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MEDICAL SERVICES POLICY MANUAL,SECTION A A-100General Program Information

A 130 Disclosure of Information/Confidentiality

A-130 Disclosure of Information/Confidentiality MSManual 07/01/20 Generally, information concerning an applicant or recipient will not be released to other parties without the individual’s written consent. Upon reasonable notice to the county and during County Office hours, an applicant or recipient has the right to view copies of the information in his or her electronic case file. The applicant/recipient can only obtain copies of information that he or she provided to the County Office. Informationmay be released without an individual’s written consent to:

1. Authorizedemployees of the Agency and the Social Security Administration; 2. The individual’s attorney, legal guardian or someone with power of attorney; 3. An individual who the recipient has asked to serve as his representative AND who has supplied confidential information for the case record which helped to establish eligibility (i.e., bank statements, income verification); 4. A court of law,when the case record is subpoenaed. 5. The Federally Facilitated Health Insurance Marketplace (FFM) when the individual is determined Medicaid ineligible for specific reasons, e.g., income, in one of the Families and Individuals Eligibility groups. Confidential information should not be released over the telephone unless county workers are assured that they are talking with individuals who are entitled to the information being requested. A-131 Authorized Representatives MSManual 07/01/20 Information may be given to Authorized Representatives that have been named on the Authorized Representative form. An Authorized Representative is one or more individuals designated by an applicant/recipient to act on his/her behalf with respect to a specific Medicaid application or renewal. In the absence of a completed authorization form, the fact that a person’s name is in the authorized representative space on an application form does not necessarily mean that he or she is an authorized representative or that information should be released to him or her. If the applicant/recipient is incapacitated, if the person who completed the application has supplied information for the case record, and if the person has a need to use information in that record to act in some capacity for the benefit of the applicant/recipient, then information can be released. An authorized representative may change, i.e., the authorized representative who helped to establish original eligibility may not necessarily be the same person who will help reestablish eligibility at reevaluation.