Michigan Department of Health and Human Services
Medicaid Provider Manual

GENERAL INFORMATION FOR PROVIDERS

SECTION 15 - RECORD KEEPING 

15.2 RECORD RETENTION - 

Providers must maintain, in English and in a legible manner, written or electronic records necessary to fully disclose and document the extent of services provided to beneficiaries. Necessary records include fiscal and clinical records as discussed below. Appointment books and any logs are also considered a necessary record if the provider renders a service that is time-specific according to the procedure code billed. Examples of services that are time-specific are psychological testing (per hour), medical psychotherapy (20-30 minutes), and vision orthoptic treatment (30 minutes). The records are to be retained for a period of not less than seven years from the DOS, regardless of change in ownership or termination of participation in Medicaid for any reason. This requirement is also extended to any subcontracted provider with which the provider has a business relationship.

15.2 ORDERS, PRESCRIPTIONS AND REFERRALS

Providers rendering or arranging services upon the written order of another provider (e.g., physician) must maintain that order, prescription or referral for a period of seven years.

15.4 AVAILABILITY OF RECORDS (Change made 7/1/15)

Providers are required to permit MDHHS personnel, or authorized agents, access to all information concerning any services that may be covered by Medicaid. This access does not require an authorization from the beneficiary because the purpose for the disclosure is permitted under the HIPAA Privacy Rule. Health plans contracting with the MDHHS must be permitted access to all information relating to services reimbursed by the health plan.

Providers must, upon request from authorized agents of the state or federal government, make available for examination and photocopying all medical records, quality assurance documents, financial records, administrative records, and other documents and records (revised 7/1/15) that must be maintained. (Failure to make requested copies available for examination and duplication and/or extraction through the method determined by authorized agents of the state or federal government may result in the provider's suspension and/or termination from Medicaid.) Records may only be released to other individuals if they have a release signed by the beneficiary authorizing access to his records or if the disclosure is for a permitted purpose under all applicable confidentiality laws.

Version General Information for Providers
Date: July 1, 2015 Page 44    

Michigan Department of Health and Human Services