Wyo. Code R. 048-0037-35
Medicaid
Chapter 35: Medicaid Benefit Recovery
Effective Date: 02/19/2019 to Current
Rule Type: Current Rules & Regulations
Reference Number: 048.0037.35.02192019
Section 1. Authority. This Chapter is promulgated pursuant to the Wyoming Medical Assistance and Services Act at Wyoming Statute § 42-4-104(a)(iv).
(a) This Chapter shall apply to and govern all Medicaid third party liability and estate benefit recoveries.
(b) The requirements of Title V and Title XIX of the Social Security Act, 42 U.S.C. § 1396(a)(25), 42 U.S.C. § 1396K(a)(1)(A), 42 U.S.C. § 1396p, 42 C.F.R. Ch, IV §§ 433.135-433.154, 42 C.F.R. § 433.36, and the Wyoming Medicaid State Plan under Title XIX of the Social Security Act also apply to Medicaid herein.
(a) This Chapter is intended to implement and to be read in conjunction with W.S. §§ 42-4-114, 42-4-201 through 42-4-208, 42-4-122, 14-2-1001 through -14-2-1008, and applicable federal law.
Section 4. Definitions. Except as otherwise specified in Chapter 1 or as defined in this Section, the terminology used in this Chapter is the standard terminology and has the standard meaning used in accounting, health care, Medicaid, and Medicare.
(a) 'Birth cost' - 'Birth costs.' As defined in W. S. § 14-2-1002(a)(i).
(b) 'Bona fide effort to sell.' The act of putting property up for sale and entering a written agreement with the Department.
(c) 'Estate recovery.' The recovery from the estate of a deceased client or from the estate of the spouse of a deceased client for reimbursement of Medicaid payments made on behalf of a client.
(d) 'Incentive allowance.' An allowance payment to the heirs, legatees or other person(s) who, having a valid claim to ownership of the deceased client's assets, who cooperate fully with the Department in maintaining and disposing of the assets so as to satisfy to the full extent possible the State's reimbursement right.
(e) 'Medicaid benefit recovery.' The recovery for reimbursement of Medicaid funds paid on behalf of a client.
(f) 'Net proceeds.' The dollar value from the sale of any real or personal property determined by deducting from the gross proceeds any amounts, including at a minimum, any liens or encumbrances against the property, realtor's commission fee, maintenance and repairs to the home required by a property inspection or needed to sell the property, an appraisal or broker's price opinion, attorney's fees and costs, and closing costs.
(g) 'Non-probate estate.' That portion of a client's estate or the estate of the spouse of a client which is not administered pursuant to the Wyoming Probate Code.
(h) 'Probate estate.' That portion of a client's estate or the estate of the spouse of a client which is administered pursuant to the Wyoming Probate Code.
(i) 'Reasonable expenses incurred preserving or disposing of the asset(s).' Reasonable expenses incurred either in maintaining or disposing of the assets of a client's estate distributed pursuant to the summary distribution provisions pursuant to the Wyoming Probate Code or distribution pursuant to an affidavit, including:
(i) Closing costs for the sale of real property which results in the partial or complete satisfaction of the Department's reimbursement right (closing costs include the reasonable attorney's fees of the seller, the cost of title insurance, and recording costs);
(ii) Costs of an Administration pursuant to W.S. § 2-1-301(viii) and probate administration pursuant to W.S. § 2-7-802;
(iii) An incentive allowance as prescribed in Section 6 of this rule;
(iv) If Medicaid participates in a probate with a claim then it should not reduce its lien by the amount of the costs to sell the property;
(v) Property insurance premiums;
(vi) Real or personal property taxes;
(vii) Utility costs which are necessary to preserve the property, only allowed if the property is vacant or not payable by a renter or lessee pursuant to a rental or lease agreement;
(viii) Other costs incurred pursuant to a written property management agreement signed by the Department;
(ix) Expenses incurred in providing necessary maintenance or making necessary repairs, without which the salability of the property would be substantially impaired.
(A) Reasonable expenses do not include payment of credit card bills, telephone (cell phone) bills, or cable bills.
