Medicare Financial Management Manual (Pub. 100-06), Ch. 8 § 80.2

Independence

Last amended: 2003Year: 2003Length: 338 wordsOfficial source
80.2 – Independence (Rev. 27, 12-19-03) The second general standard for government auditing is: "In all matters relating to the audit work, the audit organization and the individual auditors, whether government or public, should be free from personal and external impairments to independence, should be organizationally independent, and should maintain an independent attitude and appearance." Maintain independence so that opinions, conclusions, judgments, and recommendations are impartial and viewed as impartial by knowledgeable third parties. Consider the three general classes of impairments to independence: • Personal – There are circumstances in which auditors are not impartial or are not perceived to be impartial. • External – Factors external to the contractor may restrict the audit or interfere with an auditor's ability to form independent and objective opinions and conclusions. • Organizational – A government auditors' independence is affected by their place within the structure of the government entity to which they are assigned and also by whether they are auditing internally or auditing other entities. Since the contractor audits outside the government entity to which it is assigned (i.e., CMS is not related to the providers being audited), this is generally not a concern for a Medicare audit, unless you are an insurance company that in its private line of business makes payment for health care benefits to providers of service that are related to or are based on Medicare payment formulas or payment methods. Establish policies and procedures to provide reasonable assurance that all Medicare audit and payment professional staff maintains their independence so as not to impair, or appear to impair, your independence in carrying out its Medicare audit responsibilities. See Exhibit IX in §170 of this chapter for a sample of the Personal Impairment Statement to be completed by each individual involved in the desk review, field audit, and settlement activities to ensure that he/she is free of personal impairments. This statement can be completed by each individual on an annual basis and be updated during the year if circumstances that need to be disclosed arise.
Medicare Financial Management Manual (Pub. 100-06), Ch. 8 § 80.2: Independence | Justis AI