Reporting Lost or Damaged Records

Medicaid & Long-Term Care

What would you like to do?

What you need to know

In accordance with Nebraska Medicaid Regulations (471 NAC 3-003.02 #5, 3-002.01 #5, 2-001.03 #7), Medicaid providers are required to maintain documentation of services and to supply them upon request. Failing to supply records when requested is grounds for sanctions to be imposed against the provider (471 NAC 2-002.03(6).

Providers are encouraged to report lost or damaged records as soon as the loss or damage is known to the provider. To report lost or damaged records, providers should complete form ​MLTC-10, Lost or Damaged Records Attestation, and submit it to:

Program Integrity 

Division of Medicaid and Long-Term Care 

Department of Health & Human Services

Mailing Address
P.O. Box 95026, Lincoln, Nebraska 68509-5026