Page 13

Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M01 July 2020 Subchapter Subject Page ending with Page M0110.000 GENERAL INFORMATION M0110.110 4a

Certified Application Counselors and Navigators are designated on the MA application and are deemed to have client consent to release information without an additional release of information form. The client may revoke his consent to the release of information at any time by notifying the LDSS verbally or in writing. The revocation of consent or statement is to be documented in the case record. F. Safeguarding Client Information All information associated with an applicant or recipient that could disclose the individual’s identity is confidential and shall be safeguarded. Such information includes but is not limited to: • name, address, and all types of identification numbers assigned to the client; • medical services provided to the client;

• social and economic conditions or circumstances of the client; • agency evaluation of the client's personal information;

• medical data about the client, including diagnoses and past histories of disease or disabilities;

• information received for verifying income, eligibility, and amount of medical assistance payments; • information received in connection with identification of legally liable third party resources; and • information received in connection with processing and rendering decisions of recipient appeals.