Current through Reg. 49, No. 38; September 20, 2024
(a) General requirements. A provider must
develop and maintain records in accordance with:
(1) this chapter; and
(2) Chapter 49, Subchapter C, of this title
(relating to Requirements of a Contractor).
(b) Service delivery documentation. A
provider must develop and maintain service delivery records as described in
this subsection.
(1) A provider must:
(A) maintain for each individual the
attendant time sheets an individual submits to the provider as required in
§
44.307(5)
of this chapter (relating to Individual Responsibilities in All CMPAS Service
Delivery Options);
(B) ensure that
each attendant time sheet is a single document that contains:
(i) the name of the individual;
(ii) the name of the attendant who provided
services to the individual;
(iii)
the beginning and ending dates of the service delivery period;
(iv) the specific days and times the
attendant worked;
(v) the signature
of the attendant, or another person designated by the attendant, and the date
signed; and
(vi) the signature of
the individual, representative, or another person designated by the individual
or representative, and the date signed to certify the time worked and verify
the services performed by the attendant as documented on the time
sheet;
(C) ensure that
if another person signs and dates an attendant's time sheet for the attendant,
the provider documents the reason the attendant is unable to complete or sign
the time sheet and the name of the person the attendant authorized to sign the
time sheet for the attendant; and
(D) ensure that if another person signs and
dates an attendant's time sheet for an individual or representative, the
provider documents the reason the individual or representative was unable to
sign the time sheet and the name of the person the individual or representative
authorized to sign the time sheet for the individual or
representative.
(2) A
provider must develop and maintain records to demonstrate the provider's
compliance with:
(A)
§
44.203
of this subchapter (relating to Assessment and Eligibility
Determination);
(B)
§
44.206
of this chapter (relating to Service Plan and Co-payment
Disagreements);
(C)
§
44.308 of
this chapter (relating to Suspension of Services);
(D)
§
44.309 of
this chapter (relating to Termination of Services);
(E)
§
44.501
of this subchapter (relating to Determining an Individual's Co-Payment);
and
(F)
§
44.502
of this subchapter (relating to Convening an IDT).
(c) Financial records. A provider
must, in accordance with generally accepted accounting principles (GAAP) and
HHSC requirements, document and maintain financial records:
(1) to support claims submitted to HHSC and
payments received from HHSC; and
(2) to support each individual's co-payment
as calculated by the provider in accordance with §
44.501
of this subchapter (relating to Determining an Individual's Co-payment),
including documentation to support income, exclusions and deductions.
(d) Required financial records. A
provider's financial records must include:
(1) the amount of payments received from
HHSC, including:
(A) the voucher
number;
(B) the warrant
number;
(C) the date of receipt;
and
(D) any other information
necessary to trace deposits of payments received and payments made from the
payments received in the provider's accounting system;
(2) deposit slips, bank statements, cancelled
checks, and receipts;
(3) purchase
orders;
(4) invoices;
(5) journals and ledgers;
(6) time sheets, payroll, and tax
records;
(7) Internal Revenue
Service, Department of Labor, and other required governmental financial
records
(8) records of insurance
coverage, claims, and payments, including medical, liability, fire and
casualty, and workers' compensation records;
(9) equipment inventory records;
(10) records of the provider's internal
accounting procedures;
(11) a chart
of accounts, as defined by GAAP; and
(12) records of company policies.
(e) Subcontractor records. If a
provider uses a subcontractor, the provider must maintain records of the
subcontractor's activities in accordance with §
49.308 of
this title (relating to Subcontracts). The provider must maintain records to
support subcontractor claims.
(f)
Failure to maintain records. If a provider fails to maintain records in
accordance with this section, HHSC may initiate a corrective action plan and
pursue any appropriate sanction against the provider.
