17-1702

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HAWAII ADMINISTRATIVE RULES
TITLE 17
DEPARTMENT OF HUMAN SERVICES
SUBTITLE 12 MED-QUEST DIVISION
CHAPTER 1702
CONFIDENTIALITY
§17-1702-1 	Purpose
§17-1702-2 	Definitions
§17-1702-3 	Maintenance of records
§17-1702-4 	Confidential information
§17-1702-5 	Disclosure of information to administer
the public assistance or other federal
programs
§17-1702-6 	Disclosure of information to individuals
or agencies
§17-1702-7 	Dissemination of material
§17-1702-8 	Penalty
Historical Note: 	This chapter is based substantially
upon chapter 17-1301. 	[Eff 6/29/92; R 08/01/94 	]
§17-1702-1 	Purpose. 	The purpose of this chapter
shall be to define the conditions under which the
department (DHS) may disclose information relating to
applicants and recipients of medical assistance.
[Eff 08/01/94 	] 	(Auth: 	HRS §§346-10, 346-14; 42
C.F.R. §431.301) 	(Imp: 	HRS §§346-10, 346-14; 42
C.F.R. §431.301)
§17-1702-2 	REPEALED. 	[R 09/30/13]
§17-1702-3 	Maintenance of records. 	(a) 	The
department of human services, med-QUEST division and
family and adult services division (FASD), shall keep
records to document information acquired about

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applicants and recipients in the administration of
medical assistance programs.
(b) 	This information shall:
(1) 	Substantiate the expenditure of public funds;
(2) 	Be kept in confidential records and files of
the med-QUEST division and FASD; and
(3) 	Not be subject to any other law permitting
inspection of public records.
(c) 	The applicant or recipient shall have a right
to privacy and shall be informed in writing about the
confidential nature of the information acquired, except
as noted in section 17-1702-5. 	[Eff 08/01/94 	]
(Auth: 	HRS §§346-10, 346-14) 	(Imp: 	HRS §346-10; 42
C.F.R. §431.17)
§17-1702-4 	Confidential information. 	(a) 	The
following information shall be confidential and shall
not be used or disclosed except as provided in section
17-1702-5:
(1) 	Names and addresses of applicants and
recipients, and amounts of medical assistance
provided. 	This includes prohibition against
release of information to any federal, state,
or local committee or legislative body;
(2) 	Information related to the social and
economic condition or circumstances of a
particular individual, whether or not an
applicant or recipient, including wage
information obtained from the state
department of labor or from the Social
Security Administration;
(3) 	Department's evaluation of recorded or
unrecorded information about a particular
individual, whether or not an applicant or
recipient;
(4) 	Medical, psychological, or psychiatric data,
whether or not an applicant or recipient;
(5) 	Correspondence concerning a particular
individual, whether or not an applicant or
recipient; and
(6) 	The name of the worker or unit in which the
case is or was active.
(b) 	The records of any person, including all
communication, or specific medical or epidemiological
information contained therein, that indicates that a
person has or has been tested for HIV/AIDS, shall be
strictly confidential, and shall only be released in

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accordance with HRS section 325-101, HIV/AIDS
confidentiality statute. 	[Eff 08/01/94 	] 	(Auth:
HRS §§92F-18, 346-10, 346-14, 325-101, 42 C.F.R.
§431.300) 	(Imp: 	HRS §§92F-14, 346-10, 325-101; 42
C.F.R. §431.305)
§17-1702-5 	Disclosure of information to
administer the public assistance or other federal
programs. 	(a) The use or disclosure of any of the
information specified in section 17-1702-4(a) shall be
limited to the persons or purposes stipulated in this
section and, unless otherwise stated, this excludes
inspection of the entire case record.
b) 	Disclosure for purposes directly connected
with the administration of the medical assistance
program shall be allowed:
(1) 	To an employee of the DHS and the U.S.
government in the performance of the
employee’s official duties, who shall have
access to the entire case record;
(2) 	To the extent necessary to provide services
and to determine eligibility or the amount of
medical assistance for applicants or
beneficiaries;
(3) 	To the following, who shall be subject to the
standards of confidentiality that are
comparable to those of the Medicaid agency:
(A) 	Fiscal intermediary;
(B) 	Other individuals contracted by the
Medicaid agency to provide a service;
(C) 	Medicaid providers who require
eligibility, cost share or TPL
information for billing or recovery
purposes;
(D) 	Participating health plans that require
eligibility, co-payment, or TPL
information for billing or recovery
purposes;
(E) 	Private social service agencies,
including purchase of service (POS)
providers, from which a beneficiary
receives services; and
(F) 	Agencies administering programs under
the Social Security Act under such
titles as XVI-SSI (42 U.S.C. §§1381-
1383), IV-A AFDC (42 U.S.C.
§§630-644), or XX-Social Services (42

