3 Alaska Admin. Code § 26.680

Current through September 25, 2024
Section 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.

3 AAC 26.680

Eff. 1/1/2005, Register 172

In 2010 the revisor of statutes, acting under AS 01.05.031, renumbered former AS 21.36.162 as AS 21.36.510. As of Register 196 (January 2011), the regulations attorney made a conforming technical revision under AS 44.62.125(b)(6), to the authority citation that follows 3 AAC 26.680, so that the citation to former AS 21.36.162 now refers to the renumbered statute, AS 21.36.510.

Authority:AS 21.06.090

AS 21.36.510