Policy Memo AB50 Health care coverage MediCal eligibility enrollment

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The audit procedures are the major compliance methods in verifying the records. The statute provides the guidelines for these procedures which have been established with the passage of time through the legislation process. The over and underpayments requires documentation while auditing the revenant categories and these sections are one of the high risks because this involves high amounts and the material transactions. The individual transactions may not be material but the sum of these transactions eventually become material for the sake of the substance of the transactions. The audit evidences are gathered by the Recovery auditors who act on the behalf of the government and audits the employees of the government in the medical departments of the hospitals. These evidences are based on the factual information containing the information of the patient and the hospital and the relevant medical staff involved in the transactions. The auditors use these evidences to support their opinion on the information for which they are hired for. The reported information is issued to the government and the stakeholders and is the source of the certified procedures. During this process the medical staff and the auditors have to follow the procedures given by the statute and the regulatory authorities and sometimes these procedures overburden the staff which prevents the medical staff to be stuck in the compliance procedure. A formation of the number of required documentation can provide the solid basis for the auditors and will improve the clarity of operations of both the medical units and the audit reports. Section: 1 Problem Statement: Should the presumptive eligibility be streamlined and should the staff be over burdened with the compliance procedures? Defining the Problem Evidences for the post payments and the prepayments in the form of documents are requested by the auditors and these will be subject to a certain limit. There is certain disambiguation for the quantitative amount of the required documents. If remained unattended, it will increase the administrative burden and cost. whereas it will improve clarity for the audit procedures as well it will harmonize all the hospitals into a proper format for the audit procedures. The audit improvement act would reinstate and make statutory a hard cap on additional documents requests (Grave. House. Gov. 2012). The presumptive eligibility period of a patient is a period which requires immediate medical treatment. The low level income applicant or patient is identified for the relevant department or institute for either state subsidy of the federal subsidy. Defining the Policy Problem The functioning of the organization is documented for their financial internal and external information. relevant to both quantitative and qualitative aspects of the operations. The compliance structure relevant to the required internal documents is the major source of satisfying the audit evidences and these evidences provides the factual basis for the true and fair nature of disclosed and published institutional information. Key Stakeholders The ministry of health and the subsequent federal and state Medicare institutions are the immediate stakeholders in addition to this it is also providing the benefit to the low-income patients. The low-level income patients are the receivers of this centrally streamlined procedural reform. For the audit improveme