Access to Information

Access to Information A. The beneficiary or their authorized representative may have access to information in the eligibility case record to either review the file or request copies of information from the file, in certain situations and under specified conditions as required by the Health Insurance Portability and Accountability Act (HIPAA) of 1996. The privacy restrictions for protected health information (PHI) under HIPAA are specific regarding the disclosure of information to and on behalf of a Medicaid beneficiary. Privacy policies and procedures for all disclosures and the authorization forms required prior to the release of case record information are located in the HIPAA Privacy Policies Manual and the HIPAA Privacy Procedures Manual. B. The HIPAA Privacy Procedures Manual outlines requirements for the release of information, with or without consent of the beneficiary, and the type and amount of information that is allowed to be released to or for: 1. A Medicaid beneficiary. 2. A Personal Representative of a beneficiary as defined by HIPAA. 3. A legal representative of a beneficiary. 4. A parent or guardian of a minor child. 5. Law enforcement agencies or officials. 6. Public authorities. 7. A judicial or administrative hearing. 8. Federal or state agencies. 9. Audits or compliance reviews. 10. Legislators or elected officials. 11.Providers and their contractors.