Section 132.60  Recordkeeping Requirements

a)         The CSP shall maintain records, including but not limited to the following:

1)         Clinical records;

2)         Service billing files;

3)         Organizational records, including policies and procedures;

4)         Personnel records; and

5)         All other documents required in this Part.

b)         Required records shall be retained for a period of not less than 10 calendar years from the date of service, or origin of the record, except that, if an audit is initiated within the required retention period, the records shall be retained until the audit is completed and every exception resolved.  This provision is not to be construed as a statute of limitations.

c)         Required records shall be readily available for inspection, audit and copying during normal business hours by personnel representing the CSA, the public payer, HFS, CMMS, or U.S. Department of Health and Human Services, as applicable.

d)         The compilation, storage of, and accessibility to records, including electronic records, shall be governed by written policies and procedures, in accordance with the Confidentiality Act, HIPAA, HITECH, and all other applicable State and federal laws.

e)         Clinical records and other client information, regardless of format, shall be secured from theft, loss or fire.

f)         Electronic or digital signature of records is acceptable when the CSP has established the necessary policies and procedures to:

1)         safeguard the issuance and identity of users;

2)         ensure uniqueness in issuance of signature;

3)         regularly review the usage of signature;

4)         ensure adequate safeguards within the system upon application of signature to documents; and

5)         audit users to remove unnecessary, unused, and abuses on a regular frequency.