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016.06.41-202.100. Availability of Medical Records.

AR ADC 016.06.41-202.100Arkansas Administrative Code

West's Arkansas Administrative Code
Title 016. Department of Human Services
Division 06. Division of Medical Services
Rule 41. Rehabilitative Hospital Provider Manual (Refs & Annos)
Section 200.000. Rehabilitative Hospital General Information.
Ark. Admin. Code 016.06.41-202.100
016.06.41-202.100. Availability of Medical Records.
Currentness
The Medicaid Program, its designees and other state and federal agencies review medical records for documentation of services provided and billed, as well as to evaluate the medical necessity of delivered services.
A. All records must be kept for a period of five (5) years from the date of service or until all audit questions, appeal hearings, investigations or court cases are resolved, whichever is longer. Failure to furnish medical records upon request may result in sanctions being imposed. See Section I of this manual.
B. Pertinent records concerning the provision of Medicaid covered health care services are to be made available, upon request, during regular business hours to authorized representatives of the Arkansas Division of Medical Services who are acting within the scope and course of their employment.
1. All requested documentation must be made available to representatives of the Division of Medical Services (DMS) at the time of an audit by the Medicaid Field Audit Unit.
2. All documentation must be available at the provider's place of business.
C. Pertinent records are also to be made available to the Division's contracted Quality Improvement Organizations (QIOs).
• Arkansas Foundation for Medical Care, Inc., (AFMC).
• QSource of Arkansas
D. Providers are required to furnish records to the State Medicaid Fraud Control Unit and representatives of the Department of Health and Human Services and the Centers for Medicare and Medicaid Services (CMS, formerly the Health Care Financing Administration).
E. When requested records are stored off-premises or are in active use, the provider may so certify in writing and set a date and hour within 3 working days that the records will be available.
F. If an audit determines that recoupment of funds is necessary, there will be only 30 days after the provider receives the recoupment notice in which Medicaid will accept additional documentation. Additional documentation will not be accepted later.

Credits

Eff. Oct. 1, 2008.
<Editor’s Note: Nonfunctioning links so in original.>
Current with amendments received through February 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 016.06.41-202.100, AR ADC 016.06.41-202.100
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