Wyoming § 26-55-104 Persons qualified to make adverse
determinations

Wyoming Statutes

§ 26-55-104 — Persons qualified to make adverse determinations

Wyoming § 26-55-104

Title 26Insurance Code

Ch. 55ENSURING TRANSPARENCY IN PRIOR AUTHORIZATION ACT

This text of Wyoming § 26-55-104 (Persons qualified to make adverse determinations) is published on Counsel Stack Legal Research, covering Wyoming primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Wyo. Stat. Ann. § 26-55-104 (2026).

Text

(a)Each health insurer or contracted utilization review entity shall ensure that all adverse determinations are made by a physician or other appropriate licensed health care provider who has:

(i)Sufficient medical knowledge in an applicable practice area or specialty;

(ii)Knowledge of the coverage criteria;

(iii)Unless otherwise required under Wyoming law, a current and unrestricted license to practice within the scope of their profession in a state, territory, commonwealth of the United States or the District of Columbia;

(iv)Knowledge of the applicable person's medical history and diagnosis.

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(a) Each health insurer or contracted utilization review
entity shall ensure that all adverse determinations are made by
a physician or other appropriate licensed health care provider
who has:
(i) Sufficient medical knowledge in an applicable
practice area or specialty;
(ii) Knowledge of the coverage criteria;
(iii) Unless otherwise required under Wyoming law, a
current and unrestricted license to practice within the scope of
their profession in a state, territory, commonwealth of the
United States or the District of Columbia;
(iv) Knowledge of the applicable person's medical
history and diagnosis.