AGENCY: Department of Health. Medical Assistance Program

SERIES: 7881
TITLE: Medical excess refund file
DATES: 1985-2014.
ARRANGEMENT: None

DESCRIPTION: These are requests received from the Office of Community Operations for approval to give treatment to individuals whose income exceed the level specified for admittance into the program, yet who still need state assistance. If approved, the individual receives services if he/she pays a certain portion of the expenses. The requests include the client's name, date of the request, the client's social security number, the amount the client must pay, the period of treatment, the total cost of the treatment, the source of the household income (either the name of the employer or the name of the family member earning income), the signature of the approving officer and the date signed.

RETENTION

DISPOSITION

RETENTION AND DISPOSITION AUTHORIZATION

These records are in Archives' permanent custody.

APPROVED: 08/1986

FORMAT MANAGEMENT

Paper: Retain in Office for 1 year and then transfer to State Records Center. Retain in State Records Center for 2 years and then destroy.

APPRAISAL

Administrative Fiscal

While this record has not been audited at any time, the possibility exists that it may be in the future. Therefore, it should be kept for the maximum audit period.

PRIMARY DESIGNATION

Private

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