reimbursement for clubhouse rehabilitation services within the Medicaid program.  (b) Within the limits of available funding, the department may enter into contracts with certified clubhouse providers for clubhouse rehabilitation services.  (c) On or before September 1, 2019 the department shall report to the joint labor, health and social services interim committee on information, findings and recommendations related to clubhouse rehabilitation services including information to facilitate implementation of Medicaid contracts to be entered into pursuant to this section.  (d) As used in this section, "clubhouse" means a community-based psychosocial rehabilitation program that:  (i) Has members of the program, with staff assistance, engaged in operating all aspects of the clubhouse, including food service, clerical, reception, janitorial and other member services such as employment training, housing assistance and educational support; and  (ii) Is designed to alleviate a member's emotional or behavior problems with the goal of transitioning the member to a less restrictive level of care, reintegrating the member into the community and increasing social connectedness beyond a clinical or employment setting.
WY Stat § 42-4-203 (2021)
2021 Wyoming Statutes|Title 42 - Welfare|Chapter 4 - Medical Assistance and Services|Article 2 - Medicaid Benefit Recovery|Section 42-4-203 - Settlement Between Recipient and Tortfeasor or Insurer; Lien Not Discharged; Exceptions.

42-4-203. Settlement between recipient and tortfeasor or insurer; lien not discharged; exceptions.| (a) No settlement made by and between the applicant or recipient and the tortfeasor or insurer shall discharge the right to reimbursement created pursuant to this article, against any money due or owing by such tortfeasor or insurer to the applicant or recipient or relieve the tortfeasor or insurer from liability by reason of the right to reimbursement unless the settlement also provides for the payment and discharge of the right to reimbursement and the attorney general has signed a written release as provided by W.S. 42-4-201(b).  (i) Repealed By Laws 2002, Ch. 39, § 2.  (ii) Repealed By Laws 2002, Ch. 39, § 2.
WY Stat § 42-4-205 (2021)
2021 Wyoming Statutes|Title 42 - Welfare|Chapter 4 - Medical Assistance and Services|Article 2 - Medicaid Benefit Recovery|Section 42-4-205 - Insurance Policy Termination Notification Requirement.

42-4-205. Insurance policy termination notification requirement.| (a) With respect to cases for which there is an assignment in effect pursuant to W.S. 42-4-204:  (i) The department, upon receipt of the health coverage information, shall notify the obligor's insuring entity that the department shall be notified thirty (30) days prior to discontinuance of coverage;  (ii) Entities providing health insurance as defined in title 26 and health maintenance organizations and prepaid health clinics as defined in W.S. 26-34-102 shall upon request by the department, provide a list of insureds residing in the state and any records and information as necessary to accomplish the purpose of this section, unless the requirement results in an unreasonable burden;  (iii) The department and the insurance commissioner appointed pursuant to W.S. 26-2-102 shall enter into a cooperative agreement for requesting and obtaining information necessary to effect the purpose and objectives of this section;  (iv) The department shall only request information from the entity providing health insurance necessary to determine whether health insurance, as defined pursuant to title 26 or those health services provided pursuant to W.S. 26-34-102, are discontinued;  (v) The department, in consultation with the department of insurance, shall promulgate rules for the development and administration of the cooperative agreement. The rules shall include the following:  (A) A method for identifying those entities subject to furnishing information under the cooperative agreement;  (B) A method for furnishing requested information; and  (C) Procedures for requesting exemption from the cooperative agreement based on an unreasonable burden to the reporting entity.  (vi) If the department notifies the insurer that it has made payments to the provider, payment of benefits or notices of denial issued by the insurer shall be made directly to the department.  (b) Upon the department receiving notice from the obligor's insuring entity that the coverage is discontinued due to cancellation for any reasons, the department shall retain that information for use in enforcing any court order requiring the obligor to provide health insurance to the individuals stated in the court order.
WY Stat § 42-4-208 (2021)
2021 Wyoming Statutes|Title 42 - Welfare|Chapter 4 - Medical Assistance and Services|Article 2 - Medicaid Benefit Recovery|Section 42-4-208 - Recovery for Cost of Health Care.

42-4-208. Recovery for cost of health care.| (a) The department, to the extent necessary to reimburse its costs, shall be entitled to recover from any parent who:  (i) Is required by court or administrative order to provide coverage of the cost of health services to a child eligible for medical assistance under this act; and  (ii) Has received payment from a third party for the costs of such services but has not used the payments to reimburse either the other parent or guardian of the child or the provider of the services.  (b) The department shall be entitled to enforce any judgment entered pursuant to this section by garnishment or any other available statutory remedy.  (c) Claims for current and past due child support shall take priority over claims made under this section.
WY Stat § 42-4-301 (2021)
2021 Wyoming Statutes|Title 42 - Welfare|Chapter 4 - Medical Assistance and Services|Article 3 - False Medicaid Claims|Section 42-4-301 - Short Title.

