Virginia Regulatory Town Hall
Agency
Department of Medical Assistance Services
 
Board
Board of Medical Assistance Services
 
Previous Comment     Next Comment     Back to List of Comments
11/5/17  11:33 am
Commenter: Jennifer G Fidura, VNPP, Inc.

Final Draft of Medicaid Appeals workgroup Report
 

The report, in general, summarizes the discussion and consensus of the workgroup.  I would make the following request for clarification of the "plan" for the issue "Provider participation in the audit process:"

  • The first sentence references the auditors conducting an exit conference, this implies that the conference is conducted upon the end of their on-site work.
  • The final sentence states that DMAS "follows-up" with an exit conference 30 days after the provider's receipt of the preliminary findings letter and their opportunity to provide additional documentation.  Is that conference conducted face-to-face?  Is it by the same "auditors" who conducted the original review and produced the preliminary letter?  Is it done prior to and to inform the final letter or is it simply a narration of the final letter.

The text, as written, is not clear and a frequent observation by providers reflects their frustration that even though additional documentation was provided in response to the preliminary findings, it is not acknowledged in the final letter.

DMAS staff are to be commended for their willingness to continue the dialogue.

 

CommentID: 63261