Welfare Fraud Prevention Act

Wyo. Stat. Ann. tit. 42, ch. 10
in effect

Wyo. Stat. Ann. § 42-10-101 Definitions.

(a) As used in this chapter: (i) "Identity information" includes the name, alias, date of birth, address, social security number and other related information of an applicant for or recipient of a public welfare benefit; (ii) "Public welfare benefit" means as provided in W.S. 42-2-102(a)(vii).

Wyo. Stat. Ann. § 42-10-102 Enhanced identity authentication process.

Prior to awarding any public welfare benefit the department may require an applicant to complete an identity authentication process that confirms the applicant owns the identity presented in the application. The identity authentication process under this section shall consist of financial or personal questions related to the applicant. The authentication process shall be available for applicant interviews in person or by telephone.

Wyo. Stat. Ann. § 42-10-103 Enhanced eligibility verification process.

(a) Prior to awarding any public welfare benefit, and on a quarterly basis after any benefit is awarded, the department shall, to the extent practicable, determine the following information as it relates to each applicant for or recipient of a public welfare benefit: Note: Effective 1/1/2027 this subsection will read as: (a) Prior to awarding any public welfare benefit, and at the intervals specified in this section after any benefit is awarded, the department shall, to the extent practicable, determine the following information as it relates to each applicant for or recipient of a public welfare benefit: (i) Earned and unearned income information maintained by the United States internal revenue service; (ii) Weekly, monthly or quarterly reports of income and unemployment insurance payment information maintained by the department of workforce services; (iii) Income information maintained by the United States social security administration; Note: Effective 1/1/2027 this paragraph will read as: (iii) Income information maintained by the United States social security administration, reviewed by the department at every application and recertification period; (iv) Immigration status information maintained by the United States citizenship and immigration services; Note: Effective 1/1/2027 this paragraph will read as: (iv) Immigration status information maintained by the United States citizenship and immigration services and verified through the SAVE online service or other acceptable documentation; (v) Death register information maintained by the United States social security administration; Note: Effective 1/1/2027 this paragraph will read as: (v) Death register information maintained by the United States social security administration, reviewed by the department not less than on a monthly basis; (vi) Prisoner information maintained by the United States social security administration; Note: Effective 1/1/2027 this paragraph will read as: (vi) Prisoner information maintained by the United States social security administration, reviewed by the department of family services at every application and recertification period; (vii) Public housing and section 8 housing assistance payment information; Note: Effective 1/1/2027 this paragraph will read as: (vii) Public housing and section 8 housing assistance payment information, reviewed by the department of family services at every application and recertification period; (viii) Fleeing felon, probation or parole violation information; Note: Effective 1/1/2027 this paragraph will read as: (viii) Fleeing felon, probation or parole violation information, reviewed by the department of family services at every application and recertification period; (ix) Wage reporting information maintained by states contiguous to Wyoming; (x) Beneficiary records and earnings information maintained by the United States social security administration in the beneficiary and earnings data exchange system; Note: Effective 1/1/2027 this paragraph will read as: (x) Beneficiary records and earnings information maintained by the United States social security administration in the beneficiary and earnings data exchange system, reviewed by the department at every application and recertification period; (xi) Earnings and pension information maintained by the United States social security administration in the beneficiary earnings exchange record system; Note: Effective 1/1/2027 this paragraph will read as: (xi) Earnings and pension information maintained by the United States social security administration in the beneficiary earnings exchange record system, reviewed by the department at every application and recertification period; (xii) Earnings and pension information maintained by the Wyoming retirement system; Note: Effective 1/1/2027 this paragraph will read as: (xii) Earnings and pension information maintained by the Wyoming retirement system, reviewed by the department of family services at every application and recertification period and by the department of health upon the receipt of applicable information from the Wyoming retirement system; (xiii) Employment information maintained by the department of workforce services; Note: Effective 1/1/2027 this paragraph will read as: (xiii) Employment information, reviewed by the department at every application and recertification period; (xiv) Employment information maintained by the United States department of health and human services in the national directory of new hires; Note: Effective 1/1/2027 this paragraph will read as: (xiv) Employment information maintained by the United States department of health and human services in the national directory of new hires, reviewed by the department of family services at every application and recertification period; (xv) Supplemental security income information maintained by the United States social security administration in the social security income state data exchange system; Note: Effective 1/1/2027 this paragraph will read as: (xv) Supplemental security income information maintained by the United States social security administration in the social security income state data exchange system, reviewed by the department at every application and recertification period; (xvi) Veterans' benefits information; (xvii) Child care services information maintained by the department; (xviii) Utility payment information maintained by the state under the low income home energy assistance program as provided in W.S. 42-2-501; (xix) Emergency utility payment information maintained by the state or local governmental entities; and (xx) Income and employment information maintained by the department and the United States department of health and human services office of child support enforcement. (b) The department is authorized to enter into agreements with third-party vendors to obtain the following information prior to awarding any public welfare benefit, and on a quarterly basis after any benefit is awarded: (i) Information on public welfare benefits received in other states maintained in any real time national database, including the national accuracy clearinghouse; (ii) A nationwide public records data source of physical asset ownership including real property, automobiles, watercraft, aircraft, luxury vehicles or any other vehicle; (iii) A nationwide public records data source of incarcerated individuals; (iv) A nationwide best available address and driver's license data source to verify individuals are residents of Wyoming; (v) A comprehensive public records database that identifies potential identity fraud or identity theft which can closely associate name, social security number, date of birth, phone and address information; or (vi) National and local financial institutions, in order to locate undisclosed depository accounts or verify account balances of disclosed accounts. (c) In addition to the records specified in subsections (a) and (b) of this section, the department may also consider information from any database or source which is substantially similar to or a successor of any record, database or information specified under this section. (d) On not less than a quarterly basis, the department of family services and department of health shall each make available on their public websites all of the following data from findings on noncompliance and fraud investigations, provided the data is presented in the aggregate and does not include confidential or personally identifying information: [NOTE: This subsection will be effective 1/1/2027.] (i) The total number of public benefit cases investigated for intentional program violations or fraud; (ii) The total number of public benefit cases referred to the attorney general's office for prosecution; (iii) Total improper payments and expenditures; (iv) Total monies received; (v) Aggregate data concerning improper payments and ineligible recipients as a percentage of those recipients investigated and reviewed.

