Provider choice needs a record, but a receipt is a proposed safeguard—not a current federal requirement. Before selecting services, document six facts: the directory version, when and how it was delivered, accessible format, lawful choice limits, time to review, and the provider selected. Then verify identifiers carefully. A National Provider Identifier identifies a provider; it does not prove licensure, credentialing, Medicaid enrollment, waiver participation, availability, or quality. Federal Medicaid rules generally protect access to qualified, willing providers, with stated exceptions. A missing receipt, directory error, or referral pattern is a reason to investigate records—not proof of steering, discrimination, retaliation, or fraud. Signing should confirm information delivery, never waive rights or block complaints. Verify each field against primary records. Read the source checklist at david-medeiros.com/provider-check.