Section 29-5614. ACCESS TO INFORMATION

 

5614.1The managed care provider and its subcontractors 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 enrolled children.

 

5614.2The managed care provider shall permit 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 all records for audit purposes.

 

5614.3The Department may examine the records of the managed care provider and its subcontractors which were prepared in the course of carrying out the managed care provider’s obligation under its Medicaid managed care provider agreement.

5614.4The Department may conduct on-site inspections and periodic medical audits of such records as often as is necessary to protect the interests of the Department and enrolled children.

 

source

Final Rulemaking published at 43 DCR 4833, 4852 (September 6, 1996).