(j) 'Third party payer.' Any person, entity, agency, insurer, or government program that may be liable to pay, or that pays pursuant to an applicant's or client's right of recovery arising from an illness, injury, or disability for which Medicaid funds were paid or are obligated to be paid on behalf of the applicant or client. 'Third party payer' includes, but is not limited to, the following: Medicare; liability insurance carriers; medical payments coverage carriers; workers' compensation; persons or entities alleged to be liable by contract, tort, equity, or otherwise for the client's Medicaid reimbursable expenses for the illness, injury, or disability of the applicant or client; a spouse or parent of an applicant or client who is obligated by law or court order to pay all or part of such costs; a client's estate; health insurers; self-insured plans; group health plans; long-term care insurers; service benefit plans; managed care organizations; pharmacy benefit managers; and any other parties that are, by statute, contract, or agreement legally responsible for payment of claims for health care items or services for an applicant or client.
(k) 'TPL waiver.' A waiver granted by CMS of the third party liability requirements of this chapter.
(a) Assignment of Benefits, Third Party Liability, and Estate Recovery.
(i) By signing an application, an applicant shall be deemed to have made an assignment to the Department [the right to medical support or payment of medical expenses] on the applicant's behalf and on behalf of any relative, ward, or legal dependent for whom application is made.
(ii) The assignment of benefits is effective upon a determination of eligibility and remains in effect with respect to services provided during the period of eligibility for Medicaid, including any period of retroactive eligibility.
(b) Payer of last resort. Medicaid will pay for services only after payment of all other third party payers has been exhausted, except as provided by 42 U.S.C. § 1396d(b) and Title V of the Social Security Act.
(c) Recovery of payments from third party payers. If the Department pays or becomes obligated to pay Medicaid funds on behalf of an applicant or a client because of an injury, illness, or disability for which a third party is legally liable or obligated to pay, the Department may recover the full amount of such Medicaid funds from the third party to the extent of such party's liability up to the amount of medical assistance paid, as provided by law.
(d) Estate recoveries. If the Department pays or becomes obligated to pay Medicaid funds on behalf of a client who is fifty-five (55) years of age or older, or who was an inpatient in a nursing facility, intermediate care facility for people with intellectual disability or other medical institution, the Department may recover the full amount of such Medicaid funds from the estate of the deceased client or from the estate of a spouse.
(e) The Department, Division of Healthcare Financing, or its successor shall be named payee on all payments for Medicaid benefit recovery.
(a) Notification of third party liability. An applicant or client shall notify the Social Security Administration or the Department of the possibility of third party liability at the time of application, at the time of an eligibility redetermination, and within ten (10) days after any event creating third party liability or any change in potential third party payers.
(b) Notice to providers. A client shall present the client’s eligibility card to a provider at the time the client requests services. A client shall also inform a provider of the existence or possible existence of a third party payer at the time the client requests services from the provider and upon request from the provider.
(c) Cooperation in establishing paternity and obtaining medical support. As a condition of eligibility or continued eligibility, an applicant or client shall cooperate with the Department and local agency in establishing paternity of a child eligible for Medicaid or applying for Medicaid, and identifying and collecting from any third party payer. Cooperation includes:
(i) Appearing at the Department or local agency office to provide information or evidence regarding paternity;
(ii) Appearing as a witness at a court or other proceeding to testify regarding paternity;
(iii) Paying to the Department any medical support or medical payments received that are covered by the assignment of benefits;
(iv) Upon request from the Department or local agency, taking any other reasonable steps to assist in establishing paternity, determining third party liability and securing payment from third party payers; and
(v) Cooperating with the Department and the Department of Family Services in establishing paternity for applicable Medicaid births for the purposes of recovery of birth cost pursuant to W.S. §§ 42-4-122 and 14-2-1001 through 14-2-1008. Pursuant to W.S. §14-2-1003, not more than sixty (60) days after an unmarried client of Medicaid gives birth to a child, the Department shall notify the Department of Family Services of the total birth cost. Total birth cost shall include:
(A) Maternity related expenditures including prenatal and postpartum care from nine (9) months prior to delivery through two (2) months after delivery, but not to exceed the average birth cost paid by Wyoming Medicaid.
(d) The refusal to cooperate in establishing paternity as set forth above, or the refusal to cooperate in locating third party payers or recovering payments from such payers, shall render such person ineligible for Medicaid, except as provided in 42 C.F.R. § 433.147 and 433.148.
(e) Incentive allowance for Estate Recovery.
