[Code of Federal Regulations]

[Title 42, Volume 4]

[Revised as of October 1, 2006]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR431.17]



[Page 23]

 

                         TITLE 42--PUBLIC HEALTH

 

  CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF 

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 431_STATE ORGANIZATION AND GENERAL ADMINISTRATION--Table of Contents

 

                      Subpart A_Single State Agency

 

Sec.  431.17  Maintenance of records.



    (a) Basis and purpose. This section, based on section 1902(a)(4) of 

the Act, prescribes the kinds of records a Medicaid agency must 

maintain, the retention period, and the conditions under which microfilm 

copies may be substituted for original records.

    (b) Content of records. A State plan must provide that the Medicaid 

agency will maintain or supervise the maintenance of the records 

necessary for the proper and efficient operation of the plan. The 

records must include--

    (1) Individual records on each applicant and recipient that contain 

information on--

    (i) Date of application;

    (ii) Date of and basis for disposition;

    (iii) Facts essential to determination of initial and continuing 

eligibility;

    (iv) Provision of medical assistance;

    (v) Basis for discontinuing assistance;

    (vi) The disposition of income and eligibility verification 

information received under Sec. Sec.  435.940 through 435.960 of this 

subchapter; and

    (2) Statistical, fiscal, and other records necessary for reporting 

and accountability as required by the Secretary.

    (c) Retention of records. The plan must provide that the records 

required under paragraph (b) of this section will be retained for the 

periods required by the Secretary.

    (d) Conditions for optional use of microfilm copies. The agency may 

substitute certified microfilm copies for the originals of 

substantiating documents required for Federal audit and review, if the 

conditions in paragraphs (d)(1) through (4) of this section are met.

    (1) The agency must make a study of its record storage and must show 

that the use of microfilm is efficient and economical.

    (2) The microfilm system must not hinder the agency's supervision 

and control of the Medicaid program.

    (3) The microfilm system must--

    (i) Enable the State to audit the propriety of expenditures for 

which FFP is claimed; and

    (ii) Enable the HHS Audit Agency and CMS to properly discharge their 

respective responsibilities for reviewing the manner in which the 

Medicaid program is being administered.

    (4) The agency must obtain approval from the CMS regional office 

indicating--

    (i) The system meets the conditions of paragraphs (d)(2) and (3) of 

this section; and

    (ii) The microfilming procedures are reliable and are supported by 

an adequate retrieval system.



[44 FR 17931, Mar. 23, 1979, as amended at 51 FR 7210, Feb. 28, 1986]