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Marketing by a covered entity or business associate to purchase/use a product/service is not a health care operation, unless the marketing/communication describes a health-related product or service that is provided by the covered entity making the communication; is for treatment of the individual; or is for the case management/care coordination of the individual. Lists exceptions for when payment for marketing communications can be considered a health care operation. Defines ?reasonable in amount?; describes what ?direct or indirect payment? can include.


An insurance institution, agent, or insurance-support organization may disclose personal or privileged information about an individual collected or received in connection with an insurance transaction to a person whose only use of the information will be in connection with the marketing of a product or service, provided: (1) no medical-record information, privileged information, or personal information relating to an individual's character, personal habits, mode of living, or general reputation is disclosed, and no classification derived from the information is disclosed; or (2) the individual has been given an opportunity to indicate that he or she does not want personal information disclosed for marketing purposes and made no indication that he or she does not want the information disclosed; and (3) the recipient agrees to only use the information in connection with the marketing of a product or service.

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