OAR 436-105-0550
Audits
(1)
Insurers and employers are subject to periodic program and fiscal audits by the director. All reimbursements are subject to subsequent audits, and may be disallowed on any of the grounds set forth in these rules. Disallowed reimbursements may be recovered by the director directly or from future reimbursements by way of offset. If the director finds upon audit that procedures that led to disallowed reimbursements are still being used, the director may withhold further reimbursements until corrections satisfactory to the director are made.(2)
An audit may include but not be limited to a review of the records required in OAR 436-105-0500 (Insurer Participation in the Employer-at-Injury Program)(6).(3)
When there is conflicting documentation, the director will use a preponderance of evidence standard to decide eligibility for reimbursement. If there is no clear preponderance, reimbursement will be denied.(4)
The director reserves the right to visit the worksite to determine compliance with these rules.
Source:
Rule 436-105-0550 — Audits, https://secure.sos.state.or.us/oard/view.action?ruleNumber=436-105-0550.