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Summary:

Under the Independent Medical Review System in the Department of Insurance, all insured grievances involving a disputed health care service are eligible for review if certain requirements are met. Application forms for independent medical review will include a statement indicating the insured's consent to obtain any necessary medical records from the insurer and any of its providers. The insurer or its contracting providers shall provide to the independent medical review organization a copy of all of the insured's medical records in their possession, a copy of all information provided to the insured by the insurer and any of its contracting providers concerning insurer and provider decisions regarding the insured's condition and care, etc. The confidentiality of any insured medical information shall be maintained pursuant to applicable state and federal laws. The insurer shall concurrently provide a copy of documents required, except for any information found by the commissioner to be legally privileged infor

Summary:

To be approved by the commissioner, all applications for disability insurance must contain clear and unambiguous questions designed to ascertain the health condition or history of the applicant. Those questions must be based on medical information that is reasonable and necessary for medical underwriting purposes. The application must also display the notice: “California law prohibits an HIV test from being required or used by health insurance companies as a condition of obtaining health insurance coverage.”

Summary:

By written request, individuals may gain access to their personal information held by an insurance institution, agent or insurance-support organization. The entities must also provide a list of entities/persons to whom this personal information was disclosed within the last two years. Medical information in the possession of insurance entities may be provided either directly to the individual or to a medical professional designated by the individual. Mental health record information shall be supplied directly to the individual, pursuant to this section, only with the approval of the qualified professional person with treatment responsibility for the condition to which the information relates.

Summary:

By written request, individuals may gain access to their personal information held by an insurance institution, agent or insurance-support organization. The entities must also provide a list of entities/persons to whom this personal information was disclosed within the last two years. Medical information in the possession of insurance entities may be provided either directly to the individual or to a medical professional designated by the individual. Mental health record information shall be supplied directly to the individual, pursuant to this section, only with the approval of the qualified professional person with treatment responsibility for the condition to which the information relates.

Summary:

Insurance institution/agent's obligation to provide individual's requested personal information (including medical information) may be satisfied by another insurance institution or agent authorized to act on its behalf; an insurance institution, agent or insurance-support organization may make arrangements with an insurance-support organization or a consumer reporting agency to copy and disclose recorded personal information on its behalf.

Summary:

Disclosure for marketing purposes of insurance related medical records is permissible as long as the subject is given an opportunity to refuse and consents with written authorization. The information's recipient must also agree to use the medical information solely for marketing purposes. Materials disclosed that include the individual's identity are to be returned or destroyed after use.

Summary:

(a) A health insurer shall take the following steps to protect the confidentiality of an insured's medical information on and after January 1, 2015: (1) A health insurer shall permit and accommodate an insured's request for medical communication in the form and format requested by the individual, if the insured clearly states either that the communication discloses medical information or provider name and address relating to receipt of sensitive services or that disclosure of all or part of the medical information or provider name and address could endanger him or her; (2) a health insurer may require the insured to make a request for a confidential communication in writing or by electronic transmission; (3) a health insurer may require that a confidential communications request contain a statement that the request pertains to either medical information related to the receipt of sensitive services or that disclosure of all or part of the medical information could endanger the insured. The health insurer shall not require an explanation as to the basis for a insured's statement that disclosure could endanger the insured; (4) the confidential communication request shall be valid until the insured submits a revocation of the request, or a new confidential communication request is submitted; (5) a confidential communications request shall be implemented by the health insurer within seven calendar days of the receipt of an electronic transmission or telephonic request or within 14 calendar days of receipt by first-class mail. The health insurer shall acknowledge receipt of the confidential communications request and advise the insured of the status of implementation of the request if an insured contacts the insurer. ... (c) A health insurer shall not condition coverage on the waiver of rights provided in this section.

Summary:

Any health practitioner who performs a forensic medical examination of a person in the custody of law enforcement from whom evidence is sought in connection with a sexual assault crime, shall prepare a written report on standard form of the Office of Emergency Services and provided to law enforcement agency with custody of the individual. The examination and report is subject to the confidentiality requirements of the Confidentiality of Medical Information Act. The report shall be released upon request, oral or written, to any person or agency involved in any related investigation or prosecution and to defense counsel through discovery.

Summary:

A domestic violence death review team may request disclosure of information such as medical information, notwithstanding the prohibitions in other laws.

Summary:

Notwithstanding the general confidentiality protections of Welf. & Inst. Code 5328, information and records shall be disclosed to the attorney for the patient in any and all proceedings upon presentation of a release of information signed by the patient; if the patient is unable to sign the release, the staff of the facility, upon satisfying itself of the identity of the attorney and that the attorney does represent the interests of the patient, may release all information and records relating to the patient.

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