Guide to dealing with subpoenas duces tecum requesting the disclosure of records held by the State Investigation Agency (SA) following the implementation of the AS`s agreement with the Secretary of Health and Social Services pursuant to Article 1864 of the Social Security Act (Article 1864 Agreement). The guidelines contained in this document are based on Article 45 C.F.R. Part 2, as amended by Article 73 FR 53148 of 15 September 2008.1 (d) The Secretary may not enter into an agreement with a State under this Article as to whether an establishment located therein is a qualified care facility unless the State complies with the requirements set out in Articles 1819(e) and 1819( (g) and the establishment of remedies under Articles 1819(h)(2)(B) and 1819 (h)(2)(C) (with respect to the introduction and application of remedies). d) make recommendations on the effective dates of contracts with suppliers and supplier approvals in accordance with § 489.13 of this chapter. (c) The Secretary shall have the power to enter into an agreement with each State under which the State or competent local body performing the certification function described in subparagraph (a) conducts a sample survey (or if the Secretary determines that an investigation is appropriate because of material allegations of the existence of one or more significant deficiencies), B. if it is found that they exist, are harmful to the health and safety of patients), providers treated in accordance with Article 1865(a)(1) as meeting the conditions or requirements of this Title. The secretary shall pay for those services in the manner prescribed in clause (b). (b) The Secretary shall pay in advance to each such State, as reimbursement, the amounts provided for in the agreement with the Secretary (and may make adjustments as a result of previous overpayments or insufficient payments), reasonable costs related to the performance of the tasks referred to in subparagraph (a) and the appropriate share of the costs of the Federal Special Hospital Insurance Fund; resulting from planning and other coordination efforts, activities in the implementation of their agreement and other activities related to the provision of services similar to those for which payment may be made under Part A or relating to facilities and personnel necessary for the provision of those services or related to the improvement of the quality of those services. Article 1864. [42 U.S.C. To the extent deemed appropriate by the Secretary, an institution or body that certifies such a state (or local) agency, a hospital, a qualified care facility, a rural health clinic, a comprehensive ambulatory rehabilitation facility, a home health agency, or a palliative care program (as those terms are defined in section 1861) may be treated as such by the Secretary. Any state agency that has entered into such an agreement may (subject to the approval of the Secretary) provide such specialized advisory services (which such agency may and will provide to a qualified care facility at the appropriate request of that facility) (which that agency may and will provide satisfactorily to the Secretary) that such agency may require to meet one or more of the conditions set out in section 1819(a). Any such service provided by a government agency is deemed to have been provided under such an agreement.

Such an agreement provides that that state or local authority shall maintain a unit responsible for investigating such complaints, which shall have enforcement powers and have access to collection and certification reports, information collected by a private accreditation body used by the Secretary under Section 1865, and consumer medical records (but only with the consent of the consumer or his or her legal representative). .