Appropriate Submission of Authorization to Release Information Forms

This notice is to clarify and provide instructions on the appropriate processes for submitting Authorization to Release Information forms (Authorizations) to DHHS offices. This form is signed by the patient to give DHHS permission to speak with someone else about their benefits.

Some providers have been faxing Authorizations to the DHHS administrative office in error by using the fax line number that appears after clicking on the “Contact Us” link in the upper right-hand corner of any DHHS agency webpage. That link redirects the user to the contact information for the DHHS administrative office. DHHS is requesting providers cease using that fax number and instead send any required Authorization forms to the specific Office(s) requiring the Authorization. This will help ensure that the Authorization gets to the appropriate office and staff.

The Office of MaineCare Services is generally permitted to communicate with providers about the services they deliver to MaineCare members without the need for an Authorization. Other DHHS offices do not have this same permission and may ask for a client to sign a form to communicate with providers about confidential information. Providers should not submit Authorizations to MaineCare unless you are requested to do so by a specific MaineCare employee and in that circumstance, the Authorization should be sent directly to the person requesting the form through the appropriate email, fax number, or mailing address provided by that individual.    

The Authorization to Release Information form, translated into 13 languages, can be found on the DHHS Privacy and Security of Health Information webpage.

DHHS Offices that may use Authorizations:

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