Requirements for CER Information a. The Contractor shall, at a minimum, comply with, and require Providers to comply with, all statutory and regulatory requirements applicable to CER Information and other Enrollee medical records. In addition, the CER shall, at a minimum:
Requirements for CER Information. The Contractor shall, at a minimum, comply with, and require Providers to comply with, all statutory and regulatory requirements applicable to CER Information and other Enrollee medical records. In addition, the CER shall, at a minimum: Be maintained in a manner that is current, detailed, and organized and that permits effective patient care and quality review; Include sufficient information to identify the Enrollee, date of encounter and pertinent information which documents the Enrollee's diagnosis; Describe the appropriateness of the treatment/services, the course and results of the treatment/services; and Be consistent with current professional standards for providing the treatment/services, as well as systems for accurately documenting the following: Enrollee information; Clinical information; Clinical assessments; Treatment plans; Treatment/services provided; Contacts with Enrollees’ family, guardians, or significant others; and Treatment outcomes. The Contractor shall implement systems to ensure that the CER is: Updated in a timely manner by each Provider of care; Available and accessible 24 hours per day, seven days per week, either in its entirety or in a current summary of key clinical information, to triage and acute care Providers for Emergency Conditions and Urgent Care; and Available and accessible to specialty, long term care, and mental health and substance abuse Providers. The Contractor shall provide a copy of the CER at EOHHS’ request for the purpose of monitoring the quality of care provided by the Contractor in accordance with federal law (e.g. 42 USC 1396a(a)(30)) or for the purpose of conducting performance evaluation activities of the Contractor as described under this Contract. The Contractor shall provide such record(s) within 10 days of EOHHS’s request, provided however, that EOHHS may grant the Contractor up to 30 days from the date of EOHHS’s initial request to produce such record(s) if the Contractor specifically requests such an extension and where EOHHS reasonably determines that the need for such record(s) is not urgent and the Contractor is making best efforts to produce such record(s) in a timely fashion. Confidentiality of CER Information The Contractor must have and comply with written policies to ensure the confidentiality of CER information. Such policies must include the following: At a minimum, complying with all federal and State legal requirements as they pertain to confidentiality of Enrollee records, including, ...
