(a) General requirements. A provider must develop and maintain records in accordance with:
(1) this chapter; and
(2) Chapter 49, Subchapter C, of this title (relating to Requirements of a Contractor).
(b) Service delivery documentation. A provider must develop and maintain service delivery records as described in this subsection.
(1) A provider must:
(2) A provider must develop and maintain records to demonstrate the provider's compliance with:
(c) Financial records. A provider must, in accordance with generally accepted accounting principles (GAAP) and HHSC requirements, document and maintain financial records:
(1) to support claims submitted to HHSC and payments received from HHSC; and
(2) to support each individual's co-payment as calculated by the provider in accordance with §44.501 of this subchapter (relating to Determining an Individual's Co-payment), including documentation to support income, exclusions and deductions.
(d) Required financial records. A provider's financial records must include:
(1) the amount of payments received from HHSC, including:
(2) deposit slips, bank statements, cancelled checks, and receipts;
(3) purchase orders;
(4) invoices;
(5) journals and ledgers;
(6) time sheets, payroll, and tax records;
(7) Internal Revenue Service, Department of Labor, and other required governmental financial records
(8) records of insurance coverage, claims, and payments, including medical, liability, fire and casualty, and workers' compensation records;
(9) equipment inventory records;
(10) records of the provider's internal accounting procedures;
(11) a chart of accounts, as defined by GAAP; and
(12) records of company policies.
(e) Subcontractor records. If a provider uses a subcontractor, the provider must maintain records of the subcontractor's activities in accordance with §49.308 of this title (relating to Subcontracts). The provider must maintain records to support subcontractor claims.
(f) Failure to maintain records. If a provider fails to maintain records in accordance with this section, HHSC may initiate a corrective action plan and pursue any appropriate sanction against the provider.
Source Note: The provisions of this §275.207 adopted to be effective October 1, 2013, 38 TexReg 6606; amended to be effective October 1, 2019, 44 TexReg 5106; transferred effective August 1, 2022, as published in the Texas Register July 8, 2022, 47 TexReg 3983