Section 17-1739.2-20 - Cost report requirements(a) All providers shall maintain an accounting system that identifies costs in conformance with accepted accounting principles.(b) Beginning with cost reporting periods on or after January 1, 1996, participating providers shall submit the following on an annual basis no later than five months after the close of each provider's fiscal year: (2) Working trial balance;(3) Provider cost report questionnaire;(4) If the provider has its financial statement audited, then a copy of that audited financial statement;(5) Disclosure of appeal items included in the cost report; and(6) A listing of all Medicaid credit balances showing information deemed necessary by the State, and copies of provider policies and procedures to review Medicaid credit balances and refunds of overpayments to the State.(7) Such other cost reporting and financial information as the department shall request. This information may include segregation of certain costs of delivering services to acuity level C residents as opposed to acuity level A residents.(c) In subsequent years, the department may require providers to classify their costs according to the components as defined in section 17-1739.2-8 and interpretive guidelines provided by the department and submit that classification with its cost report. Final classification of costs into appropriate components shall be at the discretion of the department.(d) Claims payment for services will be suspended one hundred per cent until an acceptable cost report is received. A thirty-day maximum extension shall be granted upon written request only when a provider's operations are significantly adversely affected due to extraordinary circumstances beyond the control of the provider, as provided in Medicare guidelines.(e) Each provider shall keep financial and statistical records of the cost reporting year for at least six years after submitting the cost report form to the department and shall make such records available upon request to authorized state or federal representatives.Haw. Code R. § 17-1739.2-20
[Eff 09/01/03] (Auth: HRS § 346-59; 42 U.S.C. §1396 a(27)) (Imp: 42 C.F.R. §447.252 )