Section 182-502A-0601. Program integrity—Extrapolation.

(1) To determine an improper payment from a probability sample, the agency may extrapolate to the universe from which the probability sample was drawn.

(2) If during the course of the audit, an entity adjusts or rebills a claim or encounter that is part of the audit sample or universe, the original claim or encounter amount remains in the audit sample or universe.

(3) When the agency uses the results of an audit sample to extrapolate the amount to be recovered, the entity is entitled to the following information upon request:

(a) The sample size.

(b) The method used to select the sample.

(c) The universe from which the sample was drawn.

(d) Any formulas or calculations used to determine the amount of the improper payment.

[Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 15-01-129, § 182-502A-0601, filed 12/19/14, effective 1/19/15.]

RCW 41.05.021 and 41.05.160. WSR 15-01-129, § 182-502A-0601, filed 12/19/14, effective 1/19/15.