Recordkeeping Requirements

(A) Providers of any service covered under 130 CMR 463.000 must maintain complete records of all services rendered for each MassHealth member. All records must be kept for a minimum of six years after the date of service. Payment for maintaining the member’s record is included in the fee for doula services. Each record must contain sufficient information to document fully the nature, extent, quality, and necessity of the care furnished to the member for each date of service claimed for payment. If the documentation is not sufficient to justify the service for which payment is claimed by the provider, the MassHealth agency will not pay for the service or, if payment has been made, may consider such payment to be an overpayment subject to recovery in accordance with 130 CMR 450.000: Administrative and Billing Regulations. (B) The doula provider records must contain, at a minimum, the following: (1) MassHealth member identification, including name, date of birth, and the MassHealth member’s identification number; (2) the date, location, duration, and purpose of each perinatal visit, including a summary of doula services provided, signed by the doula; (3) the date, location, duration, and summary of doula services provided for labor and delivery support, signed by the doula; (4) upon completion of services, a summary of the services provided to the member, including any referrals made, signed by the doula; and (5) if the record or any component included therein is released for use by another party, the record must also contain a release form signed by the member. Release of the record to MassHealth for authorized use does not require the member's consent. (C) Doula providers are responsible for ensuring the privacy and security of all member information in their possession. Each doula provider must establish reasonable safeguards designed to protect the privacy and security of all member information in their possession, including doula provider records.