Wyo. Stat. Ann. § 42-10-104 Case review process.

(a) If the department finds a discrepancy or change in circumstances as a result of the activities required by W.S. 42-10-102 or 42-10-103, the department shall review the case using the following procedures: (i) If the discrepancy or change in circumstances does not affect eligibility, the department shall take no further action; (ii) If the discrepancy or change in circumstances may affect eligibility, the department shall: (A) Promptly make a determination of the effect of the discrepancy or change in circumstances on the eligibility of the applicant or recipient; and (B) Provide written notice to the applicant or recipient describing in detail the circumstances of the discrepancy or change in circumstances, the manner in which the applicant or recipient may respond and the consequences of failing to take any action. The department shall give the applicant or recipient an opportunity to explain the discrepancy or change in circumstances. (iii) The applicant or recipient shall respond within ten (10) business days from the date of the written notice of the discrepancy or change in circumstances; (iv) If an applicant or recipient does not respond to a notice of a discrepancy or change in circumstances as provided in paragraph (ii) of this subsection and the department determines that the discrepancy or change in circumstances affects eligibility for a public welfare benefit, the department shall provide a written decision of the intent to deny, reduce the benefit or close the benefit case; (v) If an applicant or recipient responds to a notice of a discrepancy or change in circumstances as provided in paragraph (ii) of this subsection, the department shall investigate and make a determination of whether or not the discrepancy or change in circumstances has been resolved and determine the applicant's or recipient's eligibility for public welfare benefits. The decision of the department shall be provided to the applicant or recipient in writing; (vi) A written decision of the department under this section shall constitute a final decision of the department subject to judicial review as provided in W.S. 16-3-114.

Wyo. Stat. Ann. § 42-10-105 Referral of cases for investigation.

(a) After review of a discrepancy or change in circumstances under W.S. 42-10-104, if the department finds that there is inadequate documentation or upon reasonable suspicion that there is fraud, misrepresentation, identity theft or another violation of law the department shall: (i) Refer the case to the fraud and recovery unit for investigation, recovery of improper payments and collection of civil penalties, if applicable and, if appropriate, referral to prosecuting authorities for criminal prosecution; (ii) Refer the information to other agencies, divisions or departments as appropriate for review of eligibility in public programs. (b) To the extent the department encounters an individual enrolled in Medicaid who the department has reason to believe is not eligible for Medicaid, the department shall inform the individual and the Wyoming Medicaid program of the reason the department does not believe the individual is eligible.

