DHHS - Medicaid Policy Manual
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Medicaid Policy                                                                 

 

Table VIII-A - Data Retention

Effective Date:  December 1, 2017

 

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Documents are to be retained for the time frame specified in this table from the date the document was received by the agency.

 

Document Types

Retention Requirements
  • Applications

Original application for the current span of eligibility is permanent if eligibility has not been interrupted for more than 3 months.  Keep all other applications at least 5 years.

 

  • Adoption Papers

  • Assets:

-          Bankruptcy/Repossession

-          Bank Statements

-          Investments (401K/IRA/Misc.)

-          Lien Agreement

-          Other Misc. Assets

-          Property Deed

-          Vehicles

  • Bill of Sale/Sales Contract/Promissory Note/Repayment Agreement

  • Closed Case (all documents)

  • Duty of Support/Medical Support Enforcement

  • Fair Hearing

  • Handwritten Statements (in any category, except NH intent to return home)

  • Lump Sum

  • Need for Attendant (478)

  • Request for Medical Information (MI706)

  • Reviews

  • Spouse Information (48)

  • Statement of Medical Need (1049)

  • Tax Filer Information (740/741)

  • Transportation/Lodging (24)

  • Cancer Program Referral (928)

  • COBRA Health Insurance (116C)

  • Employer Health Insurance (116M)

  • Income

  • Investigations

  • Long Term Care:

-    Short Term Statement (20NH)

  • Medical Bills/Receipts

  • Payments to Business Office/Other Misc. Payments

  • Returned Mail

  • School Attendance (126)

  • SSI/SSDI Status

  • Third Party Insurance (19)
  • Targeted Adult Medicaid forms (42A, 43A and 44A)

6 Years

  • Annuities

  • Assessment of Assets (932)

  • Assessment of Assets Packet and 62NH

  • Citizenship/Alien Status

  • Court Documents

  • Funeral and Burial

  • Home and Community Based Services Referral Form (927)

  • Identity

  • Intent to Return Home (75NH or handwritten statement)

  • Life Insurance/Other Insurance (Misc.)

  • MRB Packet

  • Nursing Home Letter (72NH)

  • Other Long Term Care (Misc.)

  • Refund Request (79R)

  • Release of Information (114's)

  • Social Security Number

  • Spousal Assessment/Asset Packet

  • Trusts

Permanent