§346-40 Maintenance and availability of records; penalty. (a) To enable another provider to determine the proper course of treatment in emergencies and in order to determine whether a provider is genuinely entitled to reimbursement and to protect the medicaid program against fraud and abuse, each provider of health care, service or supplies under the state medicaid program shall maintain, and keep for a period of three years, such records as are necessary to disclose fully the type and extent of health care, service or supplies provided to medicaid recipients. The department may identify the types of records necessary to be kept by promulgation of appropriate rules.
(b) No provider shall refuse or fail to make available at the provider's place of business or appropriate location, during normal business hours, or, if the appropriate representative agrees, at the mutual convenience of the parties, immediate access to all records required to be maintained under this section or rules promulgated hereunder and all diagnostic devices concerning or used for the provision of health care, service or supplies to a medicaid recipient to any duly authorized representative of the attorney general's office or the department of human services acting in the course and scope of the duly authorized representative's employment; such diagnostic devices may be examined and tested and such records may be retained by said duly authorized representative for a reasonable period of time for the purpose of examination, audit, copying, testing or photographing. This subsection shall supersede any other provision of the Hawaii Revised Statutes to the contrary notwithstanding.
(c) Whenever a provider without reasonable justification fails to keep adequate supporting records as required by this section or rules promulgated hereunder or fails to make them available as required by this section, the director of human services shall suspend the provider during the period of noncompliance with this section, and no payment may be made to such provider with respect to any item or service furnished by such provider during the period of suspension. A provider shall receive notice and be provided an opportunity for a hearing in compliance with regulations of the department of human services for such suspension.
(d) Wilful refusal or failure to make records available as provided in subsection (b) of this section is a misdemeanor. [L 1978, c 105, §6; gen ch 1985; am L 1987, c 339, §4]
Revision Note
Subsection designations "b", "c", and "d" substituted for "c", "d", and "e" pursuant to §23G-15.
Cross References
Medicaid fraud unit, see §28-91.
Case Notes
State has compelling interest in ensuring that medicaid program is not being defrauded. 481 F. Supp. 1028 (1979).
Structure Hawaii Revised Statutes
346. Department of Human Services
346-2 Appointment of personnel.
346-2.5 Criminal history record checks.
346-3 Compensation of employees.
346-4.5 Investigators; authority and access to records.
346-6 Appropriations; expenditures; donations.
346-7 Acceptance of grants-in-aid or outright grants.
346-7.5 Spouse and child abuse special fund.
346-10 Protection of records; divulging confidential information prohibited.
346-11 Unauthorized disclosure or inspection.
346-13 Attendance and testimony of witnesses.
346-14.5 Financial assistance advisory council; established.
346-17.4 Higher education stipends for students
346-17.5 Federal aid to children in foster care.
346-17.6 Consent to no cost emergency shelter and related services.
346-19.7 Prospective adoptive parents; standards and home studies.
346-19.8 Department standards and requirements; disability.
346-26 Prevention and treatment of conditions giving rise to need.
346-28.5 Family self-sufficiency escrow accounts; asset test exemption.
346-29 Applications for public assistance; manner, form, conditions.
346-31 Assignment of persons in need of public assistance to work on public projects.
346-32 Application of chapter 386 to persons in need of public assistance assigned to work projects.
346-33 Assistance payments inalienable.
346-35 Cancellation or revision.
346-36 Assistance payments, subject to change or repeal.
346-37 Recovery of payments and costs of medical assistance.
346-37.2 Department subrogated to rights.
346-37.3 Notice of child support debt.
346-37.4 to 346-37.6 REPEALED.
346-38 Incompetency of recipient.
346-39.5 Unclaimed financial assistance balances in electronic benefit transfer accounts.
346-40 Maintenance and availability of records; penalty.
346-41 Inspection of institutional facilities.
346-41.5 Hawaii qualified health centers.
346-42 Administrative inspections and warrants.
346-43 Penalties under other laws.
346-43.5 Medical assistance fraud; penalties.
346-44 Recovery of public assistance overpayments.
346-45 Confidentiality of court records.
346-46 Certified nurse aides; training programs and recertification.
346-48 Coverage of ground ambulance services.
346-51.5 Expenditure of temporary assistance for needy families funds.
346-52 Aged, blind, and permanently and totally disabled persons; eligibility for assistance.