(i) The Department may allow an incentive payment to the heirs, legatees or other person(s), when the following conditions are met:
(A) An incentive allowance shall be the lesser of ten percent (10%) of the net proceeds from the sale of the asset(s), or two-thousand ($2,000.00) dollars:
(B) An incentive allowance shall be permitted only upon approval in writing by the Department or their designee, and only if the Medicaid benefits paid on behalf of the client exceeds the net proceeds; and
(C) The net proceeds from the sale shall be determined by deducting from the sale price the costs of discharging any encumbrances on the property and other reasonable expenses incurred preserving or disposing of the asset(s).
(f) If a Medicaid client is enrolled with a private health insurer, the client must follow the rules of the primary insurance, including using an in-network provider.
(a) Verify and obtain information. At the time a client requests services from a provider, the provider shall review the client’s eligibility card for information regarding third party payers. The provider shall ask the client if the information on the card is current and whether there are or may be additional third party payers. If the provider learns of a potential third party payer that is not listed on the eligibility card, the provider shall notify the Department in writing of that information within thirty (30) calendar days.
(b) Notify the Department of requests for information. Release of information by providers for casualty related third party resources not known to the State may be identified through requests for medical reports and bills received by providers from attorneys, insurance companies, and other parties. Providers shall contact the Department before responding to such requests.
(c) Notification of death.
(i) An institutional provider shall notify the Department, in writing, of any client’s death which occurs in the facility or which occurs after the client is transported from the provider’s facility to another facility, such as a hospital or hospice.
(ii) Time of notice. The notification shall be sent to the Department on or before the end of the third working day after the client’s death.
(iii) Contents of notice. The notification shall be in the form and contain the information required by the Department, as specified in the Provider Manual.
(d) Billing. Unless otherwise provided by a TPL waiver, this subsection shall govern the submission of bills involving third party payers.
(i) When a provider is informed that the client has or may have coverage by a third party payer, the provider shall seek payment from the third party payer prior to submitting a Medicaid claim. When the amount payable by the third party payer is less than the allowable Medicaid payment, the provider may submit a Medicaid claim for the difference. The Medicaid claim shall be accompanied by documentation of the amount payable by the third party payer or submitted electronically with the appropriate coordination of benefits information, including claims adjustment reason and remark codes.
(ii) If a third party payer rejects the request for payment, the provider may submit a Medicaid claim to the Department. The provider shall attach a copy of the notice of rejection to the Medicaid claim, upload a copy of the notice of rejection to the Medicaid web portal to be linked to the corresponding electronic claim, or submit the Medicaid claim electronically with the appropriate coordination of benefits information, including claims adjustment reason and remark codes.
(iii) If a provider has not received payment or a rejection notice from a third party payer within ninety (90) days after submitting two (2) requests or attempts for payment, the provider may submit a Medicaid claim. The provider shall submit with the Medicaid claim, copies of the requests for payment to the third party payer, and any written communication the provider has received from the third party payer.
(iv) A provider which has received payment from a third party payer may submit a Medicaid claim. In such cases the provider shall submit with the Medicaid claim documentation of the payment received. The Department shall allow the Medicaid claim only to the extent the allowable Medicaid reimbursement exceeds the payment received from the third party payer and subject to the Department’s normal procedures and standards.
(v) A provider shall submit Medicaid claims to the Department within twelve (12) months of the date of service or discharge, whichever is later, regardless of the potential involvement of a third party payer, except that Medicare crossover claims shall be submitted within six (6) months after the date of payment or rejection by Medicare. Medicaid claims submitted after the time limits specified in this paragraph shall be rejected. Refer to Chapter 3 of the Medicaid rules for further information.
(vi) For the purposes of paragraph (d)(i) of this section, any amount paid by Medicaid when combined with the amount paid by the third party payer, shall not exceed the amount payable to the provider under any preferred provider or similar agreement between the provider and that third party payer. The Department is only responsible for the patient’s responsibility.
(vii) A provider shall not opt-out of participation with a third party payer. If a provider chooses to opt-out of participation with a third party payer, the Department shall not pay for services covered by, but not billed to, the third party payer. The provider shall work with the third party payer or client to have the claim submitted to the carrier.
(viii) If a provider chooses to bill Wyoming Medicaid, the provider accepts Medicaid payment as payment in full. The provider shall not bill Wyoming Medicaid and accept payment and bill the other third party. The provider shall choose whether to bill Wyoming Medicaid or bill the other party and wait for legal liability to be established.
