Responsibilities of a Health Care Program Participant

A Health Care Program Participant: (1) may not disclose any address other than the applicable designated address to any state or local agency, including the Registry of Motor Vehicles; must notify the Program in writing of a change in the Health Care Program Participant's contact information, at least seven days in advance, or immediately thereafter if such change is necessitated by an emergency or other unforeseen event; must return the identification card to the Program immediately upon withdrawal or cancellation of participation in the Program; and must promptly disclose in writing to the Program any civil, criminal or administrative proceeding in which Participant is a witness or party and any court order including, but not limited to, divorce proceedings, child support, child custody and visitation orders.