N.J. Admin. Code § 10:72-1.5

Current through Register Vol. 56, No. 21, November 4, 2024

Section 10:72-1.5 - Confidentiality of information

(a) No member, officer, or employee of the county welfare agency shall produce or disclose any confidential information to any person except as authorized below.

1. Information considered confidential includes, but is not limited to, the following:

i. Names and addresses;

ii. Medical services provided;

iii. Social and economic conditions and circumstances;

iv. County welfare agency evaluation of personal information; and

v. Medical data, including diagnosis and past history of disease or disability.

2. The county welfare agency may disclose information concerning an applicant or eligible person to persons and agencies directly related to the administration of the Medicaid program. Persons and agencies directly related to program administration are those who are properly authorized to be involved in the following:

i. The establishment of eligibility;

ii. The determination of the amount and scope of medical assistance;

iii. The provision of services for beneficiaries; and

iv. The conduct or assisting in the conduct of an investigation, prosecution, or civil or criminal proceeding related to the Medicaid program.

3. The county welfare agency may release information whenever the applicant or eligible person waives confidentiality, but only to the extent authorized by the waiver.

4. If a court issues a subpoena for a case record or any other confidential information or for any agency representative to testify concerning an applicant or eligible person, the county welfare agency shall make a statement substantially as follows:

i. "Under provisions of the Social Security Act, information concerning applicants and beneficiaries of medical assistance must be restricted to persons directly connected to the administration of such assistance. Officials of the Federal government have advised that this includes a requirement of nondisclosure of such information in response to a subpoena. If a disclosure is made of this information, either by personal testimony or by the protection of records, this is considered nonconformance with Federal requirements and may subject the State to loss of Federal financial participation in the medical assistance program."

5. In no instance is it intended that any officer or employee of the county welfare agency place him or herself in contempt of court through the refusal to follow orders of the court. In any instance of a subpoena for case record information or for agency testimony, a complete report of the disposition of the court's request shall be entered into the case record.

6. Pertinent information and records may be released in conjunction with an administrative hearing conducted by the Office of Administrative Law regarding action or inaction of the county welfare agency affecting an applicant's or eligible person's eligibility or entitlement under the Medicaid program.

N.J. Admin. Code § 10:72-1.5

Amended by R.1992 d.364, effective 9/21/1992.
See: 24 New Jersey Register 2145(a), 24 New Jersey Register 3343(a).
Stylistic change.
Amended by R.1998 d.116, effective 1/30/1998 (operative February 1, 1998; to expire July 31, 1998).
See: 30 New Jersey Register 713(a).
Adopted concurrent proposal, R.1998 d.426, effective 7/24/1998.
See: 30 New Jersey Register 713(a), 30 New Jersey Register 3034(a).
Readopted provisions of R.1998 d.116 without change.