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Regular Session, 2012
SENATE BILL NO. 281
BY SENATOR JOHNS
INSURANCE DEPARTMENT. Provides for confidentiality of records and reporting of
complaints against persons and entities subject to jurisdiction of the Department of
Insurance. (gov sig)
AN ACT1
To amend and reenact R.S. 22:42.1 and 43(A) and (B), relative to confidentiality of records2
in the custody of the Department of Insurance; to provide with respect to disclosure3
of categorical descriptors relative to complaints filed against all persons and entities4
subject to the jurisdiction of the department; and to provide for related matters.5
Be it enacted by the Legislature of Louisiana:6
Section 1. R.S. 22:42.1 and 43(A) and (B) are hereby amended and reenacted to read7
as follows:8
§42.1. Confidentiality of health information; exceptions9
A. Notwithstanding the provisions of Subsections B and C of this Section,10
the commissioner shall comply with the provisions of R.S. 22:43; however, no11
identifier listed in Subsection E of this Section of any of the following persons12
shall be part of the separate file, record, or report required pursuant to R.S.13
22:43 when recording information about any complaint or the compilation of14
statistical data:15
(1) The individual who is the subject of any health information, health16
information record, or the working papers, recorded information, documents,17 SB NO. 281
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or copies thereof or related thereto.1
(2) Anyone identified as, or who it is reasonable to believe is, a relative,2
employer, or household member of the individual who is described in3
Paragraph (1) of this Subsection, where the relative, employer, or household4
member is listed in any record described in Paragraph (1) of this Subsection.5
B.(1) All protected health information in the custody of the Department of6
Insurance shall be confidential and privileged, shall not be subject to disclosure7
under Title 44 of the Louisiana Revised Statutes of 1950, and shall not be subject to8
subpoena. Confidentiality and privilege shall be strictly maintained by the9
commissioner of insurance and all employees of the department, except as provided10
in Subsection B of this Section, and the protected health information shall be used11
exclusively for the purpose of discharging the duties and responsibilities of the12
department under this Title. No part of any health information, health13
information record, or the working papers, recorded information, documents,14
or copies thereof or related thereto, produced by, obtained by, or disclosed to15
the commissioner, or any other person, and in the custody of the commissioner16
shall be disclosed under Title 44 of the Louisiana Revised Statutes of 1950.17
(2) "Protected health Health information" as used in this Section means18
either of the following: any information in any form or medium, transmitted or19
maintained in any manner, and in the custody of the department that20
(a) Any health or medical information, documents, or records designated as21
confidential by state or federal law.22
(b) Any information, whether oral, written, electronic, visual, or in any other23
form, including demographic information collected from an individual, that is in the24
department's possession which does both of the following:25
(i) Relates relates to the past, present, or future physical or mental health or26
condition of an individual, the provision of health care, including medications and27
prescriptions, to an individual, or the past, present, or future payment for the28
provision of health care, including medications and prescriptions, to an individual.29 SB NO. 281
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(ii) Reveals the identity of the individual whose health care is the subject of1
the information, or there is a reasonable basis to believe the information could be2
utilized, either alone or with other information that is or should reasonably be known3
to be available to predictable recipients of the information to reveal the identity of4
that individual.5
C. No records, or the working papers, recorded information, documents,6
or copies thereof or related thereto, produced by, obtained by, or disclosed to7
the commissioner, or any other person, in the course of or after the resolution8
of a complaint against any person or entity subject to the jurisdiction of the9
Department of Insurance and which are in the custody of the commissioner,10
shall be disclosed under Title 44 of the Louisiana Revised Statutes of 1950.11
BD. (1) Nothing in this Section shall prohibit the communication of facts or12
documents that are part of an individual's protected health information to the13
individual or his representative. When authorized in writing by the individual, such14
facts and documents may also be released to the party designated in the written15
authorization. health information or health information records, or copies16
thereof, in the custody of the commissioner to:17
