Bill No.: SF0127                  Drafter:  JWL

LSO No.:  07LSO-0598              Effective Date:  7/1/2007

Enrolled Act No.:  SEA0064

Chapter No.:

Prime Sponsor:     Senate Labor, Health and Social Services Committee

Catch Title:       Medicaid federal compliance-2

Subject:  Federally required changes to Medicaid.

Summary/Major Elements: The federal 2005 Deficit Reduction Act was signed into law on February 8, 2006, requiring all states to make certain changes to their Medicaid laws.  This act implements some of those changes in the Wyoming Medical Assistance and Services Act (see also SF0044/SEA0050).  This act:

· Expands the list of third party payors, from which the Department of Health may seek reimbursement for Medicaid expenditures, to include specified insurers and plans that are legally responsible for payment of a claim for health care items or services;

· Prohibits the inclusion, in any health insurance policy, plan or contract, of any provision denying or limiting benefits because the insured receives services from Medicaid;

· Requires all insurance companies, plans and organizations that are liable to pay health care claims to agree, as a condition of doing business, to:

o Provide health coverage verification information;

o Accept the State's right of recovery for Medicaid expenditures;

o Provide claim information upon request to the State for three years after provision of the health care;

o Not deny a claim submitted by the state because of procedural defects if the claim is submitted by the state within three years after provision of the health care.