Contracts set standards for release of information related to MCOs’ operations.  In some states, an MCO has a contractual right to object if information given by the MCO to the state is sought subsequently by a third party.

State Disclosure

  • All information submitted by MCO to state is considered record of state under state’s freedom of information law: New York a
  • State “may” publicly report data, reports and analysis of MCO activities: Arizona b
  • State can obtain information from MCO, but if information is confidential, state cannot distribute information to others, unless distribution is required by law. MCO cannot withhold information based on information being proprietary: Arizona c
  • State must notify MCO when state is requested to disclose confidential information relating to MCO. MCO may submit statement to state, explaining why information is confidential. MCO is responsible for state’s costs associated with nondisclosure, including but not limited to legal fees: Arizona d
  • When MCO submits information to state that MCO believes is confidential, MCO must notify state of MCO’s contention: Texas e
  • If state receives request under state’s Public Information Act for information that MCO claims is confidential, state must notify MCO. To prevent release of information, MCO must demonstrate confidential nature of documents to state’s attorney general: Texas f

MCO Disclosure

  • If MCO policies are required by state regulations, policies must be available upon request to members and their representatives for review during normal business hours: New Mexico g
  • Nothing in the state-MCO contract affects right of MCO to keep information private, including but not limited to privacy rights for proprietary information, except as otherwise required by law: New Mexico h
  • MCO and providers must make all information available for review by state and federal government agencies: Tennessee i
  • Information regarding physician incentive plans must be made available upon consumer’s request: Texas j
  • Proposals submitted by MCOs are subject to state public information act: Texas k
  1. N.Y. Medicaid Advantage Plus Contract, Sect. 18, p. 6.  (back)
  2. Ariz. Contract, pp. 76-77.  (back)
  3. Ariz. Contract, p. 111.  (back)
  4. Ariz. Contract, p. 111.  (back)
  5. Tex. Contract, p. 43.  (back)
  6. Tex. Contract, p. 43.  (back)
  7. N.M. Contract, p. 27.  (back)
  8. N.M. Contract, p. 143.  (back)
  9. Tenn. Contract, pp. 344-35.  (back)
  10. Tex. Contract, Atch. B-1, p. 8-48.  (back)
  11. Tex. Contract, p. 3-24.  (back)

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