| | | 4.__Determination of "ordinary," "necessary" or "reasonable" | | costs.__In making findings concerning whether costs are | | "ordinary," "necessary" or "reasonable," the office of audit | | shall consider any practice, type, quantity, frequency or price | | level of an expenditure to be reasonable, ordinary and necessary | | if the expenditure meets any of the following standards. |
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| | | A.__A substantial number of providers of health care or | | community services in Maine incur costs of similar | | magnitude, frequency, quantity or price level to the costs | | under review. |
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| | | B.__The expenditure is reasonably incurred to produce, | | accomplish, facilitate or compensate persons for providing | | an item or service related to the purpose of a program or | | activity for which the State has contracted or for which the | | State otherwise provides payment. |
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| | | C.__The expenditure is comparable to one incurred by a | | department or agency of the State responsible for services | | or programs similar to those to which the finding applies. |
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| | | D.__The expenditure, when considered in combination with all | | amounts expended for the program under review, results in an | | overall cost that is reasonable relative to other providers | | of the same or similar items or services, taking into | | account any special needs of the population served and any | | innovative or specialized services offered by a particular | | provider. |
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| | | 5.__Employee compensation and benefit costs.__In evaluating | | the reasonableness and allowability of employee wages, salaries | | and benefits, the department shall apply the following criteria. |
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| | | A.__The department may not disallow any employee benefits, | | wages or salaries, or any expenditures as described in | | paragraph B, if the total of employee salaries, wages, | | benefits and expenses described in paragraph B is less than | | or equal to the total cost of wages, salaries, benefits and | | expenses described in paragraph B for employees of the State | | performing similar functions.__This paragraph may not be | | construed to require disallowance of greater compensation | | costs that are otherwise reasonable under applicable facts | | and circumstances. |
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| | | B.__The department shall modify its rules governing MaineCare | | reimbursement and reimbursement pursuant to grants, contracts or | | otherwise for health care providers and other agencies providing | | community services.__The office of audit shall interpret any | | existing provisions of the |
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