Iowa Admin. Code r. 441-151.6 - District program reviews and audits
Each chief
(1)
Schedule. The department shall notify each chief juvenile
court officer or designee of the providers for which a review and audit must be
conducted. The department shall identify in the notice all other judicial
districts that have a contract with the provider .
a. Annual on-site reviews and audits are
required for any provider having one or more contracts with one or more
judicial districts when the total annual value of the contracts is $100,000 or
more.
b. An on-site review and
audit are required for each provider new to the district during the first year
of the provider 's contract with the district when the total annual value of the
provider 's contracts with the judicial district is $50,000 or more.
c. Additional on-site reviews and audits are
optional but may be considered appropriate by the chief juvenile court officer
for providers, other than those described in paragraphs"a"
and"b, " based on factors such as:
(1) Length of time provider has been in
business.
(2) Amount of time
provider has offered the services being purchased.
(3) Type of service or program being
purchased.
(4) Amount of money
involved in the contract.
(5)
Whether other governmental entities contract with this provider .
(6) Findings from previous audits by the
district, the department , or other entities such as the state auditor's
office.
(2)
Location. The reviews and audits shall take place at the sites
where the program is operated and where necessary program and fiscal records
are maintained.
(3)
Scope. The contract administrator accountant shall review and
audit the provider 's service and financial records, including the client case
records and case files, to ensure that the records contain the required
documentation of the provision of the contracted service for each individual
child for whom a claim is made. The reviews and audits shall include:
a. Contact with the client.
b. Review and audit of service billings and
delivery of service.
c. Review and
audit of provider standards, staff qualifications, case files and case records,
progress reports, and billing and payment records.
(4)
Repayment. The chief
juvenile court officer may seek repayment of claims paid for noncovered
services or for services for which documentation is not established.
a. The chief juvenile court officer shall
notify the provider in writing that a repayment is due. The written notice
shall identify:
(1) The claims;
(2) The amounts of the claims that are not
documented or substantiated; and
(3) The amount of the repayment
requested.
b. The
provider shall repay the department the difference between the amount received
and the amount established through the audit, not to exceed the amount paid by
the state, when:
(1) The provider , upon
audit, fails to verify or document the provision of covered services or costs
in the amount for which a claim was paid or when the audit confirms claims paid
for noncovered services; and
(2)
Juvenile court services or the department makes a request for
repayment.
c. The
provider shall repay the department for the amount of any claims not supported
by audit when:
(1) The provider fails to
maintain adequate records for auditing purposes or fails to make records
available for audit or when the records, upon audit, fail to support the claims
submitted; and
(2) Juvenile court
services or the department makes a request for repayment.
d. A provider that is adversely affected by
the request for repayment may appeal using procedures established in
441-Chapter 7.
e. If the provider
does not make payment within 60 days, the chief juvenile court officer shall
submit to the department a copy of the notice to the provider for the
department 's review and further action if necessary.
(5)
Report. Each contract
administrator accountant shall submit to the department an annual report of the
district's review and audit activities for each state fiscal year.
a. The annual report shall be submitted by
December 31 following the end of the state fiscal year. This date may be
extended upon the written request of the chief juvenile court officer to the
department .
b. The annual report
shall include a report of the results of the review and audit for each required
audit as well as a summary of the findings of the reviews and audits conducted
on any other providers receiving state or federal funds in the state fiscal
year.
Notes
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