Alabama Administrative Code
Title 560 - ALABAMA MEDICAID AGENCY
Chapter 560-X-20 - THIRD PARTY
Section 560-X-20-.05 - Release Of Information - All Providers
Current through Register Vol. 43, No. 02, November 27, 2024
(1) Requests for copies of recipient's medical bills, histories, and statements provide Medicaid with third party resource leads. Therefore, information that is released by providers and that pertains to the care and treatment of a Medicaid recipient must be documented and reported to Medicaid in the following manner.
(2) When a Provider receives a subpoena, they should respond immediately and send a copy of the subpoena to the Third Party Division of the Alabama Medicaid Agency, indicating the records have been released. Sending a copy of the subpoena to the Third Party Division will serve as sufficient notice of a medical record request, therefore, completing a "Notification of Request for Medical Records from Provider" form is not required.
(3) Excluded from this requirement to notify Medicaid's Third Party Division is information released to the following entities:
(4) This rule is not intended to deny release of information; however, requests for information pertaining to a recipient's charges are a source of third party information and, as such, must be reviewed by the Third Party Section. It does not permit providers to deny individuals access to their records. Providers are to ensure that all HIPAA Privacy and Security rules are met regarding an individual's "right of access to inspect and obtain a copy of protected health information about the individual."
(5) Failure on the part of the provider to meet these requirements may result in recoupment of Medicaid payment.
Author: Codie Rowland, Director, Third Party Division
Statutory Authority: Code of Ala. 1975, § 22-6-6, 42 CFR §§432, 433 and 164.524; Section 1902(a)(25), Social Security Act.