CMS Pub. 100-01, ch. 7, § 30.10

Subject to the provisions of the Code of Federal Regulations, Title 41, Part 102 - Creation,

Maintenance and Use of Records, http://www.access.gpo.gov/nara/cfr/waisidx_05/41cfr102-

193_05.html CMS has the responsibility for the development and implementation of standards

and programs for the economical management of records under the health insurance program.

Specifically, CMS is required to provide for effective controls over the creation of records,

including the making of records containing adequate and proper documentation of the

contractor's administration and operations. Each contractor is required to establish and maintain

an active, continuing program for the economical and efficient management of the records

outlined in §30.20.

The contractor's programs must provide for:

• Effective controls over the creation, the organization, maintenance and use, and disposition

of all CMS health insurance claims and non-claims records; and

• Development and application of standards, procedures, and techniques designed to assure

the maintenance and security of records of continuing value and facilitate the disposal of

all records of temporary value.

The contractor provides for the continued analysis and improvement of record classification and

indexing systems, the use of filing equipment and supplies, and the reproduction and

transportation of records. The contractor assures that records are maintained economically and

efficiently for maximum usefulness.

The files established by the contractor, and all records and procedures documenting its programs

for controlling the creation, maintenance, and use of current records, for the selective retention of

records of continuing value, and for the disposal of noncurrent records, must be available for

periodic review by CMS.

Under no circumstances are any records identified by CMS as relating to a current investigation

or litigation/negotiation by the Office of the Inspector General or the Department of Justice,

ongoing Workers’ Compensation, set aside arrangements, or documents which prompt

suspicions of fraud and abuse of overutilization of services to be destroyed. These records must

be retained until you receive authorization from CMS.