AGENCY: Department of Health and Human Services. Healthcare Administration. Division of Integrated Healthcare

SERIES: 22565
TITLE: Medicaid client transportation requests
DATES: 1990-
ARRANGEMENT: Alphabetical by name

DESCRIPTION: This record series documents requests from Medicaid clients for transportation to health care providers for medical needs. Information includes name of Medicaid client, date of transport to health care provider, type of treatment received, vehicle used, location of treatment, and Medicaid authorization. These records can include personally identifiable information or protected health information.

Privacy annotation:

List of personal data included: member name, ID, address.

Purpose personal data is collected, maintained, or used: used for medical transportation requests.

Legal authority for collecting, keeping, or using personal data: Medicaid state plan 3.1-D.

RETENTION

Retain for 8 year(s)

DISPOSITION

Destroy.

RETENTION AND DISPOSITION AUTHORIZATION

Retention and disposition for this series were specifically approved by the State Records Committee.

APPROVED: 04/2000

FORMAT MANAGEMENT

Paper: Retain in Office for 1 year and then transfer to State Records Center. Retain in State Records Center for 7 years and then destroy.

Computer data files: Retain in Office for 8 years and then delete.

APPRAISAL

Administrative

PRIMARY DESIGNATION

Private. Utah Code 63G-2-302(1)(a) and (b) (2025)