| This bill requires several reforms and revisions of the |
practices of the Department of Health and Human Services, Office |
of Audit for MaineCare and Social Services in order to ensure |
that providers of health care and other community services, |
subject to audit of their financial statements or their cost |
reports, are treated fairly and reasonably with respect to |
amounts paid to them and with respect to any changes in |
interpretation or policy that might affect amounts to be returned |
to the department retroactively. The bill requires changes in |
interpretation to be applied prospectively, bars disallowance of |
compensation costs if they are no greater in aggregate than those |
paid to state employees with comparable responsibilities and |
requires industry standards to be applied when determining |
reasonableness of costs. To encourage consistency, all informal |
review decisions, as well as appeal decisions, must be published. |
To promote fairness, the office that hears appeals of MaineCare |
payments must be made independent of the department by January 1, |
2007. |