California Code of Regulations › Title 22 - Social Security › Division 2 - Department of Social Services-Department of Health Services › Part 2 - Health and Welfare Agency-Department of Health Services Regulations › Subdivision 2 - Administration › Chapter 2.1 - DEPARTMENT OF HEALTH SERVICES AUDITS AND APPEALS › Section 20201 - Definitions

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
The following definitions shall be used throughout this
						article unless otherwise noted:
(a)
					 Audit or Examination. "Audit or examination" means a systematic review or
					 examination by or on behalf of the Department of a contractor's records or
					 reports maintained or developed pursuant to a contract with the
					 Department.
(b) Audit or
					 Examination Notice. "Audit or examination notice" means a written notice of the
					 Department's final actions upon the audit or examination of a contractor and
					 which is formally issued to a contractor.
(c) Contract. "Contract" means any agreement,
					 whereby a person or entity promises to do or not to do a particular
					 act.
(d) Contractor. "Contractor"
					 means a person or entity who has entered into a contract with the
					 Department.
(e) Direct Service
					 Contract. "Direct service contract" means a contract, wherein the contractor
					 agrees to provide services directly to the public or to persons who are
					 eligible for programs administered or supported by the Department. "Direct
					 service contract" does not include contracts entered into pursuant to Chapter 7
					 (commencing with Section
					 14000) or Chapter 8 (commencing
					 with Section
					 14200) of Part 3 of Division 9 of
					 the Welfare and Institutions Code, or with governmental agencies, units of
					 government, regional centers, or area agencies on aging.
(f) Probability Sampling. "Probability
					 sampling" means a standard statistical methodology by which a sample is
					 selected based on the theory of probability (a mathematical theory used to
					 study the occurrence of random events).
(g) Qualified Underpayment. "Qualified
					 underpayment" means any payment by the Department for a service billed under a
					 direct service contract for less than the amount authorized under the contract,
					 and where the bill for that service is part of the sample identified by the
					 Department for audit.
(h)
					 Statistical Extrapolation. "Statistical extrapolation" means the methodology
					 whereby an unknown value can be estimated by projecting the results of a
					 probability sample to the universe from which the sample was drawn with a
					 calculated precision (margin of error).
1. New
						section filed 5-31-89; operative 6-30-89 (Register 89, No.
						23).
Note: Authority cited: Sections
						  208
						  and
						  38036,
						  Health and Safety Code. Reference: Sections
						  38011,
						  38020,
						  38030,
						  and
						  38041,
						  Health and Safety Code; Sections
						  11180 and
						  11181,
						  Government Code; and Stipulated Judgment in Planned Parenthood v. Department of
						  Health Services, Sacramento Superior Court, No.
						  328490.