Ch. 16, § 4. Audits

(a) The Department shall be responsible for the detection of suspected fraud, waste, or abuse of services. (b) The Department shall have the ability to conduct audits of providers or clients. (c) The Department may audit a provider or client at any time, with or without prior notice. (d) The Department may perform audits through employees, agents, or through a third party. Audits shall be performed in accordance with Generally Accepted Auditing Standards (GAAS). (e) If at any time during an audit the Department discovers evidence of an overpayment, that evidence may be referred to the MFCU or the DFS Eligibility Integrity Unit. (f) Provider self-audit. (i) A provider may conduct a self-audit at any time. The Department may review or audit the provider's self-audit. (ii) The Department may require a provider to conduct a self-audit at any time. (iii) The provider shall notify the Department within sixty (60) business days of the completion of the self-audit. (g) The Department may require the development of corrective action plans to remediate identified deficiencies.