Atribuições da auditoria do SUS / SUS audit assignments

O Sistema Nacional de Auditoria (SNA) foi criado pela Lei nº 8.689/93, ao qual "compete a avaliação técnico-científica, contábil, financeira e patrimonial do Sistema Único de Saúde, que será realizada de forma descentralizada." Tal descentralização ocorre "através dos órgãos estaduais e municipais e de representação do Ministério da Saúde em cada Estado da Federação e no Distrito Federal". O SNA obedece à regulamentação disposta no Decreto n.º 1.651/95, em todos os níveis de governo.

The National Audit System (SNA) was created by Law No. 8,689/93, which "competes for the technical-scientific, accounting, financial and patrimonial evaluation of the Unified Health System, which will be carried out in a decentralized manner." Such decentralization occurs "through state and municipal agencies and representation of the Ministry of Health in each State of the Federation and in the Federal District". The SNA complies with the regulations set out in Decree No. 1,651/95, at all levels of government.

Hospitals whacked by RAC. The audit program imposes a crushing burden on hospitals. Can it be fixed?

The audit program's growing burdens are siphoning resources from patient care. Can it be fixed?

Oversight overload: harried hospitals say the growing number of billing audits they face could actually increase costs.

Providers say the administration's growing emphasis on billing audits is pushing them to the limit and threatens to increase their costs. Many billing problems stem from simple errors, not fraud, they say. "When you get into the nuts and bolts of some of these programs you realize it's not as easy as taking the overpayment line out of the budget," says Michael Regier, of VHA.

Medicaid program; recovery audit contractors. Final rule.

This final rule implements section 6411 of the Patient Protection and Affordable Care Act (the Affordable Care Act), and provides guidance to States related to Federal/State funding of State start-up, operation and maintenance costs of Medicaid Recovery Audit Contractors (Medicaid RACs) and the payment methodology for State payments to Medicaid RACs. This rule also directs States to assure that adequate appeal processes are in place for providers to dispute adverse determinations made by Medicaid RACs. Lastly, the rule directs States to coordinate with other contractors and entities auditing Medicaid providers and with State and Federal law enforcement agencies.