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percent (25%) or more of the Medicaid claims submitted by the provider in any consecutive three (3) month period; and
(B) The amount of the claims for which records were not maintained is five thousand dollars ($5,000.00) or more.
42-4-409. Aggregation of claims in certain cases.
The amount of claims relating to violations of this act through a common scheme, or based on the same transaction or occurrence, may be aggregated to determine the level of penalty under this act, whether or not the claims were made as part of the same claim under Medicaid.
42-4-410. Suspension or exclusion as provider.
(a)The department of health or the department of family…#
(a) The department of health or the department of family services may suspend or exclude a provider from providing services and supplies under Medicaid if:
(i)The department determines that the provider has…#
(i) The department determines that the provider has committed an offense under this act or the Wyoming Medicaid False Claims Act, whether or not a criminal prosecution is brought under this act or any civil action is brought under the Wyoming Medicaid False Claims Act; or