(a) Probable existence of liability of third party payer established at time of Medicaid claim. If the Department has established the probable existence of liability of a third party payer at the time a provider submits a Medicaid claim, the Department shall reject the Medicaid claim and return it to the provider for a determination of the amount of such liability.
(b) Establishing probable existence of liability of a third party payer. The probable existence of liability of a third party payer is established when the Department receives information from any source confirming the existence and extent of liability of a third party payer. When the amount of liability is established, the Department shall process and pay Medicaid claims involving third party liability only to the extent that the Medicaid payment allowed by the Department's normal procedures and standards exceeds the amount of the third party payer's liability.
(c) Unavailability of third party payments. Third party payments are not available at the time of the submission of a Medicaid claim if the existence and extent of third party payer liability is still disputed. If third party payments are not available, the Department shall process Medicaid claims subject to its normal procedures.
(d) Reconsideration. A provider may request that the Department reconsider a decision to recover payments because of third party liability. Such request shall be made and shall be handled pursuant to the reconsideration provisions as set forth in Chapter 3, Section 14, of the Wyoming Medicaid Rules.
(e) Denial of improper claims. The Department shall deny claims which are improperly submitted or which contain errors of any kind. Denied claims may be resubmitted, subject to applicable federal and state requirements, including Chapter 1 and Chapter 16.
(a) Attorneys shall be obligated to cooperate with the Department to recover under this Section in accordance with W.S. §§ 42-4-201 through 42-4-208.
(b) An attorney representing a Medicaid client shall not disburse any insurance proceeds to the Medicaid client or retain any portion as attorney's fees prior to submitting a statement of net recovery distribution and payment to the Department.
(a) The Department may not agree to a settlement which involves the compromise or release of any portion of the federal medical assistance percentage, except as allowed by federal law.
(b) Amount of the Department’s recovery. The Department may recover from any settlement or judgment involving a third party payer the full amount of Medicaid funds paid or to be paid on behalf of the client because of the injury, illness, or disability for which such payments were made.
(i) If the Department does not file an independent action or intervene in an existing action, the Department shall calculate its reduced lien by deducting:
(A) Thirty-three percent (33%) for attorney’s fees; and
(B) A proportionate share of the reasonable attorney’s costs incurred in obtaining the client’s recovery.
(I) The Department’s proportionate share of the reasonable costs incurred in making the client’s recovery shall be determined by:
(1.) Dividing the amount of the Department’s recovery (the amount of Medicaid benefits reimbursed minus attorney’s fees as provided in this Section) by the amount of the client’s gross recovery; and
(2.) Multiplying the determined fraction by the reasonable costs incurred in making the recovery.
(II) For purposes of this section, “the reasonable attorney’s costs incurred in making the client’s recovery” shall be court costs, costs of litigation, travel costs, expert witness fees, deposition expenses, and any other costs necessarily incurred in making the recovery. Reasonable costs shall be in the sole discretion of the Department and shall not include any items for which the client is not also responsible.
(ii) The Department may consider the cost-effectiveness of reducing its claim for reimbursement after evaluating all relevant factors, including:
(A) Available insurance coverage or other factors relating to the assets or solvency of the liable third party;
(B) Factual and legal issues pertaining to liability;
(C) Legal issues or restrictions on the Department’s recovery, including problems of proof affecting the ability to obtain settlement or judgment and;
(D) Estimated fees and costs associated with the Department pursuing its claim.
(c) Structured settlements. A client’s recovery shall not be placed in a structured settlement until the Department has been reimbursed and issued a release of its reimbursement right. If a client prematurely enters into a structured settlement under which the initial payment to the client is insufficient to reimburse the Department, the client shall pay the Department all funds received in each installment until the Department is paid in full. All structured settlements shall fully comply with the requirements pertaining to annuities under the Department’s rules.
(d) Future Medicaid payments. Except as otherwise agreed, the settlement of a client’s claim does not preclude the Department from seeking Medicaid benefit recovery for Medicaid payments made after the date of such settlement.
(e) The Department shall have the right to recover directly from a third party payer to the extent of Medicaid funds paid or to be paid on behalf of a client when the existence and extent of liability of such third party payer is established. In situations where a Medicaid client was not represented by legal counsel, an attorney representing an insurance company shall not disburse any insurance proceeds to the Medicaid client prior to submitting a statement of available proceeds (declaration sheet), payment to the Department, and approval by the Department.
