Protected Health Information

Protected Health Information A. Protected Health Information (PHI) is information created or received by the Division of Medicaid that identifies an individual or for which there is a reasonable basis to believe an individual can be identified, is transmitted or maintained by electronic media or in any other form, with the exception of any such records held by the Division of Medicaid in its role as an employer or regarding a person who has been deceased for more than 50 years, and relates to the following: 1. The past, present, or future physical or mental health or condition of an individual, 2. The provision of health care to an individual, or 3. The past, present, or future payment for the provision of health care to an individual; B. Protected Health Information (PHI) consists of eligibility/financial and/or medical information and includes, but is not limited to, the following information: 1. Eligibility information: a) Name and address of applicants and beneficiaries, b) Social and economic conditions or circumstances, c) Evaluation of personal information such as financial status, citizenship, residence, age and other demographic characteristics, d) Information received in connection with the identification of legally liable third-party resources, e) Information received for verifying income eligibility and benefit level and f) Income information verifying income eligibility and benefit level received from the Social Security Administration, the Veteran’s Administration, State Retirement Board, or Medicare. Information provided by these agencies must be safeguarded according to the requirements of the agency that furnished the data. 2. Medical information: a) Medical data, including diagnosis and past history of disease or disability, b) Medical services provided, c) Medical status, psychobehavioral status, and functional ability, d) Results of laboratory tests, and e) Medication records.