AGENCY: Department of Health. Special Care Administration
SERIES: 5996
TITLE: Provider Agreement Files
DATES: 1984-2004.
ARRANGEMENT: Alphabetical by provider name.
DESCRIPTION: This is the record that medicaid providers have agreed to abide by medicaid requirements in order to be accepted in the program. These agreements are required by 42 CFR 431.107 and other sections of the CFR. The file also includes certification of the psychologists and a record of authorized signatures. These files include a copy of the Utah Social Services Health Plan Provider Agreement, Authorized Signatures for Medicaid Claims, Request for Provider Certificate, and a copy of the provider's license. Information includes the provider's name, address, and identification number; the date the agreement was signed; the name, address, telephone number, psychology license number, medicaid provider number, education level, employer identification number, and social security number of private psychologists; the name and address of individuals authorized to sign medicaid claims; and the date that the agreement was signed.
RETENTION
DISPOSITION
RETENTION AND DISPOSITION AUTHORIZATION
Retention and disposition for this series were specifically approved by the State Records Committee.
APPROVED: 10/1986
FORMAT MANAGEMENT
Paper: Retain in Office for 9 years or until the provider ceases to provide medicaid services and then destroy.
APPRAISAL
Administrative Legal
The retention period applies to the documents in the file, not to the file as a whole. This record shows that the provider is aware of all medicaid requirements and the penalties for fraudulent actions. It also includes the identity of the individual(s) authorized to file medicaid claims. If a legal action should be iniated for fraudulent action, these documents might be necessary to support the government's position. The maximum length of time to take action in federal court for medicaid fraud is nine years. Documents over nine years old would have no legal value.
PRIMARY DESIGNATION
Private