(a) Accurate reports. A PACE organization must provide CMS and the State administering agency with accurate financial reports that are—
- (1) Prepared using an accrual basis of accounting; and
- (2) Verifiable by qualified auditors.
(b) Accrual accounting. A PACE organization must maintain an accrual accounting recordkeeping system that does the following:
- (1) Accurately documents all financial transactions.
- (2) Provides an audit trail to source documents.
- (3) Generates financial statements.
- (c) Accepted reporting practices. Except as specified under Medicare principles of reimbursement, as defined in part 413 of this chapter, a PACE organization must follow standardized definitions, accounting, statistical, and reporting practices that are widely accepted in the health care industry.
(d) Audit or inspection. A PACE organization must permit CMS and the State administering agency to audit or inspect any books and records of original entry that pertain to the following:
- (1) Any aspect of services furnished.
- (2) Reconciliation of participants' benefit liabilities.
- (3) Determination of Medicare and Medicaid amounts payable.