Opinion ID: 3023610
Heading Depth: 3
Heading Rank: 2

Heading: Record Keeping Requirements

Text: Because the Secretary must verify the provider’s actual costs to ensure proper payment, “[i]t is hardly surprising that the reimbursement process begins with certain record keeping requirements.” Guernsey Mem’l Hosp., 514 U.S. at 94, 115 S.Ct. at 1236. To this end, the Medicare Act provides that “no such payments shall be made to any provider unless it has furnished such information 1 CMS formerly was known as the Health Care Financing Administration (“HCFA”). 3 as the Secretary may request in order to determine the amounts due such provider” for the cost period at issue. 42 U.S.C. § 1395g(a). The implementing regulations further state that “[p]roviders receiving payment on the basis of reimbursable cost must provide adequate cost data.” 42 C.F.R. § 413.24(a). According to the regulations, the data must be “accurate and in sufficient detail to accomplish the purposes for which it was intended,” and the data must be auditable. Id. at § 413.24(c).