New York Codes, Rules and Regulations
Title 14 - DEPARTMENT OF MENTAL HYGIENE
Chapter XIII - Office of Mental Health
Part 578 - Medical Assistance Rates Of Payment For Residential Treatment Facilities For Children And Youth
Section 578.6 - Audits

Universal Citation: 14 NY Comp Codes Rules and Regs ยง 578.6

Current through Register Vol. 46, No. 39, September 25, 2024

(a) Each residential treatment facility shall maintain the statistical and financial records which formed the basis of the reports submitted to the commissioner for six years from the date on which the reports were submitted to the commissioner, or for such longer period as may be required under Federal law.

(b) All such records shall be subject to audit for a period of six years from the later of the date on which all required reports were filed with the commissioner or the date on which such reports were due.

(c) The commissioner may enter into agreements with the Department of Social Services or other organizations or agencies having audit responsibilities to audit the financial and statistical records of any residential treatment facility. The conduct of such audits by the Department of Social Services shall be done in accordance with procedures as set forth in applicable regulations of the Department of Social Services. Audits of Medicaid by the Office of Mental Health shall also be conducted in accordance with procedures as set forth in applicable Department of Social Services regulations or as set forth in agreement(s) between the Office of Mental Health and the Department of Social Services. All other audits shall be done in accordance with this Part.

(d) Audits which are conducted by the Office of Mental Health, or its designee, shall be conducted in accordance with Part 552 of this Title and the following procedures:

(1) In addition to the draft audit report issued in accordance with section 552.6(a) of this Title a notice of the proposed rate revision shall be sent to the residential treatment facility.

(2) In addition to the provider's response to the final audit report required in section 552.7(e) of this Title, proposed rate revisions resulting from the implementation of audit findings shall be final unless within 45 days of receipt of the proposed rate revision, the residential treatment facility requests a hearing on factual issues. Requests for hearings, and the conduct of such hearings, shall be pursuant to Part 503 of this Title.

(3) Revisions to rates determined in accordance with the provisions of this paragraph shall be retroactive to the rate year covered by the audit. Any resulting overpayment shall be satisfied by either retroactive adjustments of the provisional rate paid, based on the period audited, or prospective adjustment of the current certified rate at the discretion of the commissioner.

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