(a) The individual who is the subject of the health information or health18
information record.19
(b) The authorized representative of the individual who is the subject of20
the health information or health information record.21
(c) A third party where written authorization is provided by the22
individual who is the subject of the health information record or by the23
authorized representative of the individual who is the subject of the health24
information or health information record.25
(2) Nothing in this Section shall prohibit the disclosure of copies of the26
complaint filed by the complainant or insured, the response by the person or27
entity subject to the jurisdiction of the department, or the final disposition to:28
(a) The complainant or insured.29 SB NO. 281
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(b) The authorized representative of the complainant or insured.1
(c) A third party where written authorization is provided by the2
complainant or insured or by the authorized representative of the complainant3
or insured.4
(23) Nothing in this Section shall prohibit the communication of facts,5
documents, or other information that is part of an individual's protected health6
information if requested by: a record described in this Section, or the working7
papers, recorded information, documents, or copies thereof or related thereto,8
produced by, obtained by, or disclosed to the commissioner, or any other person9
and in the custody of the commissioner to a federal or state or federal prosecuting10
attorney;, the office of the state police, public safety services, Department of Public11
Safety and Corrections, in the conduct of an insurance fraud investigation, a law12
enforcement agency, the office of the state inspector general;, the state legislative13
auditor;, or the attorney general of this state in connection with their statutory14
authority, or to any agency or communication district for the purpose of15
achieving coordinated and effective protection of the public health, safety, or16
welfare. The department shall also share information with any state or federal17
agency for the purpose of investigating or determining insurance or tax fraud or the18
offset of any governmental benefit or with any other government entity authorized19
by law to conduct any audit, investigation, or similar activity in connection with the20
administration of any state or federally funded program.21
(34) Nothing in this Section shall prohibit the commissioner from using22
any records or other information in the custody of the department in the23
furtherance of any regulatory or legal action brought as part of the24
commissioner's official duties communication of facts, documents, or other25
information which are part of an individual's protected health information pursuant26
to an order of a court of competent jurisdiction issued after a contradictory hearing27
based upon a finding that the records should be released in the interest of justice.28
(4) Nothing in this Section shall prevent the use of protected health29 SB NO. 281
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information for the compilation of statistical data in which the identity of the1
individual is not disclosed.2
E. The identifiers described in this Section as confidential shall be the3
following:4
(1) Names.5
(2) All geographic subdivisions smaller than a state, including street6
address, city, county or parish, precinct, zip code, and any equivalent geocodes,7
except for the initial three digits of a zip code if, according to the current8
publicly available data from the Bureau of the Census:9
(a) The geographic unit formed by combining all zip codes with the same10
three initial digits contains more than 20,000 people; and11
(b) The initial three digits of a zip code for all such geographic units12
containing 20,000 or fewer people is changed to 000.13
(3) All elements of dates, except year, for dates directly related to an14
individual, including birth date, admission date, discharge date, date of death,15
and all ages over eighty-nine and all elements of dates, including year, indicative16
of such age, except that such ages and elements may be aggregated into a single17
category of age ninety or older.18
(4) Telephone numbers.19
(5) Facsimile numbers.20
(6) Electronic mail addresses.21
(7) Social security numbers.22
(8) Medical record numbers.23
(9) Health plan beneficiary numbers.24
(10) Account numbers.25
(11) Certificate and license numbers.26
(12) Vehicle identifiers and serial numbers, including license plate27
numbers.28
(13) Device identifiers and serial numbers.29 SB NO. 281
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(14) Web Universal Resource Locators (URLs).1
(15) Internet Protocol (IP) address numbers.2
(16) Biometric identifiers, including finger- and voice prints.3
(17) Full face photographic images and any comparable images.4
(18) Any other unique identifying number, characteristic, or code.5
F. The retention period for records described in this Section shall be no6
