The procurement of an experienced auditor and consultant with experience in the health care industry to conduct a multitude of various types of audits, cost reports, payments, rate settings, reconciliations, supplemental payment calculations, consultations, and assistance in evaluating new reimbursement methodologies for the state of New Mexico. Also, to make recommendationsrelated to rules and policies, that improve the delivery of services and yield more robust programs and proactively identify opportunities to align and maximize project resources. The auditor must maintain accurate bookkeeping of cost settlements, compliance with all federal and state laws and rules, careful administration, and reviews of the Disproportionate Share Hospital (DSH), Safety Net Care Pool (SNCP) projects, Upper Payment Limits (UPL), and Health Care Quality Surcharge (HCQS). The audit agent will perform audits and rate settings for providers participating in the New Mexico Medicaid Program, including but not limited to, Home Health Agencies, Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), Long Term Care Facilities (LTCs), Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IIDs), Crisis Triage Centers (CTC), Adult Accredited Rehabilitation Centers (AARTCs), Emergency Ground Ambulance Service Provider for the Ambulance Supplemental Payment Program (ASPP), and Health Care Delivery and Access Act (HDAA).
