Section 51021 - Exit Conference and Audit Report(a) The provider shall be afforded a reasonable opportunity to participate in an exit conference after the conclusion of any field audit or examination of records or reports of a provider, by or on behalf of the Department, and prior to the issuance of the Audit Report. The purpose of the exit conference is to: (1) Inform the provider of the audit or examination findings and the supporting reasons and evidence.(2) Inform the provider of the specific instances in which no records were found to substantiate claims billed to the program which was the subject of the audit or examination.(3) Allow the provider an opportunity to present relevant information concerning the audit or examination findings.(b) The provider must make available to the Department any records which were identified as unavailable for review or missing within 15 calendar days of the exit conference to be included in the Audit Report.(c) Where the audit or examination involves the records or reports of a provider of pharmaceutical services: (1) The auditor or reviewer shall identify missing prescriptions by beneficiary name, beneficiary number, prescription number and date of service to the provider at the exit conference.(2) The audit worksheets relating to exceptions taken shall be furnished to the provider subsequent to the submission of missing prescriptions pursuant to subsection (b), in the event that a request for repayment of an overpayment is made.(d) An audit or examination findings issued by or on behalf of the Department shall include the following: (1) A complete copy of the audit report which identifies all items to which exception has been taken, the monetary value of each and the reason for the exception, including citation to the appropriate statutory or regulatory authority.(2) Notice of the provider's right to a hearing pursuant to the provisions of this article. A copy of the provisions of this article shall accompany such notice.Cal. Code Regs. Tit. 22, § 51021
1. Editorial correction of NOTE filed 12-14-84 (Register 84, No. 50). Note: Authority cited: Sections 14105 and 14124.5, Welfare and Institutions Code. Reference: Sections 14170 and 14171, Welfare and Institutions Code.
1. Editorial correction of NOTE filed 12-14-84 (Register 84, No. 50).