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California Medicaid Plan Records Requirements – Cal. Code Regs. tit. 22 § 53861
Link to the law
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Current as of June 2015
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California’s Medicaid plan is administered through a two plan mode, where one plan is a prepaid plan awarded by competitive bidding and the other is a prepaid plan organized or designated by the county government. Each of these plans must maintain all records necessary to verify information and reports that are required by federal, state or local authorities for five (5) years. Each plan must have records available for examination by the U.S. Department of Health and Human Services, Department of Justice, or the Comptroller General. Records that must be kept include the following:
- Papers used in the preparation of reports to the government
- Reports to the Department of Health Services
- Financial records
- Medical records
- Quality assurance and improvement records
- Prescription files
Current as of June 2015
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