C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER C—MEDICAL ASSISTANCE PROGRAMS › PART 431—STATE ORGANIZATION AND GENERAL ADMINISTRATION › Subpart F—Safeguarding Information on Applicants and Beneficiaries

42 C.F.R. § 431.300

Basis and purpose

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(a) Section 1902(a)(7) of the Act requires that a State plan must provide safeguards that restrict the use or disclosure of information concerning applicants and beneficiaries to purposes directly connected with the administration of the plan. This subpart specifies State plan requirements, the types of information to be safeguarded, the conditions for release of safeguarded information, and restrictions on the distribution of other information.

(b) For purposes of this subpart, information concerning an applicant or beneficiary includes information on a non-applicant, as defined in § 435.4 of this subchapter.

(c) Section 1137 of the Act, which requires agencies to exchange information to verify the income and eligibility of applicants and beneficiaries (see § 435.940 through § 435.965 of this subchapter), requires State agencies to have adequate safeguards to assure that—

(1) Information exchanged by the State agencies is made available only to the extent necessary to assist in the valid administrative needs of the program receiving the information, and information received under section 6103(l)(7) of the Internal Revenue Code is exchanged only with agencies authorized to receive that information under that section of the Code; and

(2) The information is adequately stored and processed so that it is protected against unauthorized disclosure for other purposes.

(d) Section 1943 of the Act and section 1413 of the Affordable Care Act.

[51 FR 7210, Feb. 28, 1986, as amended at 77 FR 17203, Mar. 23, 2012]
Notes of Decisions
Cited in 6 cases, 1983–2010 · leading case: IMS Health Inc. v. Sorrell
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IMS Health Inc. v. Sorrell (2010) ca2 · cites it 2× “(protecting privacy of genetic information); 42 C.F.R. §§ 431.300 , 431.303 (protecting records of Medicaid patients), and thirteen states and the District of Columbia have considered or enacted bills aimed at protecting medical privacy in the very same way Vermont's statute…”
Maher v. Freedom of Information Commission (1984) conn “access to public records, exempt records, (a) Except as otherwise provided by any federal law or state statute, all records maintained or kept on file by any public agency, whether or not such records are required by any law or by any rule or regulation, shall be public records…”
Stornanti v. Commonwealth (1983) mass “” 42 C.F.R. § 431.300 (1982). Massachusetts has the identical requirement.”
Department of Health Services v. Superior Court (1991) calctapp “§ 1396a(a)(7); 42 C.F.R. § 431.300 .) Welfare and Institutions Code, section 14100.”
State Ex Rel. Dugan v. Tiktin (1992) or “…be disclosed under 42 USCA § 602(a)(9), 45 CFR § 205.50 (relating to financial assistance), 42 USCA § 1396a(7), 42 CFR §§ 431.300 to 431.307 (relating to medical funds), 42 USCA § 671(a)(8), and 45 CFR §§ 1355.21 and 1355.30(1) (relatingto funds for foster care and child…”
ASSOC. FOR RET. CITIZENS/OUACHITA v. Wilson (2008) lactapp · cites it 3× “, and related regulations, specifically 42 C.F.R. § 431.300 et seq., applicable to state plans for Medicaid.”
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