Page 2995

(2) $10,000 or greater but less than $30,000 is not required to submit the report to the department but must have the report available for review by the department;

(3) less than $10,000 is not required to produce a report but shall have an attestation form on file and available for review by the department. (f) The reimbursement values referenced in (e) of this section are based upon the reimbursement values reported in each United States Internal Revenue Service form 1099 that the department issues to the provider by calendar year. (g) The report or attestation required under this section must be made in writing on a form approved by the department and submitted, if required, to the Department of Health, Office of the Commissioner, Medicaid Program Integrity. The report must include

(1) the method used to sample the claims;

(2) the sampled claims Medicaid assigned transaction control number (TCN);

(3) the outcome of the individual claim audit;

(4) the identified amount of overpayment back to the department; and

(5) if appropriate, a corrective action plan. (h) A provider shall retain all audit documents, reports, and attestations created as a result of the review for at least seven calendar years following completion. (i) Not later than 60 days after identification of the overpayment, the provider shall repay the department unless the provider has a repayment agreement with the department. The department may, in the repayment agreement, authorize repayment through one of the following means:

(1) a lump sum payable not later than two months after the date of the discovery of the overpayment;

(2) a payment plan not to exceed two years in length; the department may extend the payment plan beyond two years based on the following factors:

(A) the provider’s history of compliance with the Medicaid program generally, including prior payment agreements;

(B) the amount of the overpayment;

(D) any other factors that would impact repayment, such as type of services being provided;

(3) by offsetting future billings by the provider; if a provider chooses to offset future billings, the amount offset must be repaid not later than two years from the date of the agreement.

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Page 2995

Official source

(2) $10,000 or greater but less than $30,000 is not required to submit the report to the department but must have the report available for review by the department;

(1) the method used to sample the claims;

(2) the sampled claims Medicaid assigned transaction control number (TCN);

(3) the outcome of the individual claim audit;

(4) the identified amount of overpayment back to the department; and

(1) a lump sum payable not later than two months after the date of the discovery of the overpayment;

(2) a payment plan not to exceed two years in length; the department may extend the payment plan beyond two years based on the following factors:

(A) the provider’s history of compliance with the Medicaid program generally, including prior payment agreements;

(B) the amount of the overpayment;

(D) any other factors that would impact repayment, such as type of services being provided;

(3) by offsetting future billings by the provider; if a provider chooses to offset future billings, the amount offset must be repaid not later than two years from the date of the agreement.