Title 3 . Commerce, Community, and Economic Development

Chapter 26 . Miscellaneous

Section 680. Disclosure of nonpublic personal health information

3 AAC 26.680. Disclosure of nonpublic personal health information

(a) Except as provided in (b) of this section or in 3 AAC 26.695(a) , a licensee may not disclose nonpublic personal health information about a consumer unless authorization that complies with 3 AAC 26.685 is obtained from the consumer whose nonpublic personal health information the licensee seeks to disclose.

(b) A licensee may disclose a consumer's nonpublic personal health information without obtaining authorization from the consumer if the disclosure is

(1) required by federal or state law or regulation or is otherwise allowed by law;

(2) in response to an order issued by a governmental regulatory authority with jurisdiction over a licensee for examination, investigation, compliance, or other purposes authorized by law;

(3) compelled by a subpoena, search warrant, or other order issued by a court or administrative agency of competent jurisdiction;

(4) for detection, investigation, or reporting of fraud, misrepresentation, or another violation of law;

(5) for the performance of the following insurance functions by or on behalf of the licensee:

(A) claims administration;

(B) claims adjustment or management;

(C) underwriting;

(D) policy placement or issuance;

(E) loss control;

(F) rate development;

(G) guaranty fund functions;

(H) reinsurance, stop-loss insurance, or excess loss insurance;

(I) risk management;

(J) case management

(K) disease management;

(L) quality assurance or improvement;

(M) performance evaluation;

(N) verification of provider credentials;

(O) utilization review;

(P) peer review activities;

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

(R) grievance procedures;

(S) internal administration of compliance, managerial, and information systems;

(T) policyholder service functions;

(U) auditing;

(V) reporting;

(W) database security;

(X) administration of consumer disputes and inquiries;

(Y) external accreditation standards;

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

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

(6) required to enforce the licensee's rights or the rights of other licensees engaged in carrying out an insurance transaction or providing an insurance product or service that a consumer or customer requests or authorizes; or

(7) allowed without requiring authorization under 45 C.F.R. Parts 160 and 164.

History: Eff. 1/1/2005, Register 172

Authority: AS 21.06.090

AS 21.36.162