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