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Wyoming Pregnant by Choice CMS Extension Approved: April 7, 2020; Effective through December 31, 2027 Amendment Approved: April 30, 2025 Page 6 of 38

8. Demonstration Transition and Phase-Out. The state may suspend or terminate this demonstration, in whole or in part, at any time prior to the date of expiration, consistent with the following requirements.

a) Notification of Suspension or Termination: The state must promptly notify CMS in writing of the reason(s) for the suspension or termination, together with the effective date and a transition and phase-out plan. The state must submit its notification letter and a draft transition and phase-out plan to CMS no less than six months before the effective date of the demonstration’s suspension or termination. Prior to submitting the draft transition and phase-out plan to CMS, the state must publish on its website the draft transition and phase-out plan for a 30-day public comment period. In addition, the state must conduct tribal consultation in accordance with STC 13. Once the 30-day public comment period has ended, the state must provide a summary of each public comment received, the state’s response to the comment and how the state considered the comments received when developing the revised transition and phase-out plan.

b) Transition and Phase-out Plan Requirements: The state must minimally include in its phase-out plan the following: i) the process by which it will notify affected beneficiaries; the content of said beneficiary notices (including information on the beneficiary’s appeal rights); ii) the process by which the state will conduct administrative reviews of Medicaid eligibility prior to the termination of the demonstration for the affected beneficiaries; iii) the process by which the state will ensure ongoing coverage for eligible individuals; and, iv) any community outreach activities the state will undertake to notify affected beneficiaries (including any community resources that are available). c) Transition and Phase-out Plan Approval: The state must obtain CMS approval of the transition and phase-out plan prior to the implementation of the transition and phase-out activities. Implementation of transition and phase-out activities must be no sooner than 14 days after CMS approval of the transition and phase-out plan.

d) Transition and Phase-out Procedures: The state must comply with all applicable notice requirements found in 42 CFR, part 431 subpart E, including sections 431.206, 431.210 and 431.213. In addition, the state must assure all appeal and hearing rights are afforded to demonstration beneficiaries as outlined in 42 CFR part 431 subpart E, including 431.220 and 431.221. If a demonstration beneficiary requests a hearing before the date of action, the state must maintain benefits as required in 42 CFR 431.230. In addition, the state must conduct administrative renewals for all affected beneficiaries in order to determine if they qualify for Medicaid or CHIP eligibility under a different eligibility category prior to termination, as discussed in the October 1, 2010 State Health Official letter #10-008 and as required under 42 CFR 435.916(f)(1). For individuals determined ineligible for Medicaid, the Commonwealth must determine potential eligibility for other insurance affordability programs and comply with the procedures set forth in 42 CFR 435.1200(e).