New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 69 - AFDC-RELATED MEDICAID
Subchapter 9 - OTHER AGENCY RESPONSIBILITIES
Section 10:69-9.8 - Confidentiality of information
Universal Citation: NJ Admin Code 10:69-9.8
Current through Register Vol. 56, No. 18, September 16, 2024
(a) No member, officer, or employee of the CWA 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, including
lists;
ii. Information contained in
the application, reports of investigation, report of medical examinations,
correspondence and other records concerning the condition or circumstances of
any person from whom or about whom information is obtained, and including all
such information whether or not it is recorded; and
iii. Records of evaluation of such
information.
2. The CWA
may disclose information concerning an applicant or eligible person to persons
and agencies directly related to the administration of the AFDC-related
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 coverage;
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 AFDC-related Medicaid program.
3. The CWA 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 CWA 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 CWA 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 any
administrative hearing conducted by the Office of Administrative Law regarding
action or inaction of the CWA affecting an applicant's or eligible person's
eligibility or entitlement under the Medicaid program.
i. The CWA may release information whenever
the applicant or eligible person waives confidentiality, but only to the extent
authorized by the waiver.
ii. 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 CWA shall make a statement substantially as follows:
(1) "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."
iii. In no instance is it intended that any
officer or employee of the CWA place himself 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.
iv. Pertinent information
and records may be released in conjunction with any administrative hearing
conducted by the Office of Administrative Law regarding action or inaction of
the CWA affecting an applicant's or eligible person's eligibility or
entitlement under the NJ FamilyCare -- Children's Program.
Disclaimer: These regulations may not be the most recent version. New Jersey may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.