346-53 Determination of amount of assistance.
346-53.2 Temporary assistance for needy families; funding and programs; public comment.
346-53.4 Reimbursement to expanded adult residential care home operators.
346-53.5 REPEALED. L 1993, c 148, §2.
346-53.6 Federally qualified health centers; rural health clinics; reimbursement.
346-53.8 Kahuku medical center.
346-53.61 Centers for Medicare and Medicaid Services approval.
346-54 Report to the legislature.
346-55.1 Visitation, custody, and support when public assistance paid.
346-57 Loans to applicants for federal supplemental security income.
346-57.5 Interim assistance reimbursement special fund.
346-59.2 Comprehensive breast and cervical cancer control program.
346-59.4 Medical assistance to other children.
346-59.5 Enforcement of contracts.
346-59.6 Medicaid overpayment recovery.
346-59.9 Psychotropic medication.
346-60 Group therapy; reimbursement for services.
346-61 Optometric services, choice.
346-65 Child abuse and neglect discretionary emergency assistance.
346-66 Psychological services.
346-68 Bridge to hope program; transitional benefits.
346-69 Welfare safety net program; department of human services.
346-70 Medical assistance for other pregnant women.
346-71 General assistance to households without minor dependents.
346-97 Criminal history record checks.
346-102 Public service employment; established.
346-103 Wages or salaries of public service employment.
346-104 Refusal to work; ineligibility for public assistance.
346-144 Application; approval; statement; return.
346-145 Transportation assistance.
346-152 Exclusions; exemptions.
346-152.5 Requirements for persons exempt pursuant to section 346-152.
346-153 Records of deficiencies and complaints; release to public
346-157 Liability insurance coverage; requirement.
346-158 No smoking in child care facilities.
346-161 License for group child care home, group child care center required.
346-162 Rules; minimum standards.
346-163 Licenses and temporary permits
346-164 Suspension and revocation of licenses and permits; reissuance.
346-165 Visitation and inspection of group child care home, group child care center.
346-171 Registration for family child care home required.
346-172 Rules for registration.
346-173 Procedure for registration.
346-174 Informing parent and legal guardian of children and general public.
346-175 Visitation and inspection of family child care home; revocation of registration.
346-176 Family child care system.
346-177 Program of incentive for registration.
346-181 Preschool open doors program.
346-182 Preschool open doors special fund.
346-183 Preschool grant program special fund; established.
346-184 Preschool open doors program; provider accreditation.
346-185 Preschool open doors; procurement exemption.
346-186 Prior early learning program information.
346-221 Purpose; construction.
346-225 Confidentiality of reports.
346-228 Action upon investigation.
346-230 Termination of services.
346-231 Order for immediate protection.
346-232 Order to show cause hearing.
346-234 Guardian ad litem; counsel.
346-235 Consolidation with guardianship proceedings.
346-237 Notice of proceedings.
346-239 Required findings concerning postponed hearings.
346-244 Admissibility of evidence.
346-246 Failure to comply with court orders.
346-247 Payment for service or treatment provided to a party.
346-248 Fiscal and service responsibility.
346-250 Immunity from liability.
346-251 Presumption of capacity.
346-261 First-To-Work; establishment; purpose.
346-301 Adoption assistance program established.
346-305 Effect on prior adoption assistance agreements.
346-352 Preauthorization exemption for certain physicians and physician assistants
346-363 Exception to liability for donors.
346-364 Contract or conveyance to the department.
346-365 Program administration.
346-367 Determination of eligibility and need.
346-370 Emergency or transitional shelter volunteers.
346-371 Annual financial audit.
346-372 Provider agency and donor cooperation are not in restraint of trade.
346-374 Homeless shelter stipends.
346-374.5 Emergency shelter; minimum requirements.
346-375 Temporary emergency shelter.
346-378 Housing first programs.
346-381 Hawaii interagency council on homelessness; establishment.
346-381.5 Governor's coordinator on homelessness.
346-393 Rights of the young adult.
346-396 Voluntary care agreement.
346-397 Provision of extended foster care services.
346-399 Notice of hearings and reviews.
346-400 Case plan; reports to be submitted by the department.
346-402 Court-appointed attorneys.
346-404 Termination of jurisdiction.
346-405 Reestablishing jurisdiction.