5212 TREATMENT RECORDS AND ACCESS TO RECORDS

5212.1 In addition to the requirements set forth in 22 DCMR § 3410 each treatment record shall contain sufficient information which readily identifies and support Medicaid billing.

5212.2 Each provider shall establish procedures for safeguarding client information pursuant to 42 CFR 431.305, and shall ensure, that except as otherwise provided by federal or District law or rules, the use or disclosure of client information shall be restricted to purposes related to the administration of the Medicaid Program, as set forth in 42 CFR 431.402.

5212.3 Each provider shall allow appropriate personnel of the Department of Health and other authorized agents of the District of Columbia government and the federal government full access to the records for audit purposes.

5212.4 Each provider shall maintain all records, including, but not limited to, financial records, medical and treatment records, and other documentation pertaining to costs, billings, payments received and made, and services provided, for a six (6) years or until all audits are completed, whichever is longer.

5212.5 An MHRS provider that is a public entity shall also maintain all documentation pertaining to costs necessary to perform cost reconciliation in accordance with OMB Circular A-87.

SOURCE: Final Rulemaking published at 49 DCR 4860 (May 24, 2002).