In the case of medical examinations, x-rays, or laboratory tests, the expenditures
                              did not exceed the highest rate paid by Federal or other agencies in the State for
                              the same or similar type of service.
                           
                           
                           The auditors are encouraged to discuss each tentative audit finding, as soon as it
                              is developed, with the organization being audited. In addition, an exit conference
                              at the conclusion of each audit is a standard practice. National Disability Determinations
                              (NDD) will ordinarily be represented at the exit conference. If the State or the State
                              agency wish to consult with NDD at any time during the audit process, it should do
                              so. If the auditor becomes aware of irregularities in the State department, promptly
                              notify State and Federal officials. Irregularities include such matters as conflicts
                              of interest, falsification of records or reports, and misappropriation of funds or
                              other assets.
                           
                           
                           The audit report will be written and issued according to SSA audit procedures. Copies
                              of the final audit report will be send directly to the State agency with copies to
                              the SSA central office. State agencies will either be told that they will be contacted
                              by NDD or the State agency will be asked to respond to the report within 30 days and
                              to present any additional information which may have a bearing on the issues raised
                              in the audit report. The State agency response must discuss each recommendation contained
                              in the audit report and must clearly indicate concurrence or non-concurrence with
                              each recommendation. This response must be sent to NDD. The State will take no corrective
                              action regarding an audit recommendation until so advised by NDD.
                           
                           
                           NDD will carefully consider the audit recommendations and the State agency response;
                              obtain any other needed information; and issue a notice of final determination to
                              the State agency. The State agency will also be notified of its appeal rights.
                           
                           
                           Regarding the resolution of appeal items that are questioned and reported in an audit
                              report see 20 CFR 404.1627(b) and 416.1027(b) .
                           
                           
                           NDD will followup on the implementation of the final determination that is issued
                              on all audit recommendations. Any questions that arise at any time in the audit process
                              should be directed to NDD.