TMPPM 2010 > Volume 1, General Information > Section 8: Managed Care > PCCM > Provider Responsibilities > Medical Records Standards

   
 

8.6.13.2.2 Confidentiality of Medical Records

The relationship and all communication between physician and patient are privileged. Accordingly, the medical record containing information about the relationship is confidential.

A physician's code of ethics, as well as Texas and federal laws, protect against the disclosure of the contents of medical records to persons or agencies that are not properly authorized to receive such information.

For a provider to release the contents of a patient's medical record to a third party, the patient must first authorize the disclosure by signing and dating an authorization form. If the record is for a deceased individual, the executor of the estate must authorize the release.

PCCM's policy is to allow only medical personnel and health professionals who are directly involved in the delivery or evaluation of a patient's records to access the medical record. All requests for medical record information must be handled according to policy and law.

The client's authorization for release of such information is not required when the release is requested by and made to DADS, HHSC, DSHS, TMHP, DFPS, DARS, HHSC Office of Inspector General (OIG), the Texas Attorney General's Medicaid Fraud Control Unit (MFCU) or Antitrust and Civil Fraud Division, or HHS.

Refer to: Subsection 1.4.4, "Release of Confidential Information" in Section 1, "Provider Enrollment" (Vol. 1, General Information).


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