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Trauma Fund Recipient Audit
The State Department of Health through Oklahoma Statute §63-1-2530.9 has been charged with establishing rules and procedures for the distribution of monies from the Trauma Care Assistance Revolving Fund. Rules were included to ensure that information submitted to the Trauma Fund for reimbursement is accurate, and Fund monies are distributed equitably and in compliance with Code. This is defined through the regulation below:
Oklahoma Administrative Code 310:669-5-4. Amendments
(a) A distribution entity's data originally reported to the trauma registry may be subject to audit as established by law, contractual agreement, or for the facility's owners or operators to exercise fiscal and fiduciary responsibility. A State or Federal agency, a fiscal intermediary, or an independent auditor may perform an audit. The audit report may also be eligible for appeal.
(b) A distribution entity may also receive an additional collection(s) for care treated as uncompensated on a prior request for distribution report.
(c) When a late collection(s) or an audit or its appeal results in revising data filed in accordance with OAC 310:669-5-1 and 5-2, the distribution entity shall report to the Department according to Department guidelines. Any additional monies received from other sources of funding for a case that was reimbursed by the Trauma Fund must be returned to the Fund and applied towards future disbursements.
[Source: Added at 17 Ok Reg 3465, eff 8-29-2000(emergency); Added at 18 Ok Reg 2047, eff 6-11-20011; Amended at 22 Ok Reg 2440, eff 7-11-2005; Amended at 24 Ok Reg 2025, eff 6-25-2007]
Emergency Systems will identify an external auditing firm to meet its responsibility as managers of the Trauma Fund. The designated firm will conduct special reviews annually to audit the claims that were submitted and received reimbursement from the Trauma Fund.
For each audit year, the auditors will be reviewing cases from a predetermined calendar year for dates of service. Table below lists the contractor conducting the audit, and the letter stating the awardee for each year:
Not all recipient providers may be selected for an audit each year. Selected providers will receive communication from the auditing firm notifying them of their selection and audit instructions. The letter will include an explanation of the process and directions on how to proceed and prepare for the review.
For further inquiries, please contact Emergency Systems at firstname.lastname@example.org , or call us at (405) 271-4027.
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