(1)   A provider must meet the record keeping and other requirements of ARM 37.85.414 in addition to the requirements of this rule.

(2)   A provider must make and maintain adequate financial and statistical records in accordance with generally accepted accounting principles, as defined by the American institute of certified public accountants. The provider's records must be sufficient to allow the department and its agents to determine payment for the RHC or FQHC services provided to medicaid recipients and to provide a record that may be audited using generally accepted auditing standards. Such records must be maintained for a period of six years, three months after a cost report is filed with respect to the period covered by such records or until such cost report is finally settled, whichever is later.

(3)   The records described in (2) must be available at the provider facility at all reasonable times and shall be subject to inspection, review and audit by the department or its agents, the United States department of health and human services, the general accounting office, the Montana legislative auditor, and other governmental agencies as authorized by law.

(4)   Upon failure or refusal of the provider to make available and allow access to such records, or to report an increase or decrease in scope of services, the department may recover in full all payments made to the provider during the reporting period to which such records relate and may suspend any further payments to the provider until such time as the provider fully complies with this rule.

(5)   No later than 30 days prior to the beginning of its initial reporting period as a new provider or following a change in ownership, a provider must submit to the department or its agent an estimate of budgeted costs and visits for RHC or FQHC services for the reporting period in the form and detail required by the department and such other information as the department may require to establish a rate as provided at ARM 37.86.4413.

History: Sec. 53-6-113, MCA; IMP, Sec. 53-2-201, 53-6-101, 53-6-111 and 53-6-113, MCA; NEW, 1998 MAR p. 2045, Eff. 7/31/98; TRANS, from SRS, 2000 MAR p. 481; AMD, 2001 MAR p. 2043, Eff. 10/12/01; AMD, 2005 MAR p. 975, Eff. 6/17/05.