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Medicaid/CHIP Data Requirements in Tennessee

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        Tennessee law requires providers in the TennCare (Medicaid) program to maintain adequate medical records relating to every claim for reimbursement the provider submits for at least five years.1  All TennCare providers and managed care organizations must give the inspector general’s office access to all records regularly provided to the TennCare bureau.2  The Medicaid Fraud Control Unit may access all records, information and computerized data stored by any state agency.3  All records obtained related to fraud and abuse within the Medicaid program are confidential.  All proprietary information, including reimbursement information that is provided to the TennCare bureau or the department of commerce and insurance must remain confidential.4

 

Footnotes

  • 1. Tenn. Code Ann. § 71-5-2602 (2012)
  • 2. Tenn. Code Ann. § 71-5-2515 (2012)
  • 3. Tenn. Code Ann. § 71-5-2516 (2012)
  • 4. Tenn. Code Ann. § 71-5-142 (2012)

 

Medicaid/CHIP Data Requirements in Tennessee

Subtopic Statute/Regulation Description
Medicaid/CHIP Data Requirements Tenn. Code Ann. § 71-5-142 - Requirements for Confidentiality and Disclosure of Proprietary Information Under the TennCare Program All proprietary information, including TennCare provider reimbursement information provided to the Tennessee Department of Commerce and Insurance or...
Tenn. Code Ann. § 71-5-2515 - TennCare Data Provided to the Inspector General All providers and managed care organizations under contract with TennCare must provide the Office of the Inspector General with a copy of or access...
Tenn. Code Ann. § 71-5-2516 - Requirements for records obtained related to fraud and abuse within the Medicare or the Medicaid programs Requirements for records obtained related to fraud and abuse within the Medicare or the Medicaid programs All records that are obtained in lieu of a...
Tenn. Code Ann. § 71-5-2602 - Requirements for Record Keeping Under the TennCare Program Upon submitting a claim or receiving payment under the TennCare program, all providers must maintain adequate records, including medical records,...
Click on the individual state law in the table above to see our summary of the individual law.


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