Section .0100 ‑ Audit Review Process

Link to law: http://reports.oah.state.nc.us/ncac/title 10a - health and human services/chapter 22 - medical assistance eligibility/subchapter i/subchapter i rules.html
Published: 2015

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SUBCHAPTER 22I ‑ TITLE XIX REIMBURSEMENT AND

administrative REVIEW PROCESS

 

SECTION .0100 ‑ AUDIT REVIEW PROCESS

 

10A NCAC 22I .0101         AUDIT TO BE CONDUCTED

An audit of a provider may be conducted by the Division of

Medical Assistance, or by an auditing firm subcontracted by them.

 

History Note:        Authority G.S. 108A‑25(b);

Eff. September 24, 1980;

Amended Eff. May 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without

substantive public interest Eff. August 22, 2015.

10A NCAC 22I .0102         EXIT CONFERENCE

At the conclusion of the audit, the provider may request an

exit conference which shall be held by personnel of the unit conducting the

audit, to discuss the audit findings with the provider.

 

History Note:        Authority G.S. 108A‑25(b);

Eff. September 24, 1980.

 

10A NCAC 22I .0103         NOTICE OF PROGRAM REIMBURSEMENT

Based on the audit findings the Division of Medical

Assistance will issue to the provider a Notice of Program Reimbursement which

shall state the amount of reimbursement, if any, payable to the Division of

Medical Assistance or payable to the provider.

 

History Note:        Authority G.S. 108A‑25(b);

Eff. September 24, 1980;

Amended Eff. January 1, 1988;

Pursuant to G.S. 150B-21.3A, rule is necessary without

substantive public interest Eff. August 22, 2015.

 

10A NCAC 22I .0104         RECONSIDERATION REVIEW

Following receipt of the Notice of Program Reimbursement, a

provider may file a request for a reconsideration review with the Division of

Medical Assistance, in accordance with 10A NCAC 22J.

 

History Note:        Authority G.S. 108A‑25(b);

Eff. September 24, 1980;

Amended Eff. January 1, 1988.