Iowa Code 228.7 – Disclosures for claims administration and peer review — safeguards — penalty
Current as of: 2024 | Check for updates
|
Other versions
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.
Attorney's Note
Under the Iowa Code, punishments for crimes depend on the classification. In the case of this section:| Class | Prison | Fine |
|---|---|---|
| Serious misdemeanor | up to 1 year | between $430 and $2,560 |
Terms Used In Iowa Code 228.7
- Data collector: means a person, other than a mental health professional or an employee of or agent for a mental health facility, who regularly assembles or evaluates mental health information. See Iowa Code 228.1
- Mental health facility: means a community mental health center, hospital, clinic, office, health care facility, infirmary, or similar place in which professional services are provided. See Iowa Code 228.1
- Mental health information: means oral, written, or recorded information which indicates the identity of an individual receiving professional services and which relates to the diagnosis, course, or treatment of the individual's mental or emotional condition. See Iowa Code 228.1
- Mental health professional: means an individual who has either of the following qualifications:a. See Iowa Code 228.1
- Peer review organization: means a utilization and quality control peer review organization that has a contract with the federal secretary of health and human services pursuant to Tit. See Iowa Code 228.1
- person: means individual, corporation, limited liability company, government or governmental subdivision or agency, business trust, estate, trust, partnership or association, or any other legal entity. See Iowa Code 4.1
- Self-insured employer: means a person which provides accident and health benefits or medical, surgical, or hospital benefits on a self-insured basis to its own employees or to employees of an affiliated company or companies and which does not otherwise provide accident and health benefits or medical, surgical, or hospital benefits. See Iowa Code 228.1
- Third-party payor: means a person which provides accident and health benefits or medical, surgical, or hospital benefits, whether on an indemnity, reimbursement, service, or prepaid basis, including but not limited to, insurers, nonprofit health service corporations, health maintenance organizations, governmental agencies, and self-insured employers. See Iowa Code 228.1
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.