Establishing a Common Provider Audit Program. - (Rev. 1, 08-30-

490 - Establishing a Common Provider Audit Program. - (Rev. 1, 08-30- 02) A1-1603 The following material (sections 490 through 500) applies to providers on prospective payment or cost reimbursement. Title XVIII of the Social Security Act requires that participating health care institutions (providers) be reimbursed on a reasonable cost basis and to achieve this a comprehensive provider audit program has been established. Some grant-in-aid programs, namely title V (the maternal child health services and crippled children's programs) and title XIX (Medicaid), also require that hospitals and possibly some other providers be reimbursed on a reasonable cost basis. Other third party payers may also have the same requirement. The common provider audit program is established to reduce the cost of provider auditing to participating third party payers and avoid duplicate auditing effort. The purpose then is to have one audit of a participating provider, which will serve the needs of all participating programs reimbursing the provider for services rendered.