N.Y. Comp. Codes R. & Regs. Tit. 10 § 86-4.6 - Audits
(a) All fiscal and
statistical records and reports shall be subject to audit, which must commence
no later than six years from the date of filing or the date when due, whichever
is later. There shall be no limitation in situations involving possible fraud
or where the facility or its agent prevents the Department of Health or the
Department of Social Services from performing an audit. Notification by either
department to the facility of the department's intent to audit shall toll the
six-year period.
(b) All underlying
books, records and documentation which form the basis for fiscal and
statistical reports filed by the facility with the department, shall be kept
and maintained by the facility for not less than six years from the date of
filing or the date upon which the fiscal and statistical records were to be
filed, whichever date is later. Any rate of payment certified or approved by
the commissioner prior to audit shall represent a provisional rate until an
audit is performed and completed, at which time such rate or adjusted rate
shall represent the audit rate.
(c)
Rate revisions resulting from audits shall be retroactive to the audited rate
period or periods. Any resulting overpayments or underpayments shall be
corrected by retroactive adjustment of the provisional rate paid, based upon
the period audited.
(d) The
commissioner may promulgate rate revisions based upon audits completed by the
department or other State agencies. Unless otherwise indicated, such audits
shall not be considered final and shall not preclude conduct of a complete
audit by the Department of Health, Department of Social Services or their
agents.
Notes
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