How Long Must Records Related To The Aco Be Retained

How Long Must Records Related to the ACO Be Retained?

The retention period for records related to Accountable Care Organizations (ACOs) depends on several factors, including federal and state regulations, payer contracts, and internal policies. There's no single, universally applicable timeframe. However, understanding the key considerations will help you determine the appropriate retention period for your organization.

Key Factors Influencing ACO Record Retention

Several factors significantly impact how long you must keep ACO-related records:

1. Federal and State Regulations:

• Medicare Shared Savings Program (MSSP): The Centers for Medicare & Medicaid Services (CMS) sets requirements for ACO participants under the MSSP. These requirements specify the types of records that must be maintained and, while they don't explicitly state a specific retention period, it's crucial to retain records for as long as they are relevant to audits or potential legal actions. This could easily span several years.
• Other ACO Models: If your ACO participates in other programs, like the Next Generation ACO Model or the ACO REACH Model, the requirements may vary. Check the specific program guidelines.
• State Regulations: Some states have their own regulations regarding healthcare record retention that may exceed federal requirements. It’s crucial to consult your state's specific rules and regulations.

2. Payer Contracts:

• Specific Clauses: Contracts with payers, such as Medicare Advantage plans or commercial insurers, often include stipulations about record retention. These contracts may dictate minimum retention periods, types of records to be kept, and required formats. Carefully review all relevant contracts.

3. Internal Policies:

• Risk Management: Developing a robust internal policy that accounts for potential audits, legal issues, and operational needs is crucial. Your policy should clearly outline retention periods and procedures for proper storage and disposal of records.
• Data Security: Your internal policy should also cover security measures to protect sensitive patient information in accordance with HIPAA regulations.

Best Practices for ACO Record Retention

To avoid potential legal or financial penalties, consider these best practices:

• Develop a Comprehensive Retention Policy: This policy should be detailed and easily accessible to all relevant staff members.
• Document the Rationale: Explain the reasoning behind chosen retention periods for each record type.
• Regularly Review and Update: Your policy should be reviewed and updated periodically to reflect changes in regulations, payer contracts, and organizational needs.
• Utilize a Secure Storage System: Employ secure methods for physical and electronic storage of records, ensuring compliance with HIPAA and other relevant regulations. Consider a combination of paper and electronic storage methods.
• Establish a Clear Disposal Process: Outline a clear procedure for proper disposal of records once the retention period has expired, ensuring compliance with all regulations and ethical considerations.

The Bottom Line: Consult with Legal and Compliance Experts

Given the complexity of regulations and potential ramifications of non-compliance, it is strongly recommended that you consult with legal and compliance professionals to establish a compliant and comprehensive ACO record retention policy. They can help you navigate the intricacies of federal and state laws, payer contracts, and best practices in information governance. This proactive approach minimizes risk and ensures the long-term success of your ACO.