19 Miss. Code. R. 1-28.17 - When Authorization Required for Disclosure of Nonpublic Personal Health Information
A. A licensee shall
not disclose nonpublic personal health information about a consumer or customer
unless an authorization is obtained from the consumer or customer whose
nonpublic personal health information is sought to be disclosed.
B. Nothing in this section shall prohibit,
restrict or require an authorization for the disclosure of nonpublic personal
health information by a licensee for the performance of the following insurance
functions by or on behalf of the licensee: claims administration; claims
adjustment and management; detection, investigation or reporting of actual or
potential fraud, misrepresentation or criminal activity; underwriting; policy
placement or issuance; loss control; ratemaking and guaranty fund functions;
reinsurance and excess loss insurance; risk management; case management;
disease management; quality assurance; quality improvement; performance
evaluation; provider credentialing verification; utilization review; peer
review activities; actuarial, scientific, medical or public policy research;
grievance procedures; internal administration of compliance, managerial, and
information systems; policyholder service functions; auditing; reporting;
database security; administration of consumer disputes and inquiries; external
accreditation standards; the replacement of a group benefit plan or workers
compensation policy or program; activities in connection with a sale, merger,
transfer or exchange of all or part of a business or operating unit; any
activity that permits disclosure without authorization pursuant to the federal
Health Insurance Portability and Accountability Act privacy rules promulgated
by the U.S. Department of Health and Human Services; disclosure that is
required, or is one of the lawful or appropriate methods, to enforce the
licensee's rights or the rights of other persons engaged in carrying out a
transaction or providing a product or service that a consumer requests or
authorizes; and any activity otherwise permitted by law, required pursuant to
governmental reporting authority, or to comply with legal process. Additional
insurance functions may be added with the approval of the commissioner to the
extent they are necessary for appropriate performance of insurance functions
and are fair and reasonable to the interest of consumers.
Notes
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