Wyo. Stat. Ann. § 42-10-106 Report.

Not later than November 30 of 2017, 2018 and 2020 the department shall report to the governor and the joint labor, health and social services interim committee on the effectiveness of the eligibility verification system and the number of cases referred under W.S. 42-10-105 including information on the outcome of the cases, if available, and on the cost to the department of the system.

Wyo. Stat. Ann. § 42-10-108 Prohibition on self-attestation. Note: this section is effective as of 1/1/2027.

(a) Except as required under federal law, self-attestation shall not be accepted for any of the following eligibility factors without verification prior to enrollment in the medicaid program: (i) Income in excess of zero dollars ($0.00); (ii) Residency; (iii) Identity; (iv) Except for any presumptive eligibility period, citizenship or immigration status. (b) The department shall not rely on self-attestation to establish any medicaid eligibility factor unless expressly required by federal law.

Wyo. Stat. Ann. § 42-10-109 Residency verification; monthly address checks; multistate enrollment; monthly death record checks. Note: this section is effective as of 1/1/2027.

(a) As used in this section, "address change information" means postal change of address data, state address change databases or comparable systems. (b) On not less than a monthly basis, the department of health shall review address change information to identify potential changes in residency for medicaid recipients. (c) The department of health shall conduct monthly cross checks of address change information against enrollment records and shall initiate an eligibility redetermination when a change in residency is indicated. (d) The department of health shall submit enrollment information to any national database used to identify persons enrolled in medicaid in multiple states. Implementation of this subsection shall occur no later than October 1, 2029. (e) Not later than August 31 of each year, the department of health shall submit a public report to the joint labor, health and social services interim committee of the Wyoming legislature, including: (i) The number of persons flagged through address change information or out of state benefit activity; (ii) The number of persons removed from the medicaid program due to enrollment in multiple states; (iii) The estimated fiscal impact of this section. (f) On not less than a monthly basis, the department of health shall receive and review information from the vital statistics services and the social security administration master death file to identify any deceased persons enrolled in the medicaid program. Upon confirmation of death, the department shall promptly remove the deceased person from the program.

Wyo. Stat. Ann. § 42-10-110 Retroactive medicaid eligibility; rulemaking; reporting. Note: this section is effective as of 1/1/2027.

(a) As used in this section: (i) "Retroactive eligibility" means coverage for services furnished prior to the month of application as authorized by 42 U.S.C. § 1396a(a)(34); (ii) "Medicaid eligible population" means persons eligible for medicaid under state or federal law. (b) Retroactive medicaid eligibility shall not extend more than two (2) months prior to the month in which a completed medicaid application is submitted. (c) This limitation applies only to initial applications and shall not affect ongoing eligibility. (d) The department of health shall adopt rules necessary to implement this section. (e) Not later than August 1 of each year, the department of health shall submit a report to the joint labor, health and social services interim committee of the Wyoming legislature, including: (i) The number of medicaid applications processed; (ii) The number of applicants denied retroactive eligibility under this section; and (iii) The estimated fiscal impact of the limitation. (f) This section shall be implemented not later than January 1, 2027.

Wyo. Stat. Ann. § 42-10-201 Prohibition on waiver of work requirements and exemptions. Note: this section is effective as of 1/1/2027.

(a) The department of family services shall not seek, apply for, accept or renew any waiver of work requirements under 7 U.S.C. § 2015(o)(4) without first obtaining specific authorization from the legislature. Such authorization shall be provided in a duly enacted statute. (b) The department of family services shall not exercise the state's option to provide any exemptions from the work requirement under 7 U.S.C. § 2015(o)(6)(F), except for family caregivers as defined in section 2 of the Recognize, Assist, Include, Support and Engage Family Caregivers Act of 2017.
Source: Public.Resource.Org WY StatutesURL: https://unicourt.github.io/cic-code-wy/transforms/wy/ocwy/r78/gov.wy.code.title.42.htmlFetched: 6/28/2026

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