P.R. Laws tit. 26, § 9238

2019-02-20 00:00:00+00
§ 9238. Right to amend protected health information

(a) An individual who is the subject of protected health information has the right to submit a written request to the health insurance organization or issuer to amend such information to correct any inaccuracies. The individual must present attesting evidence that justifies such amendment.

(b) Not later than sixty (60) calendar days after receipt of a written request to amend protected health information, a health insurance organization or issuer may have an additional thirty (30) calendar-day term to act on such request.

Such additional period of time shall be notified to the individual before the initial term elapses explaining the reasons for the delay. The health insurance organization or issuer shall verify the accuracy of protected health information and do one of the following:

(1) Correct or amend the information in question and notify the individual of the changes, or

(2) notify the individual that the request for amendment has been denied, the reason for the denial, and that the individual may:

(A) Request that the healthcare provider or entity that created the record in question amend the record. The health insurance organization or issuer shall include the healthcare provider's name and address, or

(B) file a concise statement of what the individual believes to be the correct information and the reasons why the individual disagrees with the denial. The health insurance organization or issuer shall retain the statement filed by the individual with the protected health information.

(c) If the health insurance organization or issuer corrects or amends the protected health information as provided in this section, it shall furnish the correction or amendment to:

(1) Any healthcare service provider, contractor, or authorized person who has received the protected health information that has been corrected or amended from the health insurance organization or issuer within the preceding two (2) years;

(2) an insurance support organization whose primary source of protected health information is health insurance organizations or issuers, as long as the insurance support organization has systematically received protected health information from the health insurance organization or issuer within the preceding seven (7) years. However, the correction, amendment or deletion need not be furnished if the insurance support organization no longer maintains the protected health information that has been corrected or amended, and

(3) any person who furnished the protected health information that was amended.

(d) If the individual who is the subject of the protected health information files a statement pursuant to subsection (b)(2)(B) of this section, the health insurance organization or issuer shall:

(1) Clearly identify the matter or matters in dispute and include the statement in any subsequent disclosure of the protected health information, and

(2) Furnish the statement to the persons described in subsection (c) of this section.

History —Aug. 29, 2011, No. 194, added as § 14.080 on Aug. 23, 2012, No. 203, § 1, eff. 90 days after Aug. 23, 2012.