{"data":{"id":"us-wy/wyo.-stat.-26-55-104","jurisdiction":"us-wy","citation":"Wyo. Stat. § 26-55-104","heading":"Persons qualified to make adverse determinations.","body":"(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:\n(i) Sufficient medical knowledge in an applicable practice area or specialty;\n(ii) Knowledge of the coverage criteria;\n(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;\n(iv) Knowledge of the applicable person's medical history and diagnosis.","path":["TITLE 26 - INSURANCE CODE","CHAPTER 55 - ENSURING TRANSPARENCY IN PRIOR AUTHORIZATION ACT"],"source_url":"https://wyoleg.gov/statutes/compress/title26.pdf","current_through":"2026 Budget Session; as of 2026-07-01","vintage":"","retrieved_at":"2026-09-04T00:16:32Z","sha256":"9a45ff2ba6007d0ae0a85bfba92ae5c8e2cc26caa0945ce300d6f2a762fdbf83","source_id":"us-wy","stale":false,"prev":"us-wy/wyo.-stat.-26-55-103","next":"us-wy/wyo.-stat.-26-55-105"},"notice":"GroundRules: Original legal text. Not legal advice."}