111-3 Releasing Information to Others

Effective:  April 1, 2006 - November 30, 2010

Previous Policy Reference

The Department may not release enrollee information when it is to be used for a commercial or political reason.  Income Match information may be released only to those parties who have access to it.  (See section 111-3 #4.)

1. Asking the Enrollee for Permission:  You must obtain permission from the enrollee before sharing any information about him.  There are two exceptions to this.

A.     The reason for the request is listed in 111-3 #2, AND the request is NOT for Income Match information, AND the agency making the request has comparable rules for safeguarding its records.

B.      It is an Emergency - If it is an emergency, you may release the information and then get the enrollee's permission, if the request is NOT for Income Match information, AND the agency making the request has comparable rules for safeguarding its records.

The CHIP Program Manager or his designee decides what an emergency is.  Detail the nature of the emergency in the case notes.

2. Reasons You Can Release Information

With the exception of Income Match data, you may release information about CHIP enrollees when it will be used to administer medical assistance and Federal or State needs-based programs.  This includes such reasons as:     

A.     To establish eligibility.

B.      To provide related social services.

C.     To assist in any investigation, prosecution, or criminal or civil proceeding connected with the administration of the CHIP program.

D.     To confirm eligibility information for the current month for CHIP services.

Example:  Information about a SSI recipient, spouse of an SSI recipient, or parents of an SSI recipient may be released to SSA.  DO NOT require a written request from SSA.  This is because SSA will use the information to administer the SSI program, which is needs‑based.

(See Section 111-3 #4 for the rules for release of Income Match data.)

3. To Whom You Can Release Information

The Department can release case record information to outside sources who must also safeguard their case record information on specific enrollees.

When an outside source requests safeguarded information, (other than the Social Security Administration, Dept. of Workforce Services or Office of Recovery Services), ask them how they are going to keep it confidential.  Keep their written answer in the case record.  Narrate what you did.  If they can not or will not tell you what their plan is to keep it confidential, you must not give them the information.

4. Who May Have Access to INCOME MATCH Lists

The people listed below have access to Income Match records:

A.     Enrollees may see their own Income Match data.

B.      Staff who work for the SSA.

C.     IRS staff who work with tax returns or Income Match data.  (This includes those who work with Income Match safeguards.)

D.     Staff who administer the following programs in Utah, other States or Federal agencies.  Quality Control reviews, fair hearings, program outreach and referral activities performed by Local Office and State office employees, and the pursuit of over payments are aspects of program administration.

1)     Family Employment Program (FEP)

2)     Food Stamps

3)     Medicaid

4)     Child Support Enforcement (ORS)

5)     Social Security (OASDI or SSI)

6)     Unemployment Compensation (UCB)

The staffs who work for other programs do NOT have access to Income Match records from SSA Wage Match or IRS.  This includes staffs who work exclusively with other Federal programs such as Title XX (Child Care and other) programs.

Even auditors, who can see case records, may not be approved to see some Income Match records.  They must have proof of their right to see the IRS match records.  Proof of the right to see IRS data includes being named in the IRS code list of those with access or a letter from IRS.  Call the CHIP Program Specialist, if you have any questions about someone's right to the IRS match data.

5. What Happens When Someone Requests Enrollee Information For A Reason Not Listed In 111-3 #2?

You must not release information to anyone for any reason not listed in 111-3 #2 unless the enrollee gives his permission.

If the case record gets subpoenaed by an outside source, call the CHIP Program Specialist, immediately.

The legal counsel for the Department will ask the court to disallow the information from our case records.  He will cite the Federal Social Security Act and this manual material.

6. Taxpayers

There are no provisions for taxpayers to see any information from the enrollee's records.