Division of Audit

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Notices and Division Updates

COVID-19 TRI Reconciliation: A Notice with required forms (PDF) was issued on 07/01/20 to all Nursing Facilities, Intermediate Care Facilities, and PNMI Appendix C and F providers that received a temporary rate increase to assist with increased costs resulting from the COVID-19 pandemic. Providers are required to submit a financial reconciliation to DHHS-Division of Audit no later than 30 days after the authorized period has ended. The authorized period to incur expenses was extended through June 30, 2020; therefore, the reconciliation forms must be filed no later than July 31, 2020.

Electronic submissions of cost reports are preferred and can be sent to dhhs.audit@maine.gov. Original wet signatures are still needed to be sent via mail (signature pages only).

Notice to Providers of Cost-Settled Programs was issued on 04/18/19 about changes to the cost report templates.

Providers with a December 31, 2019 fiscal year end date are ordinarily required to submit their cost reports within 5 months of their fiscal year end, by May 31, 2020. However, in light of CMS’ extension for Medicare providers to file cost reports in response to the nation pandemic, the Department will apply the same extension to MaineCare cost reports.  We will accept December 31, 2019 cost reports with postmarked dates through July 31, 2020.

Audit Overview and Responsibilities

The Division of Audit at DHHS performs compliance and cost settlement audits on approximately 600 different provider organizations and/or community agencies which receive over $1.5 billion of State and Federal funds through either the MaineCare program or from contracted services.

MaineCare Audit

The MaineCare audit section conducts compliance audits and issues final cost settlements on all MaineCare cost reimbursed programs. 

These programs include Nursing Facilities, Intermediate Care Facilities for Individuals with Intellectual Disabilities, Residential Care Facilities, Private Non-Medical Institutions, and Hospitals. 

The audits are conducted to ensure that MaineCare funds are expended in accordance with the MaineCare Benefits Manual, the Provider Reimbursement Manual, and the Code of Federal Regulations. We process over 600 cost reports annually representing approximately $1 billion in MaineCare funding.

Social Service Audit

The Social Service Audit team conducts desk reviews on audits submitted by community agencies that have been performed in accordance with 2 CFR Part 200 as well as close-out reviews on all Department contracts to sub-recipients.

Internal Audit 

The Internal Audit Unit oversees all auditing of DHHS conducted by external agencies, assures corrective action plans are implemented and meeting their objective, and conducts specialized audits as needed.