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9510.1130 RECORDS, REPORTS, AUDITS, AND REPAYMENT.

Subpart 1.

Records.

The provider shall maintain complete program and fiscal records and supporting documentation identifying the services and costs provided under the special needs rate exception. The costs must be maintained in well-organized files and identified in accounts separate from other facility or program costs. Costs authorized and approved under these parts do not become part of a provider's historic cost base for the purpose of setting rates under parts 9553.0010 to 9553.0080 or Minnesota Statutes, section 252.46. The provider's records shall be kept for five years and be subject to the maintenance schedule, audit availability requirements, and other provisions of parts 9505.2160 to 9505.2245.

Subp. 2.

Reports.

The county shall submit items A and B to the commissioner.

A.

A quarterly program and fiscal review of the overall effectiveness of the services to be provided under the special needs allowance unless the commissioner determines that a different schedule of reviews is needed to evaluate the success of the program or redetermine the special needs rate exception payment. The review must be submitted no more than 30 days after the end of each quarter in which a special needs rate exception is in place and must include:

(1)

the provider's compliance with the application;

(2)

the client's progress in attaining the measurable behavioral outcomes in the individual program plan for which the special needs rate exception was requested;

(3)

the county and provider's plans to reduce reliance on the special needs rate exception; and

(4)

changes implemented in the type, frequency, or intensity of the staff intervention approved under parts 9510.1080 and 9510.1090.

B.

A final report submitted within 90 days of termination of a special needs rate exception which documents the following:

(1)

the extent to which the program goals identified in the special needs rate exception application were accomplished;

(2)

the total amount of money paid to the provider through the special needs rate exception payment for equipment and actual costs and types of equipment purchased;

(3)

the amount of expenditures incurred by the provider for costs allowable under part 9510.1090, subpart 2; and

(4)

the total amount of unexpended funds determined by subtracting subitem (3) from subitem (2).

Subp. 3.

Audits.

The commissioner may conduct program and fiscal audits of any provider receiving a special needs rate exception to identify any overpayments made to the provider and ensure compliance with parts 9510.1020 to 9510.1140.

Subp. 4.

Repayment.

Any overpayments to the provider included in the special needs rate exception payment must be paid back to the medical assistance program within 60 days of the date the provider receives the notice of overpayment from the county or the commissioner. No retroactive payment must be made if the provider's costs exceed the special needs rate exception payment.

Statutory Authority:

MS s 252.46; 256B.501

History:

10 SR 922; 14 SR 2354

Published Electronically:

October 8, 2007