1907 RECORDS AND CONFIDENTIALITY OF INFORMATION

1907.1 Each provider shall allow appropriate personnel of MAA, MRDDA and other authorized agents of the District of Columbia government and the federal government full access to all records during announced and unannounced audits and reviews.

1907.2 Each provider shall maintain all records, including but not limited to progress reports, financial records, medical records, treatment records, and any other documentation relating to costs, payments received and made, and services provided, for six years or until all audits, investigations or reviews are completed, whichever is longer.

1907.3 Each client's record shall include, but not be limited to, the following information:

(a) General information including each client's name, Medicaid identification number, address, telephone number, age, sex, name, and telephone number of emergency contact person, physician's name, address and telephone number and case manager's name and telephone number;

(b) A copy of the beneficiary freedom of choice form;

(c) A copy of the current IHP or ISP;

(d) A record of all services(s) provided, including description and dates of service;

(e) A record of all prior authorizations for services;

(f) A record of all requests for change in services;

(g) A record of the client's initial and annual health history;

(h) A discharge summary, if applicable; and

(i) Any other records necessary to demonstrate compliance with all rules and requirements, guidelines and standards for the implementation and administration of this Waiver.

1907.4 Each provider shall secure client treatment records in a locked room or file cabinet and limit access only to authorized employees.

1907.5 The disclosure of treatment information by a provider shall be subject to all provisions of applicable federal and District laws and rules, for the purpose of confidentiality of information.

SOURCE: Final Rulemaking published at 51 DCR 10207 (November 5, 2004).