Subsection 144-101-III-97-3500 - ADJUSTMENTS TO AUDIT SETTLEMENTS (Except for Appendices B and D)3500.1 Finalized cost report determinations and decisions may be reopened and corrected when the Division of Audit finds new and material evidence submitted by the provider or discovered by the Department or evidence of a clear and obvious material error.3500.2 Reopening means an affirmative action taken by the Division of Audit to re-examine the correctness of a determination or decision that is otherwise final. Such action may only be taken: 3500.2.1 At the request of either the Department or a provider, within the applicable time period set out in paragraph 3500.4; and,3500.2.2 When the reopening may have a material effect (more than one percent) on the provider's MaineCare rate payments. A correction is a revision (adjustment) in the Division of Audit's determination, otherwise final, that is made after a proper re-opening. The Division may make a correction, or require the provider to file an amended cost report.
3500.4 A re-opening of an audit may occur within three years from the date of notice containing the Division of Audit's determination, or the date of a decision by the Commissioner or a court. No time limit will apply in the event of fraud or misrepresentation. 3500.4.1 A cost report is settled if there is no request for reconsideration of the Division of Audit's findings made within the required time frame or, if such request for reconsideration was made and the Division of Audit has issued a final revised audit report.3500.4.2 No final audit will be reopened, or any hearing allowed concerning matters contained in any final audit if three years following the date of the final audit settlement have passed. This limitation does not apply in the event of fraud or misrepresentation. C.M.R. 10, 144, ch. 101, ch. III, 144-101-III-97, subsec. 144-101-III-97-3500