Catch Title: Enhanced Medicaid reimbursement rate-maternal services

Category: Public Health

Sponsor: Representative(s) Clouston, Campbell, E and Boner, Brennan, Connolly and Senator(s) Landen, Nethercott and Schuler

Effective Date: Contingent upon the state plan amendment being approved by the Centers for Medicare and Medicaid Services (CMS) . (Section 1(a) and Section 4 are effective immediately)

Bill URL: https://wyoleg.gov/2026/Introduced/HB0064.pdf

 Overview: This bill directs the Wyoming Department of Health (DOH) to apply for federal authorization to provide enhanced Medicaid reimbursement rates for maternal services delivered in rural and frontier areas . The initiative aims to increase access to prenatal, intrapartum, and postpartum care while preserving obstetric provider capacity in rural Wyoming and reducing maternal and neonatal morbidity and mortality.

Key Provisions:

• Mandated CMS Application: The DOH is required to apply to CMS for a state plan amendment to authorize enhanced reimbursement rates for maternal services provided to eligible Medicaid clients in rural and frontier areas .
• Defined “Eligible Provider”: Includes obstetrician-gynecologists, family physicians providing obstetrical services, midwives, general surgeons providing C-section backup, and other providers as determined by DOH rule .
• Administrative Geographic Definition: Grants the DOH the authority to determine which regions qualify as “rural and frontier areas” .
• Appropriation: Allocates $1,000,000 from the general fund and $1,000,000 from federal funds ($2,000,000 total) for the period from July 1, 2026, to June 30, 2028 .
• Legislative Reporting: Requires the DOH to report additional costs incurred and provide recommendations for rate modifications to the Joint Appropriations Committee and Joint Labor Committee by October 31, 2027 .
• Rulemaking: Directs the DOH to promulgate all rules necessary for implementation .

Implications:

• Significant Administrative Discretion: The DOH maintains broad authority to define “rural and frontier areas” and can expand the “eligible provider” list by rule, which may lead to variability in implementation .
• Implementation Uncertainty: The actual start date for enhanced reimbursements is [Ambiguous: Contingent on CMS approval, which lacks a fixed timeline] .
• The “Fiscal Cliff”: All funding and authority for the enhanced reimbursement rate expire on June 30, 2028, potentially creating long-term financial instability for rural providers despite the stated legislative intent for future inclusion in standard budgets
• Appropriation Cap Risk: The $2 million appropriation is a fixed amount . There is [Ambiguous: No specified mechanism to address a funding shortfall if the volume of rural maternal services exceeds the fixed budget]