(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.

Source Note: The provisions of this §27.9 adopted to be effective June 30, 2013, 38 TexReg 3985