228.7 - DISCLOSURES FOR CLAIMS ADMINISTRATION AND PEER REVIEW -- SAFEGUARDS -- PENALTY.
228.7 DISCLOSURES FOR CLAIMS ADMINISTRATION AND PEER
REVIEW -- SAFEGUARDS -- PENALTY.
1. Mental health information may be disclosed, in accordance with
the prior written consent of the patient or the patient's legal
representative, by a mental health professional, data collector, or
employee or agent of a mental health professional, a data collector,
or a mental health facility to a third-party payor or to a peer
review organization if the third-party payor or the peer review
organization has filed a written statement with the commissioner of
insurance in which the filer agrees to:
a. Instruct its employees and agents to maintain the
confidentiality of mental health information and of the penalty for
unauthorized disclosure.
b. Comply with the limitations on use and disclosure of the
information specified in subsection 2 of this section.
c. Destroy the information when it is no longer needed for
the purposes specified in subsection 2 of this section.
2. a. An employee or agent of a third-party payor or of a
peer review organization shall not use mental health information or
disclose mental health information to any person, except to the
extent necessary to administer claims submitted or to be submitted
for payment to the third-party payor, to conduct a utilization and
quality control review of mental health care services provided or
proposed to be provided, to conduct an audit of claims paid, or as
otherwise authorized by law.
b. Employees of a self-insured employer, and agents of a
self-insured employer which have not filed a statement with the
commissioner of insurance pursuant to subsection 1, shall not be
granted routine or ongoing access to mental health information unless
the employees or agents have signed a statement indicating that they
are aware that the information shall not be used or disclosed except
as provided in this subsection and that they are aware of the penalty
for unauthorized disclosure.
3. An employee or agent of a third-party payor or a peer review
organization who willfully uses or discloses mental health
information in violation of subsection 2 of this section is guilty of
a serious misdemeanor, and, notwithstanding section 903.1, the
sentence for a person convicted under this subsection is a fine not
to exceed five hundred dollars in the case of a first offense, and
not to exceed five thousand dollars in the case of each subsequent
offense. Section History: Recent Form
88 Acts, ch 1226, §1; 2009 Acts, ch 41, §263
Referred to in § 228.2