Section 7 AAC 145.531 - Personal care services, Community First Choice services, or home and community-based waiver services accounting and reporting(a) For personal care services under 7 AAC 125.010-7 AAC 125.199, Community First Choice services under 7 AAC 127, adult day services under 7 AAC 130.250, day habilitation services provided under 7 AAC 130.260, residential habilitation services under 7 AAC 130.265, employment services under 7 AAC 130.270, intensive active treatment services under 7 AAC 130.275, respite care services under 7 AAC 130.280, and meal services under 7 AAC 130.295, each target provider described in (b) of this section and in the department's Rate-Setting Methodology for Personal Care Services, Community First Choice Services, Long-Term Services and Supports Targeted Case Management Services, and Waiver Services, adopted by reference in 7 AAC 160.900, shall complete and submit an annual report to the department in accordance with this section.(b) Each August 1, the department will publish a list of target providers on the department's website and on the Alaska Online Public Notice System (AS 44.62.175). The department will establish target providers as follows: (1) the department will establish the list of target providers using (A) the department's Rate-Setting Methodology for Personal Care Services, Community First Choice Services, Long-Term Services and Supports Targeted Case Management Services, and Waiver Services, adopted by reference in 7 AAC 160.900;(B) Medicaid units of service; and(C) a time period consisting of the state fiscal year that precedes the state fiscal year that ends in the calendar year in which the list is published;(2) in the list of target providers (A) for each target provider, the department will indicate if the target provider shall prepare in that reporting cycle a full annual report as described in (c) of this section or a reduced annual report as described in (d) of this section; and(B) if the target provider's federal tax identification number received less than $750,000 in Medicaid revenue related to personal care services, Community First Choice services, or home and community-based waiver services in the state fiscal year that precedes the state fiscal year that ends in the calendar year in which the list is published;(3) a target provider shall complete and submit an annual report to the department not later than eight months after the end of the target provider's fiscal year that ends in the calendar year in which the list is published;(4) a state-owned and operated provider cannot be a target provider.(c) A full annual report consists of (1) a cover sheet or letter signed by the chief executive officer indicating that the submitted information is complete and accurate to the best of the officer's knowledge;(2) audited financial statements completed in accordance with generally accepted auditing standards (GAAS) or generally accepted government auditing standards (GAGAS);(3) a post-audit working trial balance that ties to the audited financial statements;(4) a completed statistics worksheet from the department's Cost Survey, adopted by reference in 7 AAC 160.900; the target provider shall complete the worksheet in accordance with the Cost Survey 2016 Instructions, adopted by reference in 7 AAC 160.900, and shall submit a completed worksheet regardless of whether the department requests a complete cost survey; and(5) a complete cost survey report, including a reconciliation of the post-audit working trial balance to the expense worksheet of the cost survey.(d) A reduced annual report consists of documents listed in (c)(1) - (4) of this section, except that a provider whose federal tax identification number received less than $750,000 in Medicaid revenue related to personal care services, Community First Choice services, or home and community-based waiver services as described in (b)(2)(B) of this section may substitute a reviewed financial statement for an audited financial statement as specified in (c)(2) of this section and substitute a reviewed working trial balance for a post-audit working trial balance as specified in (c)(3) of this section if the review was conducted by an independent certified public accountant.(e) A target provider shall maintain a system of accounts, records, and books to document and track financial and statistical information related to personal care services under 7 AAC 125.010 - 7 AAC 125.199, Community First Choice under 7 AAC 127, or home and community-based waiver services provided under 7 AAC 130. A target provider is responsible for ensuring that financial and statistical information is adequate to report annual costs and usage by each personal care service, Community First Choice services, or home and community-based waiver service provided.(f) A target provider shall base all financial and statistical information on an accrual method of accounting and comply with generally accepted accounting principles (GAAP). For the target provider to base financial and statistical information on an accrual method of accounting, (1) revenues must be reported in the period earned, regardless of when the payment was received; and(2) costs must be reported in the period in which they were incurred.(g) A target provider's accounting system must be adequate to separate allowable costs from nonallowable costs and capable of producing detailed reporting of allowable costs by personal care service, Community First Choice services, or home and community-based waiver service. Nonallowable costs and costs not related to the provision of recipient services must be separately tracked and reported.(h) If a target provider fails to submit a complete annual report in a timely fashion, the department may reduce Medicaid payments for services listed in (a) of this section by five percent, starting as early as the day following the date the complete annual report is due, with the payment reduction remaining in effect until the complete annual report is received.Eff. 3/1/2011, Register 197; am 11/3/2012, Register 204; am 1/1/2014, Register 208, January 2014; am 3/1/2018, Register 225, April 2018; am 10/1/2018, Register 227, October 2018; am 1/1/2021, Register 236, January 2021; am 9/9/2021, Register 239, October 2021; am 5/1/2023, Register 246, July 2023Authority:AS 47.05.010
AS 47.07.030
AS 47.07.040