Eligibility for Medicaid-criteria.

26LSO-0139

ORIGINAL Senate

File No
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SF0006

ENROLLED ACT NO. 12,

SENATE

SIXTY-EIGHTH LEGISLATURE OF THE STATE OF WYOMING
2026 Budget Session

AN ACT relating to medical assistance and services; codifying current state criteria for Medicaid eligibility; specifying applicability; requiring rulemaking; and providing for effective dates.

Be It Enacted by the Legislature of the State of Wyoming:

Section 1
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W.S. 42
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4
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106 by creating a new subsection (e) is amended to read:

42
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4
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106.

Application for assistance; determination of eligibility; assignment of benefits; resources and income allowances defined for institutionalized spouse.

(e)

The following requirements shall be met before an applicant is eligible for medical assistance under this chapter:

(i)

An applicant shall be a citizen or national of the United States and shall provide a valid social security number and proof of identity. An applicant considered to be lawfully present in the United States shall be eligible for medical assistance under this chapter. The requirement in this paragraph shall not apply when determining if the department of health will cover children in the custody of the department of family services;

(ii)

An applicant shall be a Wyoming resident or meet the criteria specified in the Wyoming Medicaid state plan. An applicant who intends to return to the applicant's home in another state or country shall not be considered a Wyoming resident;

(iii)

An applicant shall fulfill not less than one (1) of the following criteria:

(A)

Be determined disabled according to social security guidelines by the social security administration or the department;

(B)

Be entitled to receive supplemental security income or be eligible for supplemental security income
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related programs;

(C)

Be entitled to receive hospice services in accordance with a voluntary election and a health care provider statement of a terminal condition where:

(I)

The applicant has received hospice services or resided in a medical institution for not less than thirty (30) consecutive days; or

(II)

The applicant is not a supplemental security income recipient and dies before completion of the time requirement specified in subdivision (I) of this subparagraph.

(D)

Be qualified for services, pursuant to rules of the department, under a Medicaid waiver or other expansion that the legislature has authorized;

(E)

Be infected with tuberculosis and, if the person is not a Wyoming resident or United States citizen, is present in Wyoming and, if not treated, is a threat to infect Wyoming residents with tuberculosis;

(F)

Be otherwise qualified for medical assistance pursuant to federal Medicaid regulations or be eligible under a mandatory requirement of the federal government for participation in Medicaid, provided that no expansion eligibility for Medicaid beyond the eligibility as of January 1, 2026 shall occur without prior authorization by the legislature, except that the governor may authorize a temporary expansion in eligibility needed to combat a public health emergency, provided that the temporary expansion shall end not more than thirty (30) days after the adjournment of the next legislative session;

(G)

Be a child in the custody of the department of family services in foster care, basic foster care, noncitizen foster care, subsidized adoption or in residence at the Wyoming boys' school or the Wyoming girls' school;

(H)

Be enrolled in the 1115 family planning waiver. The department of health is authorized to continue operating the 1115 waiver until its planned expiration in December 31, 2027 and is not authorized to renew the waiver beyond this expiration date;

(J)

Be enrolled in the employed individuals with disabilities program under section 1902(a)(10)(A)(ii)(XV) of the federal Social Security Act;

(K)

Be enrolled in the breast and cervical cancer treatment program under section 1902(a)(10)(A)(ii)(XVIII) of the federal Social Security Act.

(iv)

An applicant shall fulfill any other criteria required pursuant to rules of the department or federal Medicaid regulations.

Section 2.

The department of health shall promulgate all rules necessary to implement this act not later than October 1, 2026.

Section 3.

This act applies to applications for medical assistance submitted or renewed on or after July 1, 2027.

Section 4.

(a)

Except as provided in subsection (b) of this section, this act is effective July 1, 2027
.

(b)

Sections 2 and 4 of this act are effective immediately upon completion of all acts necessary for a bill to become law as provided by Article 4, Section 8 of the Wyoming Constitution.

(END)

Speaker of the House

President of the Senate

Governor

TIME APPROVED: _________

DATE APPROVED: _________

I hereby certify that this act originated in the Senate.

Chief Clerk

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