42-4-301. Short title.| This act shall be known and may be cited as the "Wyoming Medicaid False Claims Act."
WY Stat § 42-4-302 (2021)
2021 Wyoming Statutes|Title 42 - Welfare|Chapter 4 - Medical Assistance and Services|Article 3 - False Medicaid Claims|Section 42-4-302 - Definitions.

42-4-302. Definitions.| (a) As used in this act:  (i) "Claim" means any request or demand under the Medicaid program, whether under a contract or otherwise, for money, property or services that:  (A) Is presented to an officer, employee or agent of the state or a political subdivision of the state; or  (B) Is made to a contractor, grantee or other recipient, if the money or property is to be spent or used on the state's behalf or to advance a state program or interest, and if the state provides or has provided any portion of the money or property requested or demanded.  (ii) "Material statement" means a statement that affects the payment or receipt of money or property;  (iii) "This act" means W.S. 42-4-301 through 42-4-306.
WY Stat § 42-4-303 (2021)
2021 Wyoming Statutes|Title 42 - Welfare|Chapter 4 - Medical Assistance and Services|Article 3 - False Medicaid Claims|Section 42-4-303 - Acts Subjecting Person to Treble Damages; Costs and Civil Penalties; Exceptions.

42-4-303. Acts subjecting person to treble damages; costs and civil penalties; exceptions.| (a) Except as provided in subsection (c) of this section, any person who commits any of the following acts in relation to the Wyoming Medicaid program shall be liable to the state for three (3) times the amount of damages which the state sustains because of the act of that person. A person who commits any of the following acts shall also be liable to the state for the costs of a civil action brought to recover any penalties or damages provided in this subsection, and shall be liable to the state for a civil penalty of not less than one thousand dollars ($1,000.00) and not more than ten thousand dollars ($10,000.00) for each violation:  (i) Knowingly presents or causes to be presented a false or fraudulent claim for payment or approval;  (ii) Knowingly makes, uses or causes to be made or used, a false record or statement material to a false or fraudulent claim;  (iii) Is a beneficiary of an inadvertent submission of a false claim to any employee, officer or agent of the state or a political subdivision of the state, or to any contractor, grantee or other recipient of state funds or funds of any political subdivision of the state, who subsequently discovers the falsity of the claim and fails to disclose the false claim and make satisfactory arrangements for repayment to the state or affected political subdivision within ninety (90) days after discovery of the false claim;  (iv) Conspires to commit a violation of paragraph (i), (ii) or (iii) of this subsection.  (b) Notwithstanding subsection (a) of this section, the court may assess not more than two (2) times the amount of damages which the state sustains because of the act in violation of subsection (a) of this section, and no civil penalty, if the court finds all of the following:  (i) The person committing the violation furnished officials of the state who are responsible for investigating false claims violations with all information known to that person about the violation within forty-five (45) days after the information is requested; and  (ii) The person has substantially cooperated with any investigation by the state.  (c) The provisions of subsections (a) and (b) of this section shall not apply to a recipient as defined by W.S. 42-1-101(a)(v). Any recipient who knowingly:  (i) Presents or causes to be presented a false or fraudulent claim shall be liable to the state for the amount of damages which the state sustains because of the claim and shall be liable for a civil penalty of not more than one thousand dollars ($1,000.00);  (ii) Violates paragraph (i) of this subsection a second or subsequent time shall be liable to the state for three (3) times the amount of damages which the state sustains because of the claim and shall be liable for a civil penalty of not more than one thousand dollars ($1,000.00).
WY Stat § 42-4-304 (2021)
2021 Wyoming Statutes|Title 42 - Welfare|Chapter 4 - Medical Assistance and Services|Article 3 - False Medicaid Claims|Section 42-4-304 - Investigations and Prosecutions; Powers of Prosecuting Authority; Remedies for Retaliation; Venue; No Private Right of Action.

42-4-304. Investigations and prosecutions; powers of prosecuting authority; remedies for retaliation; venue; no private right of action.| (a) The Medicaid fraud control unit created by W.S. 42-4-403 or a district attorney may investigate alleged violations of W.S. 42-4-303(a) and (c). If the Medicaid fraud control unit or district attorney finds that a person has violated or is violating W.S. 42-4-303(a) or (c), the unit or district attorney may bring a civil action under this section against that person.  (b) Any employee, contractor or agent of a person being investigated for a violation of W.S. 42-4-303(a) shall be entitled to recover all economic damages suffered if that employee, contractor or agent is discharged, demoted, suspended, threatened, harassed or in any other manner retaliated against in the terms and conditions of employment because of lawful acts taken in good faith by the employee or others in an action reported, filed or investigated under this act. An action by an employee, contractor or agent under this subsection shall not be brought more than three (3) years after the date when the retaliation occurred. A person may bring an action in the appropriate district court for the relief provided in this subsection. This subsection shall not otherwise be construed to create a private cause of action for violations of this act and is limited to the remedies expressly created by this subsection related to employment retaliation.  (c) Except as provided in subsection (b) of this section, any action under this act may be brought in the district court of any county in which the defendant, or any of them, resides. If the defendant is not a resident of the state of Wyoming, the action shall be brought in the first judicial district court in Laramie County.  (d) Except as provided in subsection (b) of this section, nothing in this act shall be construed to create a private cause of action.  (e) The remedies provided in this act are separate from and additional to any remedies available under the State Government Fraud Reduction Act.
WY Stat § 42-4-305 (2021)
2021 Wyoming Statutes|Title 42 - Welfare|Chapter 4 - Medical Assistance and Services|Article 3 - False Medicaid Claims|Section 42-4-305 - Limitation of Actions; Retroactivity; Burden of Proof.

