§ 100555 Health Program Audit Coordination

• •Audits must cover all health programs in a contract, not just the one originally targeted.
• •The agency can only add programs it is already allowed to audit.
• •The rule is meant to lower administrative costs by combining audits.

A state health agency is auditing a clinic’s Medicaid services because the clinic has a contract for Medicaid. The contract also covers the clinic’s Medicare services, and the agency can audit Medicare too.

The agency must add Medicare to the audit so it checks both programs at once, saving time and money.