Home Care Cost Report Audit Process Outlined 

Situation Report | December 7, 2020

In its first Home Care Cost Report Outreach Session since the Report was due (November 2), the state Department of Health (DOH) last week outlined the audit process and stated that it is still accepting cost reports. 

Audits

The state’s contractor, KPMG, intends to conduct audits of the Home Care Cost Report from now until February 2021.

DOH has selected the agencies that are subject to audit for the 2019 cost report year. Those agencies will be receiving an Agency Notification Package that includes:

  • An audit timeline and process
  • Key phases of the audit
  • Data collection related protocols
  • Communications
  • Next steps and action items
  • Documentation request details
  • Agency representation details

In last week’s meeting, KPMG reviewed the audit phases (kickoff, fieldwork, and closeout) and associated activities by agencies; how to respond to audit inquiries, including requests for documentation; the process for submitting questions; and potential audit findings.

DOH reminded agencies that all supporting documentation that was used to complete the Home Care Cost Report should have been uploaded to the Secure File Transfer Protocol (SFTP) site.

Throughout the audit process, KPMG audit teams will follow-up with clarification inquiries or requests for further information that must be acted upon within three business days (extensions can be requested). All additional supporting documentation should be uploaded via the SFTP Site.

Late Cost Reports

Though the Cost Report was due November 2, those who have not submitted them can still do so.  Such submissions will be labeled “tardy” but DOH says the agency will not be penalized.

During the Question and Answer part of the meeting, DOH said that Medicaid fee-for-service rates (determined by the Cost Report) will be calculated after the audits are completed.