NDAC 75-04-01-40
Documentation and data reporting requirements
Cite as N.D. Admin. Code ยง 75-04-01-40
1.
A licensee shall submit and retain all requisite documentation to demonstrate the right to
receive payment for all services and supports and comply with all federal and state laws,
regulations, and policies necessary to disclose the nature and extent of services provided and
all information to support claims submitted by, or on behalf of, the licensee.
2.
The department may require a licensee to submit a statement of policies and procedures, and
evidence of the implementation of the statement, in order to facilitate a determination the
licensee is in compliance with the rules of the department and with North Dakota Century
Code chapters 25-01.2 and 25-16.
3.
A licensee shall maintain program records, fiscal records, and supporting documentation,
including:
a.
Authorization from the department for each eligible individual for whom service is billed;
b.
Attendance sheets and other records documenting the days and times the eligible
individuals received the billed services from the licensee; and
c.
Records of all bills submitted to the department for payment.
4.
A licensee shall report the results of designated quality and performance indicators, as
requested by the department.
5.
A licensee shall retain a copy of the records required for six years from the date of the bill
unless an audit in process requires a longer retention.
6.
The department maintains the right to withhold a payment for services or suspend or
terminate Medicaid enrollment if the licensee has failed to abide by terms of the Medicaid
contract, federal and state laws, regulations, and policies regarding documentation or data
reporting.