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U.S.C. 	§1397).
(c) 	Disclosure for purposes directly connected
with any investigation, prosecution, or criminal or
civil proceedings conducted in connection with the
administration of medical assistance program shall be
permitted:
(1) 	To police departments, prosecutors' offices,
the attorney general's office, the
ombudsman's office, or any other state or
federal agency; and
(2) 	For such purposes as:
(A) 	The detection, investigation, or
prosecution of violations of applicable
state and federal laws of regulations in
connection with these programs,
including any and all aspects of theft,
fraud, deception, or overpayment;
(B) 	DHS' claims against estates of deceased
recipients, or initiation of paternity
and nonsupport actions by DHS under
Title IV-D of the Social Security Act
(42 U.S.C. §§651-662);
(C) 	Responding to requests for information
in connection with lawsuits challenging
the administration of the medical
assistance program; and
(D) 	Providing information to the ombudsman's
office investigating complaints about
the administration of the medical
assistance program.
(d) 	Disclosure may be allowed for purposes of the
administration of other federal or federally assisted
programs which provide assistance, in cash or in kind,
or services directly to individuals on the basis of
need. 	Disclosure shall be permitted for purposes of
administering programs such as:
(1) 	Social security - supplemental security
income; and
(2) 	Hawaii housing authority for the section 8
programs and the low income housing projects.
(e) 	Disclosure may be allowed for purposes of an
audit or similar activity, such as a financial review
or review of expenditure reports, conducted in
connection with the administration of the public
assistance programs by any governmental entity which is
authorized by law to conduct the audit or activity.
[Eff 	08/01/94; am 01/29/96; am 09/14/98; am 09/30/13]
(Auth: 	HRS §§92F-18, 346-10, 346-14, 325-101; 42

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C.F.R. §431.301) 	(Imp: 	HRS §§346-10, 571-84, 325-101;
42 C.F.R. §431.306)
§17-1702-6 	Disclosure of information to
individuals or agencies. 	(a) 	Disclosure to
individuals or agencies other than those specified in
section 17-1702-5 shall be allowed only when a written
authorization has been obtained from the applicant, the
recipient, or the legal guardian of the applicant or
recipient. 	The written authorization shall
specifically include the applicant's, recipient's, or
legal guardian's consent to have the information
released or the record reviewed;
(1) 	When individuals or agencies other than
applicants, recipients, or legal guardians of
applicants or recipients wish to obtain
information, or to review a department
record, the requesting party shall submit an
authorization signed and dated by the
applicant, recipient, or legal guardian of
the applicant or recipient specifying:
(A) 	The name of the individual or agency
authorized to receive the information or
to review the record, and the
individual's agency connection, if any;
(B) 	The specific information the department
is authorized to release and the purpose
for which the information is being
sought;
(C) 	Applicant or recipient's social security
number or birthdate, and address; and
(D) 	The expiration date, or expiration event
that relates to the applicant or
recipient or the purpose of the
authorization, and also specifying that
if no expiration date or expiration
event is specified the authorization
shall expire one year from the date the
authorization is signed;
(2) 	Reproduced copies of information requested
shall be provided at a cost related to the
cost of reproduction. 	When the information
is required for the purpose of presenting the
applicant's or recipient's administrative

