D.C. Mun. Regs. tit. 29, r. 29-9906

Current through Register Vol. 71, No. 44, November 1, 2024
Rule 29-9906 - AUDITS AND RECORD MAINTENANCE
9906.1

All Medicaid reimbursable Skilled Nursing, Home Health Aide, Physical Therapy, Occupational Therapy, Speech Pathology and Audiology services shall adhere to the audit and record maintenance requirements set forth in this section.

9906.2

Record maintenance requirements related to DMEPOS shall be governed under Subsection 996 of Chapter 9 (Medicaid Program) of Title 29 DCMR.

9906.3

DHCF shall perform audits to ensure that Medicaid payments are consistent with efficiency, economy and quality of care and made in accordance with federal and District rules governing the Medicaid program.

9906.4

DHCF shall routinely conduct the audit process to determine, by statistically valid scientific sampling, the appropriateness of services rendered and billed to Medicaid. These audits shall be conducted on-site or through an off-site desk review.

9906.5

Each Home Care Agency shall allow access to relevant records and program documentation upon request and during an on-site audit or review by DHCF, other District of Columbia government officials and representatives of the United States Department of Health and Human Services (HHS).

9906.6

Each Home Care agency shall maintain complete and accurate records reflecting the specific Home Health services provided to each beneficiary for each unit of service billed. Such records shall be maintained for a period of ten (10) years or when all audits have been completed, whichever is longer.

D.C. Mun. Regs. tit. 29, r. 29-9906

Final Rulemaking published at 64 DCR 418 (1/19/2018)