LD 1951
pg. 1
LD 1951 Title Page An Act To Establish Guidelines and Criteria for Audits Conducted by the Departm... Page 2 of 4
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LR 2882
Item 1

 
Be it enacted by the People of the State of Maine as follows:

 
Sec. 1. 22 MRSA §41-B is enacted to read:

 
§41-B.__Auditing and adjusting of health and community

 
service provider costs

 
This section governs the rules of the department and the
practices of its auditors in interpreting and applying those
rules with respect to payments of providers under the MaineCare
program and payments by the department under grants and
agreements audited pursuant to the Maine Uniform Accounting and
Auditing Practices Act for Community Agencies.

 
1.__Revised audit interpretations to be applied prospectively.__
Whenever the department's auditors revise an interpretation of a
rule, agreement, circular or guideline in a manner that results
in a negative adjustment of a provider's or agency's allowable
costs, the revised interpretation may be applied only to provider
or agency fiscal years beginning after the date of the
examination report or audit report in which the provider or
agency receives notice of the revised interpretation.__For the
fiscal year to which the report containing the revised
interpretation applies, and any subsequent fiscal year ending
prior to the issuance of the revised interpretation, the Office
of Audit for MaineCare and Social Services, referred to in this
section as "the office of audit,"__may not make any negative
adjustment to allowable costs that reflects the revised
interpretation.__For purposes of this subsection, "revised
interpretation" includes an interpretation supporting an
adjustment that was not made in the prior year, when facts
existed on which a substantially similar adjustment could have
been made in the prior year if the same interpretation had been
applied, even if reports in prior years were silent with respect
to any such adjustment.

 
2.__Timing of audits.__Unless otherwise agreed to by the
organization subject to audit, the department shall complete its
audit and issue an examination report or audit report no later
than 12 months following the filing of any cost report, financial
statement or other schedule that is subject to audit.

 
3.__Appeal time frames.__The department shall allow a provider
60 days after the provider's receipt of an audit report,
examination report or other audit determination to seek informal
review of that determination.__The department shall allow 60 days
after its receipt of a final informal review decision for a
provider to request an appeal hearing for review of that
decision.


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