Purpose of Field and In-House Audits

30.2 – Purpose of Field and In-House Audits (Rev. 107, Issued: 09-22-06; Effective: 10-01-06; Implementation: 10-02-06) Medicare in-house and field audits are conducted in order to: (1) provide reasonable assurance that program payments are based on Medicare reimbursement principles, and (2) develop other information that CMS needs to fulfill its responsibilities. In carrying out your audit responsibilities, your primary goal is to arrive at a correct settlement of the cost report. In so doing, preserve the provider’s interest and rights but at the same time apply program policies to specific situations to assure compliance with these policies. Your authority does not extend to determining whether program policies and procedures are appropriate or should be applied in a given circumstance. Rather, your responsibility is to enforce such policies and procedures. Take corrective action where noncompliance exists.