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Florida Administrative Code (Last Updated: April 18, 2024) |
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59. Agency for Health Care Administration |
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59G. Medicaid |
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59G-8. Managed Care |
1(1) Pursuant to Section 5409.967(3)(b), 6Florida Statutes (F.S.), the Agency for Health Care Administration (hereafter referred to as Agency) shall contract with independent certified public accountants to conduct compliance audits of Florida Medicaid prepaid health plans.
37(a) Certified public accountants that participate in the preparation of a plan’s financial audits or annual statements submitted by the plan pursuant to Sections 61409.967(3)(a)1. 62and 2., F.S., will be deemed to have a conflict of interest and are not independent regarding preparation of a compliance audit for that plan pursuant to Section 90409.967(3)(c)1., F.S.
92(b) The Agency will procure, pursuant to Chapter 287, F.S., services from Florida licensed certified public accountants to perform compliance audits required by Section 116409.967(3)(b), F.S. 118Rates established for the services utilized for compliance audits will be established through the procurement process and will be comparable to market rates the Agency pays for similar accounting and auditing services.
150(c) A Florida Medicaid prepaid health plan audited pursuant to Section 161409.967(3)(b), F.S., 163must pay the Agency costs, charges, and expenses for the compliance audit at the rates established by the Agency pursuant to the procurement process. The rates established by the Agency for compliance audits will include:
1981. Travel reimbursement.
2012. Compensation of professional and support services.
2083. The Agency’s administrative costs directly related to the audit.
218(2) The Agency will prepare and provide each Florida Medicaid prepaid health plan audited a detailed statement of the costs, charges, and expenses for the audit. A plan must pay the Agency the costs, charges, and expenses identified in the detailed statement within 15 days of the Agency’s presentation of the statement to the plan.
273Rulemaking Authority 275409.961, 276409.967 FS. 278Law Implemented 280409.967 281FS. History283‒284New 5-1-14.
