Cost Sharing - (Rev. 1, 08-30-02)

490.2 - Cost Sharing - (Rev. 1, 08-30-02) A1-1603.2 The costs incurred in auditing providers performing services for more than one of the above programs are to be shared on the basis of the amount of reimbursement (benefits paid) to individual providers by the respective programs. Any proposed modification to this method of sharing costs of audit will be evaluated on the basis of its merits. Alternative methods proposed should adhere to the basic principle that audit dollars are expended to protect the integrity of benefits paid. Costs to be shared include all costs incurred from the point of securing the cost report from the provider through the publishing and distribution of the audit findings (or cost settlement data where no audit is performed). If final settlement is included in the common audit program, these costs should also be shared. There have been some questions concerning the definition of reimbursement (benefits paid). Reimbursement by the program means the dollar amounts of payments made from program funds at final settlement and should include payments to providers for inpatient and outpatient services and, if applicable, combined physician billing.