Alabama Administrative Code
Title 560 - ALABAMA MEDICAID AGENCY
Chapter 560-X-53 - PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE)
Section 560-X-53-.15 - Data Collection, Record Maintenance, Report
Current through Register Vol. 43, No. 02, November 27, 2024
(1) A PO must collect data, maintain records, and submit reports as specified by AMA and CMS in the PACE agreement to enable monitoring of the operation, cost, quality, and effectiveness of the program and establishment of payment rates.
(2) Written procedures must be established to safeguard all data, records, and financial books against loss, destruction, unauthorized use, or alteration.
(3) All federal and state laws are to be followed regarding the confidentiality and disclosure of health information and records for Participants. Written procedures must be established to ensure that confidentiality is maintained. Records should be updated timely in order to maintain accurate records. Each Participant has the right to review their record and must be allowed timely access to review and copy his or her records. Each Participant may also request amendments to his or her records. Only authorized individuals may receive information or copies of a record. Original medical records are to be released only in accordance with federal and state laws, court orders, or subpoenas.
(4) Records are to be retained as specified in 42 CFR 460.200.
(5) At a minimum, AMA and CMS are to have access to data and records pertaining to participant health outcomes, financial information, medical records, and personnel records.
Author: Linda Lackey, Medicaid Administrator, LTC Project Development Unit.
Statutory Authority: State Plan, Attachment 2.2-A, Attachment 3.1-A and Supplement 3; 4 2 CFR 460 Subpart L.