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H-151 Division of Welfare and Supportive Services DWSS PROGRAM, REVIEW, AND EVALUATION (PRE) AUDIT Medical Assistance Manual CASE RECORDS AND RETENTION 23 Oct 01 MTL 04/23 Qualified providers and hospitals may not delegate the authority to determine PE to another entity. Trained and certified staff must make the PE eligibility determinations. Third parties may assist in gathering information from applicants and assist in completion of the application paperwork, but they may not make the PE determination. Only PE certified staff will have access to the DWSS PE portal system.

H-155 CONDITIONS OF PARTICIPATION

Participating qualified providers and hospitals must meet all conditions of participation as set forth in the Division of Health Care Financing and Policy (DHCFP), Medicaid Services Manual, Chapter 100 all inclusive.

H-160 CASE RECORDS AND RETENTION (NRS 239.080, NRS 230.125)

The qualified provider or hospital must maintain case files in accordance with the State’s record retention schedule. Records must be maintained for 37 months after the PE period end date.

Note: The qualified provider or hospital is required to maintain documentation regarding the PE eligibility determination and can be maintained as paper or electronic files.

H-165 AUTHORITY

42 CFR 435.1110, 42 CFR 435.907, 42 CFR 435.1102, 42 CFR 435.1103, NRS 422.306, SSA 1915(f)(2), SSA 1915(f).