Medicare_Carriers_Manual / 10031 / 10031

Why This Topic Matters

Understanding the scope of permitted disclosures and interagency coordination helps organizations handle beneficiary information appropriately when Medicare data intersects with state-administered programs and other federal or state benefit systems.

Article Sections

1. Disclosure to State Agencies or to Carriers Acting for State Agencies Administering Programs Receiving Grants-in-Aid

   Introduces the overall disclosure topic and describes the kinds of state agency and carrier relationships addressed in the section.

2. A. Information That May Be Disclosed and Authorization Required

   Summarizes the types of beneficiary-related information discussed and the general authorization context for disclosures to state entities and related administrators.

3. B. Procedures for Supplying Title XVIII Information to State Agencies

   Covers the general process for providing Medicare billing and payment information to state agencies and the types of arrangements referenced for information exchange.

4. C. Disclosure to Title V and Title XIX Agencies of Information Indicating Unprofessional or Unethical Practices by Physicians and Other Practitioners

   Addresses interagency sharing of information connected to professional conduct concerns and the agencies referenced in that context.

5. D. Disclosure to Title XIX Agencies of Physician Charge Information

   Discusses the general subject of charge information sharing with Medicaid-related agencies and the background for those requests.

6. 1. General Nature of the Information Which is to be Released

   Describes the broad categories of charge-related data discussed for release and the related geographic and procedural context.

7. 2. Carrier Involvement

   Outlines the carrier’s role in receiving, evaluating, and forwarding requests for information through the channels referenced in the article.