Definitions.

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42-11-102. Definitions.

(a) As used in this chapter:

(i) "Account" means the private ground ambulance service provider assessment account created by W.S. 42-11-103;

(ii) "Ambulance" has the same meaning as defined in W.S. 33-36-102(a)(i)(A) and (B);

(iii) "Department" means the department of health;

(iv) "Fiscal year" means the twelve (12) month period beginning October 1 and ending September 30;

(v) "Private ground ambulance service provider" means any person operating a licensed ambulance service designed to operate on the ground, which is not owned or operated by the state or any city, town, county, special district or other political subdivision of the state or local government;

(vi) "License" and "licensed" means an ambulance business license issued under W.S. 33-36-104 that is not expired and has not been revoked or suspended;

(vii) "Medicaid" means the medical assistance program established by title XIX of the federal Social Security Act and administered in this state by the department pursuant to the Wyoming Medical Assistance and Services Act;

(viii) "Net patient revenue" means all amounts received by a private ground ambulance service provider licensed under W.S. 33-36-104 for the provision of licensed, ground ambulance services in the state of Wyoming. The department shall establish a procedure for determining net patient revenue for purposes of the assessment provided under W.S. 42-11-104;

(ix) "Quarterly adjustment payment" means the quarterly payments made to private ground ambulance service providers that the department may establish and distribute pursuant to W.S. 42-11-106;

(x) "Rate enhancement" means Medicaid reimbursement rate increases to private ground ambulance service providers, as determined by the department and approved by the Centers for Medicare and Medicaid Services;

(xi) "Upper payment limit" means a limitation on aggregate Medicaid payments to private ground ambulance service providers, or another applicable class of Medicaid payees, as established by the Centers for Medicare and Medicaid Services;

(xii) "Upper payment limit gap" means the amount calculated annually by the department constituting the difference between the applicable upper payment limit and Medicaid payments made subject to that limit in a fiscal year, excluding any payments authorized by this chapter.


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