(a)  Client information from the Medicaid record may be disclosed without the consent of the client under the following circumstances:

(1)           To other employees of the county department of social services for purpose of making referrals, supervision, consultation or determination of eligibility;

(2)           To other county departments of social services when the client moves to that county and requests Medicaid;

(3)           Between the county departments of social services and the Division of Medical Assistance for purposes of supervision and reporting.

(b)  Client information may be disclosed without consent to individuals requesting approval to conduct studies of client records, provided such approval is requested in writing and the written request will specify and be approved on the basis of:

(1)           An explanation of how the findings of the study have potential for expanding knowledge and improving professional practices;

(2)           A description of how the study will be conducted and how the findings will be used;

(3)           A presentation of the individual's credentials in the area of investigation;

(4)           A description of how the individual will safeguard the information;

(5)           An assurance that no report will contain the names of individuals or other information that makes individuals identifiable.

(c)  Client information may be disclosed without consent to federal, state, or county employees for the purpose of monitoring, auditing, evaluation, or to facilitate the administration of other state and federal programs, provided that the need for the disclosure of confidential information is justifiable for the purpose and that adequate safeguards are maintained to protect the information from re-disclosure.

(d)  Client information may be disclosed without consent for purposes of complying with other state and federal statutes and regulations and court orders.

(e)  When information is released without the client's consent, the client shall be informed to the extent possible, of the disclosure.  The method of informing the client of the disclosure shall be documented in the appropriate record.


History Note:        Authority G.S. 108A-54; 108A-80; 42 C.F.R. 431.306;

Eff. September 1, 1984;

Transferred from 10A NCAC 21A .0411 Eff. May 1, 2012.