Medicare Managed Care Manual (Pub. 100-16), Ch. 18a § 100
Adequate and Sufficient Records
100 - Adequate and Sufficient Records
(Rev. 30, 09-05-03)
Cost data developed by an HCPP must be current, accurate, and in sufficient detail for
CMS to make a proper determination of the HCPP's costs. Records must be maintained
in a consistent manner from one reporting period to another. However, a proper regard
for consistency need not preclude a desirable change in accounting procedures if the
HCPP makes a full disclosure to CMS of the significant changes in advance and secures
approval for the change.
At a minimum, the following financial records/information must be maintained:
• Matters of ownership, organization, and operation of the HCPP's financial,
medical, and other record keeping systems;
• Financial statements for the current and prior three reporting periods (this will
include such things as management letter comments and access to related
workpapers);
• Federal income tax or information returns for the current and prior three reporting
periods;
• Asset acquisition documents and leases;
• Agreements, contracts, and subcontracts;
• Franchise, marketing, and management agreements;
• Schedules of charges for the HCPP's fee-for-service patients;
• Records pertaining to costs of operations;
• Amounts of income received by source and payment;
• Cash flow statements;
• Any financial reports filed with other Federal programs or state authorities; and
• Minutes from the Board of Directors' meetings taking place during the reporting
period.