12213675, 59G-8.800 - Florida Administrative Rules, Law, Code, Register

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Notice: 12213675

Notice of Development of Rulemaking

Department:

AGENCY FOR HEALTH CARE ADMINISTRATION

Division:

Medicaid

Chapter:

MANAGED CARE

Overview

RULE:

59G-8.800

Financial Compliance Audits of Medicaid Prepaid Plans

PURPOSE:

The purpose of the rule is to implement the provisions found in s. 409.967(3)(c), F.S., regarding the achieved saving rebates.  Statutory mandate requires any audit required under s.409.967(3), F.S., to be conducted by an independent certified public accountant who meets criteria specified by rule. The rule must also provide that: 
1.	The entity selected by the agency to conduct the audit may not have a conflict of interest that might affect its ability to perform its responsibilities with respect to an examination.
2.	The rates charged to the prepaid plan being audited are consistent with rates charged by other certified public accountants and are comparable with the rates charged for comparable examinations.
3.	Each prepaid plan audited shall pay to the agency the expenses of the audit at the rates established by the agency by rule. Such expenses include actual travel expenses, reasonable living expense allowances, compensation of the certified public accountant, and necessary attendant administrative costs of the agency directly related to the examination. Travel expense and living expense allowances are limited to those expenses incurred on account of the audit and must be paid by the examined prepaid plan together with compensation upon presentation by the agency to the prepaid plan of a detailed account of the charges and expenses after a detailed statement has been filed by the auditor and approved by the agency.
4.	All moneys collected from prepaid plans for such audits shall be deposited into the Grants and Donations Trust Fund, and the agency may make deposits into such fund from moneys appropriated for the operation of the agency.

SUBJECT:

Financial compliance audits of Medicaid prepaid plans

RULEMAKING AUTHORITY:

409.919, FS

LAW:

409.967, FS

PRINT PUBLISH DATE:

10/30/2012 Vol. 38/61

RELATED STATUTES
AND LAWS:

409.919, FS, 409.967, FS

OVERSIGHT COMMITTEE:

Joint Administrative Procedures Committee
Florida Administrative Law Central Online Network (F.A.L.C.O.N.)

RELATED COURT CASES:

Division of Administrative Hearings

FEDERAL eRULEMAKING
WEB PORTAL:

Regulations.gov

HOW TO LINK TO
THIS NOTICE:

http://flrules.org/gateway/ruleno.asp?id=59G-8.800&PDate=10/30/2012&Section=1

REFERENCE MATERIALS:

No reference(s).

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