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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 9 of 38

(9) Are not pregnant. 17. Demonstration Disenrollment. If a woman becomes pregnant while enrolled in the demonstration, she may be determined eligible for Medicaid under the state plan. The state must not submit claims under this demonstration for any woman who is found to be eligible under the Medicaid state plan. In addition, women who receive a sterilization procedure and complete all necessary follow-up procedures will subsequently be disenrolled from this demonstration.

18. Eligibility Determination Process. Eligibility and enrollment processes for this demonstration must comply with section 1943 of the Act and implementing federal regulations at 42 CFR part 435. The state must ensure that any changes made to the state’s Medicaid eligibility and enrollment processes to ensure compliance with section 1943 of the Act and implementing regulations at 42 CFR part 435 are implemented for the demonstration and its population concurrently with the implementation for the state plan. A delay in implementing any such changes for the demonstration may subject the state to the penalty described in STC 10.

V. BENEFITS AND DELIVERY SYSTEMS

19. Family Planning Benefits. Individuals eligible under this demonstration will receive family planning services and supplies as described in section 1905(a)(4)(C) of the Act, which are reimbursable at the 90 percent federal matching rate and are limited to those services and supplies whose primary purpose is family planning to prevent or delay pregnancy. The specific family planning services provided under this demonstration are as follows:

a) Approved methods of contraception;

b) Screening for sexually transmitted infection (STI) or sexually transmitted disease (STD) during a family planning visit, Pap smears and pelvic exams;

Note: The laboratory tests done during an initial family planning visit for contraception include a pap smear, screening tests for STIs/STDs, blood count and pregnancy test. Additional screening tests may be performed depending on the method of contraception desired and the protocol established by the clinic, program or provider. Additional laboratory tests may be needed to address a family planning problem or need during an inter-periodic family planning visit for contraception. c) Drugs, supplies, or devices related to women’s health services described above that are prescribed by a health care provider who meets the state’s provider enrollment requirements (subject to the national drug rebate program requirements); and,

d) Contraceptive management, patient education, and counseling;

20. Family Planning Related Benefits. Family planning-related services and supplies are defined as those services provided as part of or as follow-up to a family planning visit for