LD 1951
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Page 3 of 4 An Act To Establish Guidelines and Criteria for Audits Conducted by the Departm... LD 1951 Title Page
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LR 2882
Item 1

 
(1) The site must include a search feature allowing
users to obtain information on specific issues of
interest.

 
(2) The site must protect information that is personal
or confidential. The parties to a consent decree or
settlement agreement may provide for the
confidentiality of the decision.

 
Sec. 3. 22 MRSA §42, sub-§7, ķI is enacted to read:

 
I.__By January 1, 2007 all hearing officers to whom the
department refers appeals to the commissioner concerning
MaineCare payment and cost report audit and review issues
must be employed and supervised by a person or agency of
State Government independent of the department and not
subject to the department's supervision or discipline.

 
Sec. 4. Rules; effective date. The Department of Health and Human
Services shall amend its rules governing reimbursement,
contracting, grants, payments, cost reports and audits with
respect to providers of health and community services to ensure
that all of the requirements of this Act are applied to all
audits completed on or after the effective date of this Act.
Unless the law requiring the department to adopt or amend these
rules indicates otherwise, rules adopted pursuant to this section
are routine technical rules as defined in the Maine Revised
Statutes, Title 5, chapter 375, subchapter 2-A.

 
SUMMARY

 
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.


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