Specifications include, but are not limited to: The Centers for Medicare and Medicaid Services (“CMS”) requires the state operating agency of the 1915(c) Home and Community-Based Services Waiver (“Waiver Service”) to conduct fiscal audits on all Waiver Service providers annually to strengthen the fiscal integrity and financial accountability of the Medicaid program. Financial accountability is one (1) of the six(6) mandatory Waiver assurances that the State must demonstrate compliance with. This is achieved through an annual fiscal audit of post payment reviews. The fiscal audit of post payment reviews is conducted to ensure that the services are authorized; approved services are rendered as identified on the individual’s person-centered service plan; and claims are coded correctly and billed appropriately. The State is required to conduct the annual fiscal audit on all Waiver Service providers and report annually to CMS to ensure that services are rendered, and claims are coded correctly and billed appropriately.
