Idaho Admin. Code r. 16.03.09.305

Current through September 2, 2024
Section 16.03.09.305 - REIMBURSEMENT SYSTEM AUDITS
01.Scope of Reimbursement System Audits. The Department reserves the right to audit financial and other records of the provider, and, when warranted, the records of entities related to the provider. Audits consist of the following types of records:
a. Cost verification of actual costs for providing goods and services;
b. Evaluation of provider's compliance with the provider agreement, reporting form instructions, and any applicable law, rule, or regulation;
c. Effectiveness of the service to achieve desired results or benefits; and
d. Reimbursement rates or settlement calculated under this chapter.
02.Exception to Scope for Audits and Investigations. Audits as described in these rules do not apply to the audit processes used in conducting investigations of fraud and abuse under IDAPA 16.05.07, "The Investigation and Enforcement of Fraud, Abuse, and Misconduct."

Idaho Admin. Code r. 16.03.09.305

Effective March 17, 2022