California Code of Regulations
Title 22 - Social Security
Division 2 - Department of Social Services-Department of Health Services
Part 2 - Health and Welfare Agency-Department of Health Services Regulations
Subdivision 2 - Administration
Chapter 2.1 - DEPARTMENT OF HEALTH SERVICES AUDITS AND APPEALS
Section 20201 - Definitions
Current through Register 2024 Notice Reg. No. 38, September 20, 2024
The following definitions shall be used throughout this article unless otherwise noted:
(a) Audit or Examination. "Audit or examination" means a systematic review or examination by or on behalf of the Department of a contractor's records or reports maintained or developed pursuant to a contract with the Department.
(b) Audit or Examination Notice. "Audit or examination notice" means a written notice of the Department's final actions upon the audit or examination of a contractor and which is formally issued to a contractor.
(c) Contract. "Contract" means any agreement, whereby a person or entity promises to do or not to do a particular act.
(d) Contractor. "Contractor" means a person or entity who has entered into a contract with the Department.
(e) Direct Service Contract. "Direct service contract" means a contract, wherein the contractor agrees to provide services directly to the public or to persons who are eligible for programs administered or supported by the Department. "Direct service contract" does not include contracts entered into pursuant to Chapter 7 (commencing with Section 14000) or Chapter 8 (commencing with Section 14200) of Part 3 of Division 9 of the Welfare and Institutions Code, or with governmental agencies, units of government, regional centers, or area agencies on aging.
(f) Probability Sampling. "Probability sampling" means a standard statistical methodology by which a sample is selected based on the theory of probability (a mathematical theory used to study the occurrence of random events).
(g) Qualified Underpayment. "Qualified underpayment" means any payment by the Department for a service billed under a direct service contract for less than the amount authorized under the contract, and where the bill for that service is part of the sample identified by the Department for audit.
(h) Statistical Extrapolation. "Statistical extrapolation" means the methodology whereby an unknown value can be estimated by projecting the results of a probability sample to the universe from which the sample was drawn with a calculated precision (margin of error).
1. New section filed 5-31-89; operative 6-30-89 (Register 89, No. 23).
Note: Authority cited: Sections 208 and 38036, Health and Safety Code. Reference: Sections 38011, 38020, 38030, and 38041, Health and Safety Code; Sections 11180 and 11181, Government Code; and Stipulated Judgment in Planned Parenthood v. Department of Health Services, Sacramento Superior Court, No. 328490.
