| (13) Reviews of exclusions and adjustments. When a
provider disputes a HHSC exclusion or adjustment of a reported expense,
the provider may request an informal review of HHSC'S disallowance.
Informal reviews are governed by requirements specified in §355.110
of this title (relating to Informal Reviews and Formal Appeals).
(14) Access to records. Each provider and each provider's
designated agents must give HHSC access to any and all records necessary
to verify information submitted to HHSC on cost reports, including
records that pertain to related-party transactions or other business
activities engaged in by the provider. If a provider does not allow
HHSC to inspect pertinent records within 30 days after HHSC sends
the provider written notice, HHSC places the provider on vendor hold
and withholds payments until the provider gives HHSC access to the
records. HHSC or its designee has the authority to cancel the provider's
contract if the provider continues to deny access.
(15) Maintaining records. Providers must ensure that
all records pertinent to services rendered under their contracts with
DFPS are accurate and sufficiently detailed to support the financial
and statistical information contained in their cost reports. Providers
must retain these records for at least three years and 90 days after
the end of the contract period.
(16) Failure to maintain adequate records. If HHSC
discovers that a provider has failed to maintain adequate records
as specified in paragraph (15) of this section, HHSC notifies the
provider of the deficiencies in the provider's recordkeeping and gives
the provider 90 days to correct them. HHSC or its designee has the
authority to cancel the provider's contract if the provider fails
to correct the deficiencies within 90 days after the date of HHSC's
notification.
(17) All cost reports must be completed in accordance
with the federal regulations and guidelines listed in order of precedence
in subparagraphs (A) and (B) of this paragraph, as applicable:
(A) The Code of Federal Regulations (CFR):
(i) 45 CFR, Part 74; and
(ii) 48 CFR, Part 31.
(B) The Office of Management and Budget Circulars:
(i) A-87 (for state and local governmental entities);
(ii) A-122 (for nonprofit and for-profit corporate
entities); and
(iii) A-110 (for all residential child care contractors).
(18) For cost reporting purposes, costs incurred under
less-than-arms-length (related-party) transactions are allowable only
up to the cost to the related party as per OMB Circulars A-87 and
A-122 and §355.102(i) of this title (relating to Related Party
Transactions).
(19) Limits on related-party administration salary
costs. To ensure that the results of HHSC's cost analyses accurately
reflect the costs that an economic and efficient provider must incur,
HHSC sets upper limits for certain wages at the 90th percentile in
the array of costs per unit of service or total annualized cost,
as appropriate for a specific cost categories, as reported by all
contracted facilities, unless otherwise specified. The specific cost
categories that are subject to the 90th percentile cap are:
(A) Related-party facility administrator/director salary,
wages, and benefits with the cap based on an array of nonrelated-party
administrator/director salaries, wages, and benefits;
(B) Related-party assistant administrator/director
salary, wages, and benefits with the cap based on an array of nonrelated-party
assistant administrator/director salaries, wages, and benefits;
(C) Related-party facility owner, partner, or stockholder
salaries, wages, and benefits (when the owner, partner, or stockholder
is not the facility administrator/director or assistant administrator/director),
with the cap based on an array of nonrelated-party administrator/director
salaries, wages, and benefits.
(20) Cost report training. It is the responsibility
of the provider to ensure that each preparer signing the Cost Report
Methodology Certification has completed the required state-sponsored
cost report training. Preparers may be employees of the provider or
persons who have been contracted by the provider for the purpose of
cost report preparation. Preparers must complete cost report training
for each program for which a cost report is submitted. Preparers must
complete cost report training every other year for the odd-year cost
report in order to receive a certificate to complete both that odd-year
cost report and the following even-year cost report. If a new preparer
wishes to complete an even-year cost report and has not completed
the previous odd-year cost report training, to receive a certificate
to complete the even-year cost report, the preparer must complete
an even-year cost report training. A copy of the most recent cost
report training certificate for each preparer of the cost report must
be submitted with each cost report. Contracted preparer's fees to
complete state-sponsored cost report training are allowable.
(A) New preparers. Preparers who have not previously
completed the required state-sponsored cost report training and received
a completion certificate must attend state-sponsored classroom-based
cost report training for each contracted program for which a cost
report is to be submitted.
(B) If a provider fails to file a completed cost report
signed by preparers who have completed the required cost report training,
HHSC has the authority to institute a vendor hold and withhold payments
from the provider until the provider submits an acceptable cost report.
A provider's failure to submit a cost report after HHSC has placed
the provider on vendor hold may result in nonrenewal or cancellation
of the provider's contract with DFPS.
|
| Source Note: The provisions of this §700.1751 adopted to be effective July 31, 1991, 16 TexReg 3944; transferred effective September 1, 1992, as published in the Texas Register September 11, 1992, 17 TexReg 6279; amended to be effective January 1, 1994, 18 TexReg 8975; transferred effective September 1, 2004, as published in the Texas Register September 17, 2004, 29 TexReg 9014; amended to be effective January 1, 2008, 32 TexReg 9938; amended to be effective August 31, 2010, 35 TexReg 7726; transferred effective November 15, 2017, as published in theTexas Register November 3, 2017, 42 TexReg 6201 |
