4201.558
When a utilization review agent determines a document in the custody of the agent that contains confidential patient information or confidential physician or other health care provider financial data is no longer needed, the document shall be destroyed by a method that ensures the complete destruction of the information. Added by Acts 2005, 79th Leg., […]
4201.601
If the commissioner believes that a person or entity conducting utilization review is in violation of this chapter or applicable rules, the commissioner: (1) shall notify the utilization review agent, health maintenance organization, or insurer of the alleged violation; and (2) may compel the production of documents or other information as necessary to determine whether […]
4201.602
(a) The commissioner may initiate a proceeding under this subchapter. (b) A proceeding under this chapter is a contested case for purposes of Chapter 2001, Government Code. Added by Acts 2005, 79th Leg., ch. 727, § 4, eff. April 1, 2007.
4201.554
Notwithstanding this subchapter, a utilization review agent shall provide to the commissioner on request individual medical records or other confidential information to enable the commissioner to determine compliance with this chapter. The information is confidential and privileged and is not subject to Chapter 552, Government Code, or to subpoena, except to the extent necessary to […]
4201.555
(a) If an individual submits a written request to a utilization review agent for access to recorded personal information concerning the individual, the agent shall, within 10 business days from the date the agent receives the request: (1) inform the requesting individual in writing of the nature and substance of the recorded personal information; and […]
4201.556
(a) A utilization review agent may not publish data that identifies a particular physician or other health care provider, including data in a quality review study or performance tracking data, without providing prior written notice to the physician or other provider. (b) The prohibition under this section does not apply to internal systems or reports […]
4201.557
A utilization review agent shall maintain all data concerning a patient or physician or other health care provider in a confidential manner that prevents unauthorized disclosure to a third party. Added by Acts 2005, 79th Leg., ch. 727, § 4, eff. April 1, 2007.
4201.551
(a) A utilization review agent shall preserve the confidentiality of individual medical records to the extent required by law. (b) This chapter does not authorize a utilization review agent to take any action that violates a state or federal law or regulation concerning confidentiality of patient records. Added by Acts 2005, 79th Leg., ch. 727, […]
4201.552
(a) A utilization review agent may not disclose individual medical records, personal information, or other confidential information about a patient obtained in the performance of utilization review without the patient’s prior written consent or except as otherwise required by law. (b) If the prior written consent is submitted by anyone other than the patient who […]
4201.553
A utilization review agent may provide confidential information to a third party under contract with or affiliated with the agent solely to perform or assist with utilization review. Information provided to a third party under this section remains confidential. Added by Acts 2005, 79th Leg., ch. 727, § 4, eff. April 1, 2007.