MO HealthNet providers must retain for five years (seven years for the Nursing Home, CSTAR and Community Psychiatric Rehabilitation Programs), from the date of service, fiscal and medical records that coincide with and fully document services billed to the Missouri Medicaid program, and must furnish or make the records available for inspection or audit by the Department of Social Services, Missouri Medicaid Audit and Compliance Unit (MMAC) or its representative upon request.
Failure to furnish, reveal and retain adequate documentation for services billed to MO HealthNet may result in recovery of the payments for those services and may result in additional sanctions to the provider’s participation in the MO HealthNet program. This policy continues to apply in the event of the provider’s discontinuance as an actively participating MO HealthNet provider, change of ownership and/or management, or any other circumstance.
In addition, MMAC requests that any provider who believes their documentation in support of servicing Missouri Medicaid participants is no longer available, due to extenuating circumstances or unforeseen events, complete and submit an Attestation of Medical Record Loss or Destruction Form that can be found here:
Providers who are deactivating their MO HealthNet enrollment or changing owner/managers will be asked to inform the MMAC Provider Enrollment Unit (PEU) of the physical location of their Medicaid records, along with the name and contact information for the custodian of those records.
Any questions should be directed to MMAC at MMAC.ProviderEnrollment@dss.mo.gov