D.C. Mun. Regs. tit. 29, r. 29-5013
Current through Register Vol. 71, No. 37, September 13, 2024
5013.1 Each Provider shall maintain complete and accurate records reflecting the specific PCA services provided to each beneficiary for each unit of service billed. Such records must be maintained for a period of ten (10) years or when all audits have been completed, whichever is longer.
5013.2 Each Provider shall be responsible for maintaining the confidentiality of each beneficiary's care, treatment, and records. The disclosure of personal health information by the Provider is subject to all of the provisions set forth in applicable District and Federal laws and rules.
5013.3 Each beneficiary's record shall be readily retrievable and shall be kept in a locked room or file maintained and safeguarded against loss or unauthorized use at the location of the Provider's place of business that is identified on the Provider's Medicaid Provider application.
5013.4 Each Provider shall permit reviews and on-site inspections to be conducted by CMS and its agents, and DHCF, and its agents to determine Provider compliance with all applicable laws.
5013.5 Each Provider shall comply with the terms of its Medicaid Provider Agreement with respect to the maintenance of all beneficiary and financial records.
5013.6 Each beneficiary's record shall include, but is not limited to, the following information:
(a) General information including the beneficiary's name, Medicaid identification number, address, telephone number, age, sex, name and telephone of emergency contact person, authorized representative (if applicable), and primary care physician's or advanced practice registered nurse's name, address, and telephone number;(b) Health care information, including all referrals, assessments, service authorizations, plans of care, and progress notes;(c) Dates and description of PCA services rendered, including the name and NPI of the personal care aide performing the services;(d) Documentation of each supervisory visit of the R.N., including signed and dated clinical progress notes;(e) Discharge summary, if applicable; (f) Copies of any written notices given to the beneficiary; and (g) Any other appropriate identifying information that is pertinent to beneficiary care. D.C. Mun. Regs. tit. 29, r. 29-5013
Final Rulemaking published at 60 DCR 15537 (November 8, 2013); amended by Final published at 63 DCR 014134 (11/18/2016)Authority: An Act to enable the District of Columbia to receive federal financial assistance under Title XIX of the Social Security Act for a medical assistance program, and for other purposes approved December 27, 1967 (81 Stat.774; D.C. Official Code § 1-307.02 (2012 Repl.)) and Section 6(6) of the Department of Health Care Finance Establishment Act of 2007, effective February 27, 2008 (D.C. Law 17-109; D.C. Official Code § 7-771.05(6) (2012 Repl.)).