Revision 21-4; Effective December 1, 2021
Staff must make reasonable efforts to limit the use or disclosure of individually identifiable health information to determine eligibility and operate the program. Disclosure of medical information from HHSC records must be minimal to achieve the requested disclosure. For example, If a person authorizes release of income verification, including disability income, do not release related case medical information unless specifically authorized by the person.
Case information may be released to Medicaid providers to help in providing services and filing claims for payment.
Only release case information, such as personal information or addresses, to a person who has written permission from the applicant or recipient to get the information.
You must have the applicant’s or recipient’s consent to respond to inquiries from their relatives or friends requesting addresses or personal information. Inform the applicant or recipient of any inquiries. Allow the applicant or recipient to decide if they wish to share the information before providing the information to the inquiring party.
The applicant or recipient authorizes the release of information by completing and signing:
- Form H1003, Appointment of an Authorized Representative;
- Form H1826, Case Information Release; or
- A document containing all following information:
- the case name and case number, or full name, including middle initial, and either their date of birth or Social Security number;
- a description of the information to be released. If a general release is authorized, provide the information that can be disclosed to the person. Withhold confidential information from the case record, such as names of people who disclosed information about the household without the household's knowledge, and the nature of pending criminal prosecution;
- a statement specifically authorizing HHSC to release the information;
- the name of the person or entity to whom the information will be released;
- the purpose of the release;
- an event that triggers an expiration of the authorization, or an expiration date of the release;
- a statement about whether refusal to sign the release affects eligibility for or delivery of services;
- a statement describing the person's right to revoke the authorization to release information;
- the date the document is signed; and
- the signature of the person or Authorized Representative (AR).
If the case information released includes individually identifiable health information, the document must clearly indicate the applicant or recipient understands any information released may not be private and may be released again by the person receiving the information.
When information is requested from the case records of a deceased person, protect the privacy of the deceased person. Follow policy to determine who can act for the deceased person about individually identifiable health information.
Do not include Form H1826 or other information release authorization documents in application packets.
The HHSC Office of the Chief Counsel handles questions about the release of information under the Open Records Act. Refer all questions and issues encountered by people concerning release of information to the Open Records Division, Office of the General Counsel.
Follow Confidential Nature of Medical Information – HIPPA policy for restrictions on the release of a person's protected health information under the Health Insurance Portability and Accountability Act (HIPAA) privacy regulations.