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D.C. Municipal Regulations (Last Updated: September 13, 2017) |
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Title 29. PUBLIC WELFARE |
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Chapter 29-54. STANDARDS FOR MANAGED CARE PRIMARY CARE PROVIDERS THAT ARE PAID ON A FEE-FOR-SERVICE BASIS FOR SERVICES RENDERED TO AFDC AND AFDC-RELATED MEDICAID RECIPIENTS |
Section 29-5409. ACCESS TO INFORMATION
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5409.1Each fee-for-service primary care provider shall maintain all records required by the Medicaid managed care provider agreement, at cost, for five (5) years or until all audits are completed, whichever is longer. The records shall include all physical records originated or prepared in connection with the performance of the Medicaid managed care provider agreement, including but not limited to, books, reports, working papers, documents, financial records, medical records and charts, and the other documentation pertaining to costs, payments received and made, and services provided to covered enrollees.
5409.2Each fee-for-service primary care provider shall afford authorized personnel of the Department, the United States Department of Health and Human Services, the Controller General of the United States and any of their duly authorized representatives full access to the records for audit purposes.
5409.3The Department may examine the records of any fee-for-service primary care provider that were prepared in the course of carrying out the provider’s obligation under his/her Medicaid managed care provider agreement. The Department may conduct on-site inspections and periodic medical audits of such records of as often as is necessary to protect the interests of the Department and AFDC and AFDC-related Medicaid recipients in the District.