Utah Admin. Code R986-700-730 - Audits and Investigations
(1) The
Department has the right to investigate a child care provider and audit the
provider's records.
(a) An audit or
investigation may be performed by a person or entity under contract with the
Department, a Department employee, or other person authorized by the Department
to obtain information on behalf of the Department.
(b) A provider must cooperate with an
investigation or audit to determine ongoing client eligibility or if client
eligibility was correctly determined.
(2) A client or a provider must cooperate
with any investigation or audit in a timely manner.
(a) A timely manner means ten business days
for written or electronic documentation and two business days to return a phone
call or email request.
(b)
Cooperation means timely:
(i) providing
information and verification of any record as requested by the
Department;
(ii) returning a
telephone call; and
(iii)
responding to an email request.
(c) Cooperation with an audit includes
submitting a written statement that the person chooses not to respond to an
audit finding included in a draft audit report.
(3) If a client fails to cooperate with an
investigation or audit without good cause, the case will be referred to the
public assistance overpayments unit and the client may be found liable for an
overpayment.
(4) If a provider
fails to cooperate with an investigation or audit without good cause, or fails
to keep an accurate and complete time and attendance record for three years
without good cause, CC payment may be withheld until the provider cooperates
and the Director of OCC may recommend disqualifying the provider pursuant to
Sections R986-700-733 and
R986-700-734. The provider will
also be referred to the public assistance overpayments unit and the provider
may be found liable for an overpayment.
(a)
If a provider significantly impairs or unnecessarily delays an audit or
investigation, CC payment may be withheld and the Director of OCC may recommend
disqualifying the provider pursuant to Sections
R986-700-733 and
R986-700-734.
(5) Good cause. Good cause is
limited to circumstances where the client or provider can show that the reason
for the failure to cooperate, to timely respond to a request, or to provide or
keep a record was due to circumstances beyond the client or provider's control
or were compelling and reasonable.
(6) Providing incomplete or incorrect
information will be treated as a failure to cooperate if the incorrect or
insufficient information results in an improper decision with regard to
eligibility.
(7) A provider has the
burden of proof to demonstrate the provider actually provided care to any CC
client for which it receives CC payment.
Notes
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