Section 405 IAC 1-14.7-4 - Scope of reviewsAuthority: IC 12-15-1-10; IC 12-15-21-3
Affected: IC 4-21.5-3; IC 12-13-7-3; IC 12-15
Sec. 4.
(a) The office shall perform a desk review or field audit of a submitted cost report to determine the reasonableness, appropriate classification, and allowability of reporting. The office may request documentation to justify the submitted cost report.(b) The office shall contact a provider to notify them that they have been selected for a field audit as follows:(1) The office shall provide an audit notification letter to the provider identifying the information the provider is required to submit in advance of the field audit date. Failure to submit the required information by the due date in the audit notification letter shall result in the implementation of the prefield information rate reduction as identified in section 12 of this rule.(2) The office shall schedule the field audit date with the provider. If the office and provider are unable to reach an agreement on a scheduled field audit date, the office shall assign a date for the field audit to begin not earlier than fifteen (15) days after the date the provider was initially contacted to schedule the field visit. The office shall confirm the field audit date by providing a written notice identifying the date of the scheduled field audit.(3) After assignment of a field audit date, a provider may submit a one (1) time request that the scheduled field audit be postponed to a later date as follows: (A) The office shall approve or deny the request in writing within fifteen (15) days of receiving the request.(B) A delay of the scheduled field audit date does not extend the due date of the required information.(c) If a field audit indicates a provider's records are inadequate to support data submitted to the office, or the additional requested documentation is not provided under the office's request and the office is unable to complete the audit, the following actions shall be taken:(1) The office shall provide a written notice listing the deficiencies in documentation.(2) The provider shall be allowed fifteen (15) days from the date of the notice to provide the documentation and correct the deficiencies.(3) Not earlier than fifteen (15) days from the date of the notice, the office shall give a final written notice (follow-up letter) listing the outstanding deficiencies in documentation.(4) Failure to submit the required information by the due date in the written notice shall result in the implementation of the field work - follow-up letter and rate reduction as identified in section 12 of this rule.Office of the Secretary of Family and Social Services; 405 IAC 1-14.7-4; filed 8/20/2024, 9:11 a.m.: 20240918-IR-405240088FRA