| (ii) an auditor determines that reported costs are
not verifiable.
(4) Allowable and unallowable costs. Providers must
follow the guidelines specified in §355.102 and §355.103
of this title (relating to General Principles of Allowable and Unallowable
Costs and Specifications for Allowable and Unallowable Costs) in determining
whether a cost is allowable or unallowable. In addition, providers
must adhere to the following principles:
(A) Client room and board expenses are not allowable,
except for those related to respite care.
(B) The actual cost of adaptive aids, medical supplies,
dental services, and minor home modifications is not allowable for
cost-reporting purposes. Allowable labor costs associated with acquiring
adaptive aids, medical supplies, dental services, and home modifications
should be reported in the cost report. Any item purchased for participants
in this program and reimbursed through a voucher payment system is
unallowable. Refer to §355.103(b)(20)(K) of this title.
(g) Reporting revenue. Revenues must be reported on
the cost report in accordance with §355.104 of this title (relating
to Revenues).
(h) Reviews and field audits of cost reports. Desk
reviews or field audits are performed on cost reports for all contracted
providers. The frequency and nature of field audits are determined
by HHSC staff to ensure the fiscal integrity of the program. Desk
reviews and field audits will be conducted in accordance with §355.106
of this title (relating to Basic Objectives and Criteria for Audit
and Desk Review of Cost Reports), and providers will be notified of
the results of a desk review or a field audit in accordance with §355.107
of this title (relating to Notification of Exclusions and Adjustments).
Providers may request an informal review and, if necessary, an administrative
hearing to dispute an action taken under §355.110 of this title
(relating to Informal Reviews and Formal Appeals).
|
| Source Note: The provisions of this §355.513 adopted to be effective September 1, 2009, 34 TexReg 5654; amended to be effective December 13, 2010, 35 TexReg 10944; amended to be effective June 20, 2011, 36 TexReg 3707; amended to be effective November 25, 2012, 37 TexReg 9086; amended to be effective January 1, 2015, 39 TexReg 9193; amended to be effective September 1, 2023, 48 TexReg 4631 |