42-4-305. Limitation of actions; retroactivity; burden of proof.| (a) A civil action under W.S. 42-4-304(a) shall not be brought more than six (6) years after the date on which the violation was committed or more than three (3) years after the date when facts material to the right of action are known or reasonably should have been known by the official of the state charged with responsibility to act in the circumstances, whichever occurs last, provided that in no event shall a civil action be brought more than seven (7) years after the date on which the violation is committed.  (b) In any action brought under W.S. 42-4-304(a), the state shall be required to prove all essential elements of the cause of action, including damages, by clear and convincing evidence.  (c) Notwithstanding any other provision of law, a guilty verdict rendered in a criminal proceeding charging false statements or fraud is admissible in any civil action which involves the same transaction as in the criminal proceeding and which is brought under W.S. 42-4-304.
WY Stat § 42-4-306 (2021)
2021 Wyoming Statutes|Title 42 - Welfare|Chapter 4 - Medical Assistance and Services|Article 3 - False Medicaid Claims|Section 42-4-306 - Remedies Under Other Laws; Liberality of Construction; Joint and Several Liability.

42-4-306. Remedies under other laws; liberality of construction; joint and several liability.| (a) The provisions of this act are not exclusive, and the remedies provided for in this act shall be in addition to any other remedies provided for in any other law or available under common law.  (b) Liability pursuant to this act is joint and several for any violation done by two (2) or more persons.
WY Stat § 42-4-401 (2021)
2021 Wyoming Statutes|Title 42 - Welfare|Chapter 4 - Medical Assistance and Services|Article 4 - Medicaid Fraud Control|Section 42-4-401 - Short Title.

42-4-401. Short title.| This act may be cited as the "Wyoming Medicaid Fraud Control Act".
WY Stat § 42-4-402 (2021)
2021 Wyoming Statutes|Title 42 - Welfare|Chapter 4 - Medical Assistance and Services|Article 4 - Medicaid Fraud Control|Section 42-4-402 - Definitions.

42-4-402. Definitions.| (a) As used in this act:  (i) "Claim" means as defined in W.S. 42-4-302(a)(i);  (ii) "Provider" means a person who furnishes services or supplies for which payment is claimed under Medicaid;  (iii) "Record" means information in physical or electronic form relating to:  (A) The treatment or care of any patient;  (B) A service or supply provided to a Medicaid recipient;  (C) Rates paid for a service or supply;  (D) Any other information required to be kept by rule of the Medicaid program.  (iv) "Unit" means the Medicaid fraud control unit created by this act to investigate and prosecute fraud, waste, abuse, bribery, kickback and related cases under Medicaid;  (v) "This act" means W.S. 42-4-401 through 42-4-412.
WY Stat § 42-4-403 (2021)
2021 Wyoming Statutes|Title 42 - Welfare|Chapter 4 - Medical Assistance and Services|Article 4 - Medicaid Fraud Control|Section 42-4-403 - Medicaid Fraud Control Unit Created; Duties.

42-4-403. Medicaid fraud control unit created; duties.| (a) The Medicaid fraud control unit is recognized and continued in existence within the office of the attorney general. The unit shall conduct a statewide program for investigating and prosecuting violations of all applicable state laws pertaining to fraud in the administration of the Medicaid program and the provision of services or supplies, or the activities of providers of services or supplies, under the state Medicaid plan. The unit may also conduct criminal investigations and prosecutions relating to patient abuse, neglect, exploitation and other violations of law, if the violation is primarily connected to Medicaid.  (b) The office of the attorney general shall employ attorneys, auditors, agents and other personnel which are necessary to carry out the duties specified in this act in an effective and efficient manner. Agents employed under this subsection shall have the qualifications and powers of an agent under W.S. 9-1-611(b)(i).  (c) The unit may file criminal charges without consultation with another person or entity outside the office of the attorney general. Before the filing of criminal charges under this act, the unit may consult with the district attorney of the judicial district in which the prosecution would take place. If the district attorney, after consultation, concurs with the decision to file criminal charges, the unit may refer the case to the district attorney. A district attorney may request that the unit assign an attorney to assist with prosecution under this act.