1. (a) Federal and state laws and regulations prohibit the disclosure of information about a Medicaid client without effective consent by the client or the client's parent or legal guardian, except for purposes directly connected with the administration of the Medicaid program, as described in:

   1. (1) 42 U.S.C. §1396a(a)(7);
   2. (2) 42 C.F.R. §§431.301 - 431.306;
   3. (3) Texas Human Resources Code §12.003 and §21.012; and
   4. (4) Texas Government Code §552.101.
2. (b) A provider is not considered directly connected with the administration of the program. Although a provider is not entitled to confidential information without prior consent, the provider may verify a client's eligibility status.
3. (c) An entity with which HHSC contracts to perform certain administrative functions, including contractors for outreach, informing, and transportation services, may receive confidential information without a client's consent, but only to the extent necessary to perform and administer the contract. A contracted entity is bound by the same standards of confidentiality applicable to the Medicaid program, and the entity must provide effective safeguards to ensure confidentiality.

Source Note:The provisions of this §257.9 adopted to be effective May 29, 2025, 50 TexReg 3129.