Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 332 - MAINECARE ELIGIBILITY MANUAL › Part 1 - GENERAL INFORMATION › Section 144-332-1-2 - CONFIDENTIALITY

Current through 2024-29, July 17, 2024
The Department of Health and Human Services, in accordance
					 with Federal Regulation (
					 42 CFR
					 431.306 ) and State statutes, must maintain
					 the individual's information in a manner which will ensure that this
					 information is restricted to persons or agency representatives who are subject
					 to standards of confidentiality comparable to those of the Department.
Section 2.1
: Release of
				  Information
Information from the case record will be released under the
					 following circumstances:
I. The
				  individual has the right to review information in their case record at any
				  time. When the medical source requests that the medical information be kept
				  confidential, that information may not be reviewed by the individual.
II. All information pertaining to a decision
				  of eligibility for assistance, including medical and social data for
				  preparation of an Administrative Hearing will be made available to the
				  individual or the individual's representative. If the individual is being
				  represented by an attorney, permission to release information to the attorney
				  must be obtained in writing from the individual.
III. Financial information relating to
				  eligibility will be given to general assistance administrators if necessary for
				  making a determination of granting general assistance.
IV. Information relating to whether an
				  individual is a recipient in a particular month will be given to hospitals,
				  physicians, pharmacists, and other medical providers inquiring in order to
				  determine whether to provide their service under MaineCare. The address of the
				  individual is not to be released.
V. Information necessary for other Offices
				  within the Department to administer their programs may be given. These Offices
				  include Office of Child and Family Services (OCFS) - Child Protective Services,
				  Office of Aging and Disability Services (OADS) - Adult Protective Services,
				  Division of Support Enforcement and Recovery (DSER), Fraud Investigation and
				  Recovery Unit (FIRU), the Preventive Health Program (PHP), and the Division of
				  Administrative Hearings. Information may also be provided to other Offices
				  within DHHS if there is a written Memorandum of Understanding between OFI and
				  that Office.
VI. For those agencies
				  having a contract with the Department information may be released that is
				  needed for the agency to fulfill the terms of the contract. Agencies include
				  Home and Community Based Waiver agencies and Community Action
				  Programs.
VII. In the event of the
				  issuance of a subpoena or order from the court for the case record or for any
				  agency representative to testify concerning an applicant or recipient, the
				  Department's attorneys will call the Court's attention to the statutory
				  provisions and the regulations against disclosure of information. The decision
				  in regard to release of information will be with the presiding judge.
VIII. Pursuant to
				  42
				  CFR §
												435.1200, for Members or
				  individuals who have been determined not eligible for Medicaid, the Department
				  will transfer via secure electronic interface, the individual's electronic
				  account to other insurance affordability programs, such as the federally
				  facilitated marketplace.