US · guidance
CMS Pub. 100-04, ch. 29, § 270.1.8
Disclosure of Individually Identifiable Beneficiary Information to an
Appointed Representative
(Rev. 2729, Issued: 06-21-13, Effective: 07-23-13, Implementation: 07-23-13)
In accordance with the provisions of the Privacy Act, before the MAC may release beneficiary-specific
information to an appointed representative, the beneficiary or appellant must complete and sign CMS-1696,
or other conforming written instrument, naming that individual as his/her representative. The MAC shall
use caution in releasing beneficiary-specific information to appointed representatives. The representative is
entitled to receive only information that the party (beneficiary or appellant) would be entitled to receive
(e.g., the determination letter) and that which is pertinent to the case/claim for which the representative is
being appointed.
For more information about the disclosure of identifiable information about beneficiaries, see the Medicare
General Information, Eligibility, and Entitlement Manual, Chapter 6: see also §300 below.
History
(Rev. 2729, Issued: 06-21-13, Effective: 07-23-13, Implementation: 07-23-13)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
03096f4a22e630f991fc9c81c5cf7864b36c184b18677022512649d318f65eee
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