Audit Selection Priorities - (Rev. 1, 08-30-02)

310.1 - Audit Selection Priorities - (Rev. 1, 08-30-02) A1-1271.1 A. General The contractor shall use the ASCR to decide which providers to audit. This determines the audit matrix within the BPRs. It shall base audit decisions upon the results (problems discovered) of its uniform desk review, professional surveys of filed cost reports, and prior audit/review findings. B. Audit Group The audit group provides for planning audits/initiatives that must be performed either because a special circumstance requires immediate audit attention, e.g., termination, merger, fraud or abuse, new providers, or because of special CMS instructions. The audit group is defined yearly in the CMS Budget Performance Requirements (BPR guidelines). Generally, existence of a special circumstance dictates that an audit is necessary. However, the contractor shall use discretion in this area, especially where there is a short period cost report from a new provider, a relatively small amount of Medicare payment, low Medicare utilization, or involvement of OIG or GAO, prohibiting an audit.