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(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;
(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;
(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
Note to HTML Version:
The Alaska Administrative Code was automatically converted to HTML from a plain text format. Every effort has been made to ensure its accuracy, but neither Touch N' Go Systems nor the Law Offices of James B. Gottstein can be held responsible for any possible errors. This version of the Alaska Administrative Code is current through June, 2006.
If it is critical that the precise terms of the Alaska Administrative Code be known, it is recommended that more formal sources be consulted. Recent editions of the Alaska Administrative Journal may be obtained from the Alaska Lieutenant Governor's Office on the world wide web. If any errors are found, please e-mail Touch N' Go systems at E-mail. We hope you find this information useful. Copyright 2006. Touch N' Go Systems, Inc. All Rights Reserved.
Last modified 7/05/2006