[Code of Federal Regulations]

[Title 42, Volume 4]

[Revised as of October 1, 2006]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR430.33]



[Page 11]

 

                         TITLE 42--PUBLIC HEALTH

 

  CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF 

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 430_GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS--Table of 

 

Subpart C_Grants; Reviews and Audits; Withholding for Failure To Comply; 

   Deferral and Disallowance of Claims; Reduction of Federal Medicaid 

                                Payments

 

Sec.  430.33  Audits.



    (a) Purpose. The Department's Office of Inspector General (OIG) 

periodically audits State operations in order to determine whether--

    (1) The program is being operated in a cost-efficient manner; and

    (2) Funds are being properly expended for the purposes for which 

they were appropriated under Federal and State law and regulations.

    (b) Reports. (1) The OIG releases audit reports simultaneously to 

State officials and the Department's program officials.

    (2) The reports set forth OIG opinion and recommendations regarding 

the practices it reviewed, and the allowability of the costs it audited.

    (3) Cognizant officials of the Department make final determinations 

on all audit findings.

    (c) Action on audit exceptions--(1) Concurrence or clearance. The 

State agency has the opportunity of concurring in the exceptions or 

submitting additional facts that support clearance of the exceptions.

    (2) Appeal. Any exceptions that are not disposed of under paragraph 

(c)(1) of this section are included in a disallowance letter that 

constitutes the Department's final decision unless the State requests 

reconsideration by the Appeals Board. (Specific rules are set forth in 

Sec.  430.42.)

    (3) Adjustment. If the decision by the Board requires an adjustment 

of FFP, either upward or downward, a subsequent grant award promptly 

reflects the amount of increase or decrease.



[53 FR 36571, Sept. 21, 1988, as amended at 56 FR 8846, Mar. 1, 1991]