11 CRR-NY 410.12NY-CRR

STATE COMPILATION OF CODES, RULES AND REGULATIONS OF THE STATE OF NEW YORK
TITLE 11. INSURANCE
CHAPTER XVIII. EXTERNAL APPEALS OF ADVERSE DETERMINATIONS OF HEALTH CARE PLANS
PART 410. EXTERNAL APPEALS OF ADVERSE DETERMINATIONS OF HEALTH CARE PLANS
11 CRR-NY 410.12
11 CRR-NY 410.12
410.12 Confidentiality.
(a) No health care plan may share an insured's medical and treatment records or any other confidential information, including HIV related and mental health related information, with a certified external appeal agent or a clinical peer reviewer designated by such certified external appeal agent unless the insured, or a person authorized pursuant to law to consent to health care for the insured, has signed a specific release of information for HIV, mental health and drug and alcohol abuse or otherwise appropriate release in a manner and in such form as prescribed by the superintendent and commissioner in accordance with section 2782 of the Public Health Law for confidential HIV related information and sections 33.13 and 33.16 of the Mental Hygiene Law for mental health related information and as required by any applicable Federal law or regulation.
(b) No certified external appeal agent or clinical peer reviewer designated by such certified external appeal agent shall, except as specifically authorized by an appropriate release signed by the insured or by a person authorized pursuant to law to consent to health care for the insured, divulge confidential medical and treatment information or other information obtained through the review of an external appeal to any individual or group except the certified external appeal agent to whom the appeal was assigned and, as necessary, the superintendent and commissioner.
11 CRR-NY 410.12
Current through May 31, 2021
End of Document