D.C. Mun. Regs. tit. 29, r. 29-10304
To be reimbursed by DHCF, each HSS agency shall report costs annually to DHCF on a cost survey template designated by DHCF no later than one-hundred and twenty (120) days after the end of the agency's cost survey period, which shall correspond to the fiscal year used by the HSS agency for all other financial reporting purposes, unless DHCF has approved an exception. All cost surveys shall cover a period of twelve (12) months unless the agency obtains advance permission from DHCF to allow an alternative reporting period, for good cause.
A cost survey that is not completed in accordance with the requirements of this section shall be considered an incomplete filing, and DHCF shall notify the HSS agency within thirty (30) days of the date on which DHCF received the incomplete cost survey.
In the absence of specific instructions or definitions contained in the accompanying regulations, cost survey forms, and instructions, the treatment and allowability of costs shall be determined in accordance with the Medicare Principles of Reimbursement, 42 C.F.R. Part 413 , and the interpretations found in the CMS Provider Reimbursement Manual.
The following categories of expense shall be excluded from allowable costs:
Each HSS agency shall maintain adequate accounting records, financial records, and statistical data for proper determination of allowable costs and in support of costs reflected on each line of the cost survey.
All of the HSS agency's accounting and financial records, including the general ledger and records of original entry, and all transaction documents and statistical data, shall be retained for a period of not less than seven (7) years after the filing of a cost survey. If the records relate to a cost survey period under audit or appeal, records shall be retained until the audit or appeal is complete.
DHCF, or its designee, shall review each cost survey for completeness, accuracy, compliance, and reasonableness.
Not later than January 1, 2025, and every three (3) years thereafter, DHCF, or its designee, shall evaluate expenditures subject to the requirements in this Section through financial reviews of cost surveys.
Financial reviews shall be conducted to establish the PMPM rate upon rebasing as set forth in § 10303.
At the conclusion of each financial review, DHCF shall provide an HSS agency with a reviewed cost survey including a description of each adjustment and the reason for each adjustment. An HSS agency that disagrees with the reviewed cost survey may request an administrative review or hearing subject to the following requirements:
After DHCF has received and reviewed an HSS agency's request for an administrative review or hearing, as described in § 10304.10, the following shall occur:
DHCF shall retain the right to conduct audits at any time. Each HSS agency shall grant full access, during announced or unannounced audits by DHCF, DHCF's designee, DHS, other District of Columbia officials, and U.S. Department of Health and Human Services (HHS) auditors, to relevant financial records, statistical data to verify costs previously reported to DHCF and any other documents which pertain to the determination of costs.
D.C. Mun. Regs. tit. 29, r. 29-10304