2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 1 - MEDICAL ASSISTANCE ACT (§§ 71-5-NEW — 71-5-199) › Section 71-5-130 - Determination of payments to vendors - Audits

(a)
With regard to the payments to vendors pursuant to this part:
(1)
The payment for all vendors providing health care that receive payment pursuant to this part shall be determined by the comptroller of the treasury, in accordance with rules and regulations established by the department, pursuant to §
71-5-105
, and shall be paid by the department;
(2)
In order that payment can be determined for all vendors providing health care that receive payment pursuant to this part, the department shall require such vendors to submit to the comptroller of the treasury, cost data, statistical data, and other information, as may be necessary, on such forms as are approved or formulated by the department, in consultation with the comptroller of the treasury and the Tennessee Hospital Association. The comptroller of the treasury, in consultation with the department, may require that such cost data and other information, in order to be acceptable, be certified by the administrator of the vendor and by a licensed public accountant or certified public accountant; and all such data shall be subject to audit by the comptroller of the treasury, or agency or organization designated by the comptroller of the treasury;
(3)
(A)
To be eligible to receive payment, contracting hospitals shall use uniform hospital statistics and classification of accounts as published by the American Hospital Association for all accounting records, or any other acceptable accounting methods approved by the department in consultation with the comptroller of the treasury and the Tennessee Hospital Association;
(B)
In consultation with the comptroller of the treasury, the department may also require other vendors to use uniform statistics and classification of accounts;
(4)
(A)
Any contracting hospital that does not adopt the uniform classification of accounts, as it shall be established by the department, or that does not submit certified statements when required by the department, shall be assessed a penalty of ten dollars ($10.00) for each day the hospital is not in compliance with this subsection (a);
(B)
Any nursing home that does not adopt a uniform classification of accounts, or does not submit certified statements, or does not submit cost data and other information, as required by the department, shall be assessed the penalty provided by subdivision (a)(4)(A);
(C)
Any other vendor providing health care pursuant to this part that does not adopt a uniform classification of accounts, or does not submit certified statements, or does not submit cost data and other information, as required by the department, shall be assessed the penalty provided by subdivision (a)(4)(A);
(5)
(A)
The comptroller of the treasury in carrying out responsibilities under this part, with regard to the determination of payments for particular vendors, and the auditing of data submitted, is hereby authorized to enter into contracts and agreements, and to make such arrangements as are necessary with other state departments and agencies, and with organizations or firms providing such services. The final authority for the determination and certification of payment to the department shall be the comptroller of the treasury;
(B)
The departments of human services and health may enter into agreements with the comptroller of the treasury with regard to services performed in payment determination and auditing, and are hereby authorized to reimburse the comptroller of the treasury for the performance of such services out of funds available to the department; and
(6)
All legal aids granted to the comptroller of the treasury by any other law are expressly reserved to the comptroller of the treasury in auditing any contracting vendor for the purpose of verifying the cost data and other information submitted by the vendor.
(b)
Nothing contained in this part shall be construed as obligating the state during any fiscal year for any payment exceeding the amount appropriated by the general assembly for this purpose, and budgeted by the department or departments administering these programs.
Acts 1984, ch. 787, § 10; T.C.A., § 14-23-130; Acts 1988, ch. 779, §§ 3-5.