Medicaid agency: WDH
Wyoming Medicaid runs statewide fee-for-service under the Wyoming Department of Health's Healthcare Financing Division. The division also administers Kid Care CHIP through the same eligibility system, and Wyoming does not contract with a Medicaid enrollment broker; Enroll Wyoming, a federally funded ACA Navigator program, helps with Marketplace and Medicaid/CHIP applications, but it is a federal grant program, not a state vendor relationship. Comprehensive managed care does not operate in Wyoming: CMS's 2024 enrollment data show only 202 of the state's 73,053 Medicaid enrollees (0.3%) in any managed care arrangement, all of them in Magellan Healthcare of Wyoming's non-risk Care Management Entity for children and youth with serious emotional or behavioral health needs. Wyoming has not expanded Medicaid under the ACA, and because it lacks the ACA expansion adult group, WDH's own public framing treats the state's exposure to the federal Medicaid work-requirements mandate taking effect January 1, 2027 as comparatively minimal; Wyoming has not joined the multistate litigation challenging CMS's work-requirements rule. Wyoming's family-planning-only Section 1115 demonstration, Pregnant By Choice, runs through December 31, 2027; three other 1115 applications remain pending at CMS, including a Tribal Uncompensated Care demonstration, addressing reimbursement gaps in care delivered through Indian Health Service and tribal facilities, that has remained pending for over a decade without approval or denial, one of the longest-unresolved 1115 applications nationally.
Wyoming Medicaid is a fee-for-service program; no comprehensive managed care organization operates in the state. The one managed-care-adjacent structure is Magellan Healthcare of Wyoming's statewide Care Management Entity, a non-risk prepaid ambulatory health plan covering children and youth ages 4 through 20 with serious emotional disturbance or serious and persistent mental illness. Magellan has held this role since July 1, 2015; Wyoming moved the contract off capitated risk to a non-risk payment model effective July 1, 2018, and it now runs concurrently with the Children's Mental Health waiver's own 1915(b) authority, Wyoming's Care Management Entity (CME). CMS's most recent managed care enrollment report counts 202 of Wyoming's 73,053 Medicaid enrollees in this program for 2024, the entirety of the state's managed care enrollment, at 0.3% of the caseload.
Long-term services and supports run fee-for-service through home and community-based services waivers rather than an integrated managed-care benefit. The Community Choices Waiver covers people 65 and older and adults 19 to 64 with a qualifying disability who meet a nursing facility level of care, renewed effective July 1, 2026 through June 30, 2031. The Comprehensive Waiver and the Supports Waiver both cover people with intellectual or developmental disabilities and people with brain injury who meet a nursing facility or ICF/IID level of care, each running through March 31, 2029. Wyoming's only Program of All-Inclusive Care for the Elderly, in Laramie County, closed in 2021 due to state budget cuts, and no PACE program currently operates in the state.
Not integrated into managed care
Behavioral health for the general Medicaid population is fee-for-service. The one carve-out is Magellan Healthcare of Wyoming's Care Management Entity, a non-risk prepaid ambulatory health plan covering children and youth with serious emotional disturbance or serious and persistent mental illness, tied to the Children's Mental Health waiver (through June 30, 2029) and its concurrent 1915(b) authority, Wyoming's Care Management Entity (CME).
Carved out
Dental is a direct fee-for-service Medicaid benefit; Wyoming does not contract with a separate dental benefit administrator.
Change Healthcare handles Wyoming Medicaid's pharmacy point-of-sale claims processing and its state maximum allowable cost pricing program, and fields provider questions on prior authorization and the preferred drug list.
Non-emergency medical transportation is state-administered rather than brokered. Wyoming Medicaid reimburses mileage and travel costs directly (private vehicle, taxi, shuttle, the Wyoming Rural Transit Program, Greyhound, or airline) through its own Customer Service Center.
The Wyoming Integrated Next Generation System (WINGS) replaced the state's legacy MMIS; its core claims and benefit-management module is operated by Acentra Health. WYhealth, the state's care-management program for chronic disease, maternity, and hospital-discharge support for the general Medicaid population, is operated by Telligen.
39 agency updates tracked for Wyoming. Available with Pro.
See them with ProWyoming's Joint Labor, Health and Social Services Committee directed staff to draft legislation raising the personal needs allowance for Medicaid nursing home residents from $50 to $100 monthly and the asset limit from $2,000 to $5,000. The current limits date to 2001 and 1989 respectively and have not kept pace with inflation, according to hospital association and ombudsman testimony. Supporters, including the Wyoming Hospital Association and the Long-Term Care Ombudsman, say the low thresholds cause residents to lose coverage over small asset fluctuations and create uncompensated care burdens for facilities. The change is estimated to cost the state $1.3 million annually; the committee will consider the draft bill at its November meeting.
Healthy Wyoming, a state advocacy organization, is calling on the Wyoming Legislature to permanently extend postpartum Medicaid coverage from 60 days to 12 months when lawmakers convene this winter. The state enacted a temporary extension in 2023 that is set to expire in March. The group also advocates for prioritizing rural health services in the state's allocation of over $200 million in federal Rural Health Transformation funding. The organization frames both priorities as essential to addressing healthcare affordability and access challenges in Wyoming.
14 active waivers tracked for Wyoming. Available with Pro.
See them with ProNo active solicitations currently tracked for Wyoming.
4 managed care contracts tracked for Wyoming. Available with Pro.
See them with Pro6 bills tracked for Wyoming. Available with Pro.
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