Medicaid Policy
Medicaid Policy
No Previous Policy
Applicants and recipients have the right to receive information about their own eligibility and benefits. This right includes viewing and copying information contained in their case record. Although applicants and recipients have the right to information about their own case, the right is not absolute. Some information is of such a nature that it cannot be released to applicants or recipients. Item 2 below discusses what case information cannot be released to applicants and recipients.
What Case Information Can Be Released to Applicants and Recipients
Allow applicants and recipients to view and receive copies of information in their own case record that is not restricted under item 2 below. Authorized representatives may also view and receive a copy of case record information. Have the applicant or recipient sign a statement to allow a representative to receive information when the representative is not named on the case record as an authorized representative.
Do not allow applicants or recipients to remove case records from the eligibility worker's work area. When applicants or recipients want a copy of information from their case record, make the requested copy for them, as long as the information is not restricted under item 2 below. Do not charge the person for the first 10 pages copied. If the person wants more than10 pages copied, charge what it costs your local office to make each additional copy.
Restricted Information that Cannot Be Released to Applicants and Recipients
Some case record information is restricted. Applicants and recipients cannot view or receive copies of any restricted information in their case record. Since applicants and recipients cannot view or receive copies of restricted information, such information cannot be used to deny, reduce, or terminate benefits, or increase a spenddown or MWI premium. Finally, restricted information cannot be used at a fair hearing. See sections 113-1 and 115.