Utah Admin. Code R590-206-18 - Required Authorization for Disclosure of Nonpublic Personal Health Information

(1) A licensee may not disclose nonpublic personal health information about a consumer or customer unless an authorization is obtained from the consumer or customer before the disclosure.

(2) This Section R590-206-18 does not prohibit, restrict, or require an authorization for the disclosure of nonpublic personal health information by a licensee for the performance of the following:

(a) claims administration, adjustment, or management;

(b) detecting, investigating, or reporting fraud, misrepresentation, or criminal activity;

(c) underwriting;

(d) policy placement or issuance;

(e) loss control;

(f) ratemaking or guaranty fund functions;

(g) reinsurance or excess loss insurance; (h) risk management;

(i) case management;

(j) disease management;

(k) quality assurance or quality improvement;

(l) performance evaluation;

(m) provider credentialing verification;

(n) utilization review;

(o) peer review activities;

(p) actuarial, scientific, medical, or public policy research;

(q) grievance procedures;

(r) internal administration of compliance, managerial, or information systems;

(s) policyholder service functions;

(t) auditing;

(u) reporting;

(v) database security;

(w) administration of consumer disputes and inquiries;

(x) external accreditation standards;

(y) replacement of a group benefit plan or workers compensation policy or program;

(z) activities in connection with a sale, merger, transfer, or exchange of all or part of a business or operating unit;

(aa) an activity that permits disclosure without authorization pursuant to the Health Insurance Portability and Accountability Act;

(bb) disclosure that is required to enforce a 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

(cc) an activity permitted by law, required by a governmental reporting authority, or to comply with legal process.

Notes

Utah Admin. Code R590-206-18

Amended by Utah State Bulletin Number 2017-15, effective 7/11/2017 Adopted by Utah State Bulletin Number 2023-23, effective 11/21/2023