P.R. Laws tit. 26, § 9233

2019-02-20 00:00:00+00
§ 9233. Definitions

For purposes of this chapter:

(a) Disclose.— Means to release, transfer, or otherwise divulge protected health information.

(b) Health information.— Means any information or data, whether oral or recorded, in any form or medium that:

(1) Is created or received by the health service organization or issuer.

(2) Is related to the past, present or future physical, mental or behavioral health or condition of an individual or a member of the individual's family; the provision of healthcare services to an individual or the past, present or future payment for the provision of healthcare services to an individual.

(3) Is related to the payment for the provision of healthcare services to an individual.

(4) Includes, for purposes of this Health Insurance Code, demographic, genetic, financial exploitation, or abuse information, as such term is defined in §§ 10371–10377 this title.

(c) Protected health information.— Means health information:

(1) That identifies an individual who is the subject of the information, or

(2) with respect to which there is a reasonable basis to believe that the information could be used to identify an individual.

Identifiers shall include, but not be limited to:

(A) Name or nickname of the individual, his/her family members or employers.

(B) Address, except that the information is provided in the aggregate by municipality.

(C) Any element of dates (except year) directly related to a particular person, including date of birth, admission or discharge date or date of death.

(D) Telephone number, fax number, bank account number, social security number, policy or contract number, email address, medical record number, driver's license number.

(E) Biometric identifiers.

(F) Full face photography, among others.

(d) Research.— Means the process of inquiry including, but not limited to, any of the following: the systematic development and testing of a hypothesis; and the description and analysis of processes, behaviors and physical, social, political or medical phenomena.

(e) Scientific, medical or public policy research.— Means research conducted to improve the effectiveness of diagnosis and treatment procedures or the operations of the public or private healthcare systems, the results or findings of which are intended for publication or dissemination to benefit the public in general. Provided, That the scientific, medical or public policy research excludes all activities listed in § 9240(h)(1) of this title.

(f) Unauthorized.— Means a collection, use or disclosure of protected health information made by a health insurance organization or issuer without the authorization of the subject of that protected health information or that is not in compliance with this chapter.

(g) Insurance support organization.— Means a person or entity that regularly engages in the practice of collecting information from health insurance organizations or issuers, producers or other insurance support organizations for the purpose of ratemaking or ratemaking-related functions, detecting or preventing fraud or material misrepresentation in connection with insurance underwriting or insurance claim activity. For purposes of this chapter, insurance producers, government institutions, healthcare institutions and healthcare professionals shall not be considered “insurance support organizations”.

(h) Research organization.— Means a person or organization engaged in scientific, medical or public policy research and that has an Institutional Review Board.

History —Aug. 29, 2011, No. 194, added as § 14.030 on Aug. 23, 2012, No. 203, § 1, eff. 90 days after Aug. 23, 2012.