Medicare General Information, Eligibility and Entitlement Manual (Pub. 100-01), Ch. 6 § 80
Disclosure to Third Parties for Other than Program Purposes
80 - Disclosure to Third Parties for Other than Program Purposes
(Contractors)
(Rev. 1, 09-11-02)
A. Non-medical Information
Non-medical information about an individual may be disclosed for other than a program
purpose, to persons or organizations designated by the individual, if the individual
authorizes disclosure, and if disclosure is consistent with the proper and efficient
administration of the Act.
B. Disclosure of Medical Information to a Physician, Institution, or Other Supplier of
Services
The contractor may disclose medical information to a supplier of medical services solely
for the purpose of the beneficiary's care or treatment. Such supplier will be informed that
the information is being furnished in connection with the treatment of the beneficiary and
that its use should be restricted to that purpose.
C. Disclosure to the Source of Medical Evidence
Occasionally in the course of reviewing medical evidence submitted to substantiate a
claim, contractor medical personnel may discover a medical condition of which the
source of the information is unaware. (For purposes of this section, the "source" of the
information is the part submitting the evidence.) In cases where a serious or potentially
serious condition is found, the contractor may wish to inform the source of the
information. If the source of the information indicates that the beneficiary is not
institutionalized and the identity of the beneficiary's current physician is not known, the
source should recommend that the beneficiary consult a physician or institution of the
beneficiary's choice for further treatment.
D. Disclosure to a Source of Medical Services other Than the Source of the Information
Medical information may also be disclosed, upon request, to the beneficiary's physician
or to a medial institution at which the beneficiary is or was a patient when such physician
or institution is not the source of the information. However, consent for the release must
be obtained from the beneficiary.