| (a) Federal and state laws and regulations prohibit
the disclosure of information about Medicaid clients without effective
consent by the client or on behalf of the client, except for purposes
directly connected with the administration of the Medicaid program,
as described in 42 U.S.C., §1396a(a)(7); 42 C.F.R. §§431.301
- 431.306; Human Resources Code, §12.003 and §21.012; and
Government Code, §552.101. Case management providers are not
considered directly connected with the administration of the program.
Although case management providers are not entitled to confidential
information without prior consent, they are able to verify a client's
eligibility status.
(b) Entities with which HHSC or the department contracts
to perform certain administrative functions, including contractors
for outreach, informing, and transportation services, may receive
confidential information without the client's consent, but only to
the extent necessary to perform and administer the contract. These
contracted entities are bound by the same standards of confidentiality
applicable to the Medicaid program, and they must provide effective
safeguards to ensure confidentiality.
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