(a) (1) The department shall adopt regulations that specify the type of information requested from providers, including reasonable timeframes. All providers shall upon request of the department for any records, or for any information contained in records pertaining to an individual program, make the requested records or information available to the department for inspection or copying. The information required to be made available pursuant to this section shall include, but not be limited to, information necessary to establish a rate, collect provider sustained overpayments in a timely and efficient manner, or to perform a financial, fiscal, performance, or program audit. This section shall not be construed to modify applicable rules of confidentiality.
(2) Providers, upon request of the department, shall allow timely access to a provider’s records and facilities in order to conduct a financial, fiscal, performance, or program audit.
(3) Providers shall allow the department immediate access to program information or access to a facility if the deputy director of the children and family services division of the department serves the provider with notice that, in the opinion of the deputy director, the immediate access to a facility or program information is required based on one of the following conditions or circumstances:
(A) A temporary suspension order has been served on a provider.
(B) Based on reliable evidence, the department has a valid basis for believing that proceedings have been, or will shortly be, instituted against a provider in a state or federal court for purposes of determining whether the provider is insolvent or bankrupt under appropriate state or federal law.
(C) A provider is, or will shortly be, taking action that might reasonably hinder or defeat the department’s ability to collect overpayments in the future.
(4) The department shall adopt regulations that specify timeframes and penalties for failure to submit requested information or allow facility access that may include reduction or termination of the AFDC-FC rate. Penalties shall not be imposed until the provider has been given a reasonable opportunity to respond or provide access.
(b) The department shall apply and enforce only those statutes, regulations, all-county letters, or similar written directives, that are made available to providers, in writing, for any period for which a rate is effective.
(c) The department shall consult with representatives of providers concerning the development of those standards and the modification of existing standards. Providers shall receive written notice of, and have the opportunity to comment upon, new and modified standards proposed by the department.
(d) The department shall make available to providers, in writing, any new or modified standards prior to the beginning of the period upon which a rate is calculated, if possible, or as quickly as it is administratively practical to do so. Notwithstanding subdivisions (b) and (c), in the event of an unanticipated circumstance or unusual expenditure, the department may exercise its discretion in interpreting what is an allowable or a reasonable expenditure. However, the department shall make those interpretations available to providers, in writing, as quickly as it is practical to do so.
(Amended by Stats. 2017, Ch. 732, Sec. 79. (AB 404) Effective January 1, 2018.)
Last modified: October 25, 2018