(f) The Department shall have the right to recover from any attorney who knowingly fails to notify the Department of any settlement or judgment or fails to ensure the Department is reimbursed to the extent of its reimbursement right.
(g) The Department shall have the right to recover directly from a provider which has received Medicaid funds paid on behalf of a client to the extent the provider has received payments from a third party payer for the same services.
(h) The Department shall have the right to recover from any attorney who knowingly fails to notify the Department of any settlement or judgment or fails to ensure the Department is reimbursed to the extent of its reimbursement right.
(a) Pursuant to W.S. § 42-4-207(c), the Department may impose a pre-death lien against a client’s real property:
(i) If the client is an inpatient in a nursing facility, intermediate care facility for people with intellectual disability, or other medical institution; and the client cannot reasonably be expected to be discharged from the facility and return home; or
(ii) If the client has been institutionalized for ninety (90) days or longer without a discharge plan, it is presumed that the client will not be discharged and return home; however, an applicant or the client will be provided with a notice of their right to a hearing prior to a determination being made that the applicant or the client is permanently institutionalized.
(b) Pursuant to W.S. § 42-4-207(j), the Department may impose a lien upon property of any estate, as defined in W.S. § 42-4-206(g), of a deceased client for the amount of medical assistance provided while the client was fifty-five (55) years of age or older or while the client was an inpatient in a nursing facility, intermediate care facility for people with intellectual disability or other medical institution. The lien may be imposed regardless of the presence in the home of individuals identified in W.S. § 42-4-207(e).
(i) For estate recovery purposes, the Department defines “legal title” for real property in W.S. § 42-4-206(g) to mean title of record in the county public property records.
(c) If the client has purchased a long-term care partnership certified policy, the Department shall take into consideration the benefits paid by the policy in determining the extent of estate recovery.
(d) The Department may recover against a lien imposed under W.S. § 42-4-207 only after the death of the client’s surviving spouse, if any, and:
(i) If the client has no surviving child who is under age twenty-one (21), or is blind, or permanently and totally disabled.
(e) A claim filed pursuant to W.S. § 42-4-206(a) against the surviving spouse’s estate, is limited to the value of the assets of the estate determined to exist at the time of death of the surviving spouse that were marital property or jointly owned property at any time during the marriage.
(f) The Department may foreclose its lien outside the probate action pursuant to W.S. §§ 2-7-717.
(g) Procedures for recovery from non-probate estate.
(i) The Department shall have the right to recover from non-probate assets pursuant to W.S. §§ 42-4-206 or 207, and shall have the discretion to decide how to proceed.
(ii) The Department shall have the right to recover directly from a transferee or other individual or entity which has possession, control, or ownership of property received from the non-probate estate of a deceased client.
(h) Any lien or claim against the estate or assets of a client age fifty-five (55) years or older when receiving medical assistance or an inpatient in a facility, intermediate care facility for people with intellectual disability or other medical institution shall be limited to amounts expended for nursing facility services, home and community-based services including waiver services, related hospital and prescription drug services, and any items or services under the State Plan.
(i) Reasonable expenses incurred in preserving or disposing of the assets are only allowed if:
(i) They are documented with specificity and by an itemized statement or ledger of expenses with copies of receipts,
(ii) They are paid by someone other than the client (use of the client’s personal funds will not be reimbursable), and
(iii) They were paid after one of the following events occurred:
(A) Client entered a nursing facility, an assisted living facility, an intermediate care facility for people with intellectual disability, or other medical institution, never returned home, and failed to pay the expenses; or
(B) Client passed away.
(j) The Department may decline to pursue an estate recovery if it determines that it is not cost-effective to recover.
(k) Bona Fide Efforts to Sell. The Department may enter into a stipulation and consent agreement with Medicaid client(s), heirs, or legatees when the following conditions are met:
(i) The client has received Medicaid for a period of at least six (6) months;
(ii) Net proceeds shall be paid to the Department to reimburse medical payments made on behalf of the client;
(iii) The property shall be actively placed on the market;
(iv) The property shall not be sold for less than eighty percent (80%) of fair market value, unless the Department provides approval of the sale of the property for less than eighty percent (80%) of its value; and
(v) If the net proceeds exceed the amount of the Medicaid benefits paid, Medicaid will receive payment in full for the benefits and services provided to the Medicaid client(s) and eligibility for benefits shall be redetermined.
