La. Admin. Code tit. 50 § II-10153
Current through Register Vol. 50, No. 11, November 20, 2024
Section II-10153 - Audits, Inspections, ReviewsA. General. Facilities shall be subject to audits, inspections of the quality of care provided, and review of each applicant/recipient's need for SN-NRTP, SN-TDC, SN-ID, SN, IC I, or IC II services.B. Audits. All nursing facility providers participating in the Medicaid Program shall be subject to audit. A sufficient representative sample of each type of Long Term Care provider shall be fully audited to ensure the fiscal integrity of the program and compliance with program regulations governing reimbursement. Limited scope and exception audits shall be conducted as needed. The facility shall retain such records or file as required by the Department of Health and Hospitals-Bureau of Health Services Financing and shall have them available for inspection for three years from the date of service or until all audit exceptions are resolved, whichever period is longer. NOTE: If the department's limited scope audit of the residents' Personal funds account indicate a material number of transactions were not sufficiently supported or material non-compliance, the department shall initiate a full scope audit of the account. The cost of the full scope audit shall be withheld from the vendor payments. (Refer to Subchapter L, Sanctions and Appeal Procedures.)
La. Admin. Code tit. 50, § II-10153
Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 22:34 (January 1996).AUTHORITY NOTE: Promulgated in accordance with R.S. 46:153.