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hearing appeal, there shall be no charge. 	In
either case, actual postage cost shall be
charged.
(b) 	Disclosure to persons directly connected with
the administration or enforcement of programs which are
required to participate in the State Income and
Eligibility Verification System (IEVS). 	Information
disclosed shall be limited to that which is required to
enable IEVS operations and shall be protected from
unauthorized disclosure.
(c) 	Disclosure to state or county law enforcement
officers of the current residence and business address
of a recipient, when the information is needed for:
(1) 	An official administrative, civil, or
criminal law enforcement purpose to identify
a recipient as a fugitive felon or parole
violator; or
(2) 	An official purpose and the department has
informed the recipient of the circumstances
in which the recipient’s address may be
released.
(d) 	The release or use of information concerning
individuals applying for or receiving medical
assistance shall be:
(1) 	Limited by the provisions of section
17-1702-5;
(2) 	Limited to the purposes for which they are
furnished;
(3) 	Subject to the standards of confidentiality
of this chapter; and
(4) 	In accordance with HRS section 325-101,
HIV/AIDS confidentiality statute.
(e) 	The case record or information shall not be
released in a judicial or administrative proceeding,
either voluntarily or in response to any subpoena
unless permitted by section 17-1702-5. 	This includes
requests or subpoenas from a governmental authority,
the courts, a law enforcement official, the ombudsman's
office, the attorney general's office, or from any
other outside source.
(f) 	Where disclosure is not permitted for the
purpose of the administration of the medical assistance
programs, the family or individual shall be informed
whenever possible of a request for information from an

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outside source, and permission shall be obtained to
meet the request. 	In an emergency situation, when the
individual's consent for the release of information
cannot be obtained, the individual shall be notified
immediately. 	[Eff 08/01/94; am 09/14/98;
am 10/21/05] 	(Auth: 	HRS §§346-10, 346-14,
325-101; 42 C.F.R. §431.300) (Imp: 	HRS §§92F-19;
346-10, 325-101; 42 C.F.R. §§431.305, 431.306,
45 C.F.R. §164.508)
§17-1702-7 	Dissemination of material. 	All
material sent or distributed to applicants,
beneficiaries, or Medicaid providers, including
material enclosed in envelopes containing checks, shall
be limited to the administration of medical assistance
programs.
(1) 	Mailing or distribution of holiday greetings,
general public announcements, partisan voting
information, and non-citizen registration
notices shall be prohibited.
(2) 	Material relating to the health and welfare
of applicants and beneficiaries, such as
announcement of free medical exams,
availability of surplus food, and consumer
protection information may be mailed or
distributed.
(3) 	The Medicaid agency shall distribute voter
registration information and registration
materials as required by the National Voter
Registration Act of 1993 (Pub. L. 103-931).
(4) 	Only the names of the persons directly
connected with the administration of the
medical assistance programs and identified in
an official capacity with the DHS shall be
contained in material sent or distributed to
applicants, beneficiaries, and providers.
[Eff 	08/01/94; am 09/30/13] 	(Auth: 	HRS
§§346-10, 346-14; 42 C.F.R. §431.300) (Imp:
HRS §§346-10, 346-14; 42 C.F.R. §431.307)
§17-1702-8 	Penalty. 	(a) 	Any person who fails to
safeguard confidential information or who violates
rules governing the confidential nature of DHS

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information may be prosecuted for a violation.
Violators shall include, but shall not be limited to:
(1) 	Any person, including any person who acquires
information through authorized inspection,
who, knowing the information to have been
acquired from the records or files of the
department, intentionally divulges the
information other than as authorized by law;
and
(2) 	A person who intentionally and knowingly aids
or abets an unauthorized person in the
inspection of the records or files.
(b) 	If the court determines that DHS acted in a
willful and intentional manner in failing to properly
maintain the case record, the provisions of section
92F-17, HRS, shall apply.
(c) 	Any person or institution who wilfully
violates any provision of the HIV/AIDS confidentiality
statute shall be penalized in accordance with HRS
section 325-102. 	[Eff 08/01/94 	] 	(Auth: 	HRS
§§92F-17, 346-10, 346-14, 325-101) 	(Imp: 	HRS
§§92F-11, 346-11, 346-14, 325-101; 42 C.F.R. §431.304)