# WAC 182-502A-0501: WAC 182-502A-0501. Entity self-audits

> Washington · Regulations · In force

URL: https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_502A_0501

## Section

- **Citation:** WAC 182-502A-0501
- **Heading:** WAC 182-502A-0501. Entity self-audits
- **Jurisdiction:** Washington
- **Kind:** Regulations
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Washington Administrative Code / Title 182 / Chapter 182-502A / Section 182-502A-0501

## Text

(1) The medicaid agency may require an entity to self-audit.
(a) The agency gives written notice of the instruction to self-audit.
(b) The entity must acknowledge receipt of the notice within thirty calendar days of receiving it.
(c) The entity must comply with all terms included in the notice; failure to timely comply with the notice constitutes failure to comply with a program integrity activity.
(d) The agency does not require an entity to self-audit any services or encounters that are included in an active state or federal program integrity activity, rate adjustment, cost settlement, or other payment adjustment.
(e) The agency reviews the self-audit and states in writing whether it accepts or rejects the results of the self-audit. If the agency rejects the results it may:
(i) Instruct the entity to repeat the self-audit; or
(ii) Audit the entity.
(2) When an entity self-discloses overpayments, it must:
(a) Submit to the agency written notice of the self-audit and identify each claim included in the self-audit.
(b) Report and repay the overpayment to the agency within sixty calendar days of identifying the overpayment, unless the overpayment is:
(i) Included in an active state or federal program integrity activity; or
(ii) Related to a state-initiated rate adjustment, cost settlement, or other payment adjustment.
(c) The entity's overpayment report must include:
(i) The reason for the overpayment;
(ii) How the entity calculated the overpayment; and
(iii) A list of claims associated with the overpayment.
(d) The agency reviews the self-audit and states in writing whether it accepts or rejects the methodology and findings. If the agency rejects the findings it may:
(i) Instruct the entity to repeat the self-audit; or
(ii) Audit the entity.
ort must include:
(i) The reason for the overpayment;
(ii) How the entity calculated the overpayment; and
(iii) A list of claims associated with the overpayment.
(d) The agency reviews the self-audit and states in writing whether it accepts or rejects the methodology and findings. If the agency rejects the findings it may:
(i) Instruct the entity to repeat the self-audit; or
(ii) Audit the entity.
(e) The agency does not accept any identified overpayment as full or final repayment before the completion of its review of the entity's self-audit findings.
(3) The entity's dispute and appeal rights under this section are identical to its rights during an audit conducted by the office of program integrity.

## Nearby sections

- [WAC 182-502A-0101 WAC 182-502A-0101. Purpose](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_502A_0101.md)
- [WAC 182-502A-0201 WAC 182-502A-0201. Definitions](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_502A_0201.md)
- [WAC 182-502A-0301 WAC 182-502A-0301. Authority to conduct program integrity activities](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_502A_0301.md)
- [WAC 182-502A-0401 WAC 182-502A-0401. Program integrity activities](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_502A_0401.md)
- [WAC 182-502A-0501 WAC 182-502A-0501. Entity self-audits](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_502A_0501.md)
- [WAC 182-502A-0601 WAC 182-502A-0601. Extrapolation](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_502A_0601.md)
- [WAC 182-502A-0701 WAC 182-502A-0701. Agency outcomes](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_502A_0701.md)
- [WAC 182-502A-0801 WAC 182-502A-0801. Dispute resolution process](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_502A_0801.md)
- [WAC 182-502A-0901 WAC 182-502A-0901. Administrative hearing (formal appeal) right](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_502A_0901.md)
- [WAC 182-502A-1001 WAC 182-502A-1001. Metrics](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_502A_1001.md)
- [WAC 182-502A-1101 WAC 182-502A-1101. Managed care organizations](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_502A_1101.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_182_502A_0501. Check the current official text before relying on it. Not legal advice.