(a) Notice of right to request undue hardship waiver. At the time the Department imposes a lien or files a probate claim, it shall provide written notice by mail to the personal representative or known heirs of the right to request an undue hardship waiver.
(b) Request for undue hardship waiver.
(i) Any individual who receives notice pursuant to subsection (a) may request an undue hardship waiver.
(ii) A request for an undue hardship waiver shall be mailed to the Department by certified mail, return receipt requested, within thirty-three (33) days of the date of the Department's notice pursuant to subsection (a). The request shall include documentation that the decedent's home is part of the estate, that the decedent's home is part of a business, including a working farm or ranch, show that recovery of the home would result in the heirs or beneficiaries losing their means of making a living, and provide other relevant documentation upon the Department's request. The failure to provide the information required by this paragraph with the request shall result in the dismissal with prejudice of the undue hardship waiver request.
(c) Consideration of request. Within thirty (30) days of receipt of a request for an undue hardship waiver, the Department shall consider whether the information furnished shows an undue hardship. During the thirty (30) days of review, the Department may request additional information before making a final decision. The request shall be made in writing by certified mail, return receipt requested. The party to whom the request is directed shall provide the requested information within thirty (30) days after the receipt of the certified mail. The Department shall have fifteen (15) days from receipt of the additional information to make a decision. Failure to provide the requested information shall result in a denial of the request. The Department's decision shall be in writing, and shall be delivered by certified mail, return receipt requested. If the request is denied, the Department shall provide notice of the opportunity to request that the Department reconsider the decision.
(d) Reconsideration. A party may request that the Department reconsider a decision to deny an undue hardship waiver. Such request shall be made and shall be handled pursuant to the reconsideration provisions as set forth in Chapter 3, Section 14, of the Wyoming Medicaid Rules. A party may submit any additional relevant information at the time of the request. A party that fails to request reconsideration pursuant to this section may not subsequently request an administrative hearing pursuant to Chapter 4 regarding the adverse action.
(e) Administrative Hearing. If an administrative hearing is requested, it shall be conducted in accordance with Wyoming Medicaid Rules, Chapter 4, Medicaid Administrative Hearings, except the burden of proof in subsection (f) applies to this Chapter.
(f) Burden of proof. If an administrative hearing is requested, it shall be conducted in accordance with the Wyoming Medicaid Rules, Chapter 4, Medicaid Administrative Hearings, except the burden of proof in subsection (f) applies to this Chapter.
(a) For any code, standard, rule, or regulation incorporated by reference in this rules:
(i) The Department has determined that incorporation of the full text in these rules would be cumbersome or inefficient given the length or nature of the rules:
(ii) The incorporation by reference does not include any later amendments or editions of the incorporated matter beyond the applicable date identified in subsection (b) of this section; and
(iii) The incorporated code, standard, rule, or regulation is maintained at the Department and is available for public inspection and copying at cost at the same location.
(b) Each rule or regulation incorporated by reference in these rules is further identified as follows:
(i) Referenced in Section 2 and 5 is Title V of the Social Security Act, which is incorporated as the effective date of this Chapter and can be found at http://ssa.gov.
(ii) Referenced in Section 2 is Title XII of the Social Security Act, including 42 U.S.C. §§ 1396a(25), 1396k(a)(1)(A), and 1396p, which is incorporated as of the effective date of this Chapter and can be found at http://ssa.gov.
(iii) Referenced in Section 2 is 42 C.F.R. §§ 433.135 through 433.154, which is incorporated as of the effective date of this Chapter and can be found at http://www.ecfr.gov.
(iv) Referenced in Section 2 is 42 C.F.R. § 433.36, which is incorporated as of the effective date of this Chapter and can be found at http://www.ecfr.gov.
(v) Referenced in Section 2 is the Wyoming Medicaid State Plan, which is incorporated as of the effective date of this Chapter and can be found at https://health.wyo.gov/healthcarefin/medicaid/spa/.
(vi) Referenced in Section 5 is 42 U.S.C. § 1396d(b), which is incorporated as of the effective date of this Chapter and can be found at http://ssa.gov.
(vii) Referenced in Section 6 is 42 C.F.R. § 433.148(b), which is incorporated as of the effective date of this Chapter and can be found at http://www.ecfr.gov.
(viii) Institutional Provider Manual at wymedicaid.portal.conduent.com/manuals, go to provider, select provider manuals and bulletins, choose institutional manual, and go to Medicaid Death Report Form.