Independent Audit Reimbursement Form

The Methods of Implementation includes an independent financial audit requirement.
The Independent Reimbursement Form is now available. You can also find this form on the Nursing Home Reimbursement webpage under Independent Audit Materials and on the Myers and Stauffer website under the cost report template section.

Reimbursement

This form is available for providers to complete in order to be reimbursed for costs related to completing the audit requirement. In reimbursing costs related to each entity’s independent financial audit per this section, Medicaid will reimburse the greater of:

• The percentage of the audited entity’s total revenue coming from nursing home and assisted living Wisconsin Medicaid revenue (including patient liability for Medicaid members) for the audit year; or
• 10% of audit cost.

Submissions

Providers must submit the completed Independent Reimbursement Form and accompanying detailed invoices to WINHRS under the Independent Auditor Documentation event.