Medical Records Retention in North Carolina

Medical records are the subject of both federal and state regulations, which may vary greatly. Federal Statutes Billing Records We start with the federal statute that determines the statute of limitations for Medicare (Title XVIII), Medicaid (Title XIX), and Maternal and Child Health (Title V). (42 CFR Part 1003) The Inspector General must notice his or her intent to impose a penalty, assessment or exclusion from health programs via certified mail, return receipt requested, to the respondent. This notice must be made within 6 years from the date on which the claim was presented, the request for payment was made, or the incident occurred. This means that billing records must be retained for 6 years from the time of billing. PATIENT RECORDS Hospitals are subject to the Medicare Conditions of Participation §482.24(b) Standard:  Form and Retention of Record) reads as follows: “Medical records must be retained in their original or legally reproduced form for a period of at least 5 years.” However, since the statute of limitations for civil penalties is one year longer, hospitals generally retain patient medical records for at least 6 years. HIPAA The entities that are regulated by the HIPAA Privacy Rule are referred to as “Covered Entities”. Covered entities are most health plans, healthcare providers and clearinghouses. The Privacy Rule defines the term “health plan” very broadly and among other things covers  most private health plans (group and individual), ERISA employer health plans (except those with less than 50 members and that do not utilize a third party administrator), Medicaid , Medicare and other federal and state healthcare programs. Also included are health maintenance...
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