Ohio Code 5160.45 – Disclosure of medical assistance information
(A) As used in sections 5160.45 to 5160.481 of the Revised Code, “information” means all of the following:
Terms Used In Ohio Code 5160.45
- Another: when used to designate the owner of property which is the subject of an offense, includes not only natural persons but also every other owner of property. See Ohio Code 1.02
- Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
- Medical assistance program: means all of the following:
(1) The medicaid program;
(2) The children's health insurance program;
(3) The refugee medical assistance program;
(4) Any other program that provides medical assistance and state statutes authorize the department of medicaid to administer. See Ohio Code 5160.01
- medical assistance recipient: includes an individual applying for a medical assistance program, a former medical assistance recipient, or both. See Ohio Code 5160.01
- Person: includes an individual, corporation, business trust, estate, trust, partnership, and association. See Ohio Code 1.59
- state: means the state of Ohio. See Ohio Code 1.59
- United States: includes all the states. See Ohio Code 1.59
(1) Records, as defined in section 149.011 of the Revised Code;
(2) Any other documents in any format;
(3) Data derived from records and documents that are generated, acquired, or maintained by the department of medicaid, a county department of job and family services, or an entity performing duties on behalf of the department or a county department.
(B) Except as permitted by this section, section 5160.47, or rules authorized by section 5160.48 or 5160.481 of the Revised Code, or when required by federal law, no person or government entity shall use or disclose information regarding a medical assistance recipient for any purpose not directly connected with the administration of a medical assistance program.
(C) Both of the following shall be considered to be purposes directly connected with the administration of a medical assistance program:
(1) Treatment, payment, or other operations or activities authorized by 42 C.F.R. Chapter IV;
(2) Any administrative function or duty the department of medicaid performs alone or jointly with a federal government entity, another state government entity, or a local government entity implementing a provision of federal law.
(D) The department or a county department of job and family services may disclose information regarding a medical assistance recipient to any of the following:
(1) The recipient or the recipient’s authorized representative;
(2) The recipient’s legal guardian in accordance with division (C) of section 2111.13 of the Revised Code;
(3) The attorney of the recipient, if the department or county department has obtained authorization from the recipient or the recipient’s authorized representative or legal guardian that meets all requirements of the Health Insurance Portability and Accountability Act of 1996, 42 U.S.C. § 1320d et seq., regulations promulgated by the United States department of health and human services to implement the act, section 5160.46 of the Revised Code, and any rules authorized by section 5160.48 of the Revised Code;
(4) A health information or health records management entity that has executed with the department a business associate agreement required by 45 C.F.R 164.502(e)(2) and has been authorized by the recipient or the recipient’s authorized representative or legal guardian to receive the recipient’s electronic health records in accordance with rules authorized by section 5160.48 of the Revised Code;
(5) A court if pursuant to a written order of the court.
(E) The department may receive from county departments of job and family services information regarding any medical assistance recipient for purposes of training and verifying the accuracy of eligibility determinations for a medical assistance program. The department may assemble information received under this division into a report if the report is in a form specified by the department. Information received and assembled into a report under this division shall remain confidential and not be subject to disclosure pursuant to section 149.43 or 1347.08 of the Revised Code.
(F) The department shall notify courts in this state regarding its authority, under division (D)(5) of this section, to disclose information regarding a medical assistance recipient pursuant to a written court order.