D.C. Mun. Regs. tit. 29, r. 4207

Current through Register Vol. 71, No. 49, December 6, 2024

Rule 4207 - RECORDS AND CONFIDENTIALITY OF INFORMATION: GENERAL

4207.1

Each provider of waiver services shall establish and implement a privacy plan to protect the privacy and confidentiality of a beneficiary's records.

4207.2

The disclosure of information by a provider of waiver services shall be subject to all provisions of applicable District and federal laws governing the privacy and security of health and personal information.

4207.3

Each provider of waiver services shall maintain comprehensive records of the waiver services provided to each beneficiary, and shall maintain each record for a period of no less than ten (10) years.

4207.4

Each beneficiary's electronic case management record shall include, but shall not be limited to, the following information:

(a) General information including each beneficiary's name, Medicaid identification number, address, telephone number, age, sex, name and telephone number of emergency contact person, physician's name, address, and telephone number;

(b) A signed copy of the beneficiary's Bill of Rights and Responsibilities;

(c) A complete PCSP which includes all signatures as required in Section 4204 of this chapter;

(d) A copy of the initial and all subsequent level of care determinations, case manager attestation/evaluation forms, and the results of the comprehensive assessment tool;

(e) A record of the initial signed Waiver Beneficiary Freedom of Choice form;

(f) A record of all case management in- home site visits and telephone contacts;

(g) A record of all PERS plans of care, if PERS were approved under the PCSP;

(h) A record of the initial and annual Pre-Admission Screening and Resident Review (PASRR) for mental illness, cognitive deficiency, and intellectual/developmental disability and Psychiatric Evaluation, as necessary;

(i) A record of quarterly reviews and narrative notes;

(j) A record of the beneficiary's initial and annual health history;

(k) A record of all prior authorizations for services;

(l) A record of all requests for program modification requests including initiations, changes, discharges, transfers, suspensions, and terminations;

(m) A discharge summary, if applicable; and

(n) Any other records necessary to demonstrate compliance with all regulations, requirements, guidelines, and standards for the implementation and administration of this waiver.

4207.5

Each direct-services provider of waiver services shall be responsible for maintaining records related to the provision of services delivered in accordance with the specific provider requirements set forth under this chapter.

D.C. Mun. Regs. tit. 29, r. 4207

Final Rulemaking published at 64 DCR 6787 (7/21/2017)