less than three calendar years, and the records may be disposed of thereafter7
according to R.S. 44:401 et seq.8
§43. Complaints against insurers persons and entities subject to the jurisdiction9
of the Department of Insurance; file by company person or entity10
subject to jurisdiction; public information11
A. The department shall file all complaints which it receives against any12
named insurer a person or entity subject to the jurisdiction of the department in13
a separate file for each such person or entity subject to the jurisdiction of the14
department insurer. This record shall be maintained in such a manner as to permit15
the public to readily ascertain information concerning complaints against any person16
or entity subject to the jurisdiction of the department insurance companies,17
without the necessity of reviewing each individual complaint. The retention period18
for each record described in this Section shall be no less than three calendar19
years, and any record may be disposed of thereafter according to R.S. 44:40120
et seq. The commissioner shall avail himself of such computer equipment as he has21
available to perform this task.22
B.(1) The record required by this Section shall contain the following23
information including but not limited to the following:24
(a) Date of complaint.25
(b) Name of the company respondent person or entity against whom the26
complaint is lodged.27
(c) Name Category of the complainant or insured.28
(d) Category of the respondent person or entity against whom the29 SB NO. 281
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complaint is lodged.1
(de) Nature of Reason for the complaint.2
(ef) Action and findings by the department Disposition.3
(fg) Date of any such action disposition.4
(gh) The response of the insurance company respondent, person or entity5
against whom the complaint is lodged in addition to the type of coverage.6
(i) Type of coverage.7
(2) It shall be sufficient for compliance with this Section that the8
commissioner uses the same coded categorical descriptors established by the9
National Association of Insurance Commissioners (NAIC) Complaint Database10
System (CDS) for the commissioner's database fields for the following11
categorical descriptors:12
(a) Category of the complainant or insured.13
(b) Category of the respondent person or entity.14
(c) Type of coverage.15
(d) Reason for complaint.16
(e) Disposition.17
(3) Where a categorical descriptor for the category of the complainant18
or insured, category of the respondent person or entity, type of coverage, reason19
for complaint, or disposition is unique to the state of Louisiana, that unique20
categorical descriptor shall be reported, and the commissioner shall be in21
compliance with this Section when using that unique categorical descriptor.22
(4) Where the response of the person or entity against whom the23
complaint is lodged is reported, it shall be sufficient for the commissioner to24
disclose the following applicable categorical descriptors:25
(a) Respondent agreed with complainant.26
(b) Respondent disagreed with complainant.27
(c) Respondent asserted that insufficient information was provided in28
the complaint.29 SB NO. 281
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(d) No response was provided by respondent.1
(e) Respondent did not contest the complaint.2
(f) Respondent completed corrective action.3
(g) Respondent provided information.4
(h) Respondent provided an incomplete response.5
(i) Respondent appealed the disposition.6
(5) If respondent completes corrective action, the commissioner shall7
disclose the applicable categorical descriptor for the specific corrective action8
completed by reporting that categorical descriptor in the categorical descriptor9
database field for corrective actions.10
(6) If an appeal is taken, the final disposition on appeal shall be provided11
subject to any decision of the appellate tribunal.12
(27) The computer program employed by the commissioner shall, at a13
minimum, be able to sort the information in this database on any of the fields14
described in Paragraph (1) of this Subsection and print out a written report thereof15
no later than sixty days from the effective date of the Act which originated as16
Senate Bill 281 of the 2012 Regular Session of the Louisiana Legislature.17
(8) Where there was a final disposition of a complaint prior to the18
effective date of the Act which originated as Senate Bill 281 of the 2012 Regular19
Session of the Louisiana Legislature and the record of that complaint is in the20
custody of the department, it shall be sufficient for the commissioner to report21
the information required under this Section utilizing the database described in22
this Section. It shall not be necessary for those records of complaints to be23
reviewed for the purpose of applying new categorical descriptors or for new24
categorical descriptors to be applied to those complaints.25
* * *26
Section 2. This Act shall become effective upon signature by the governor or, if not27
signed by the governor, upon expiration of the time for bills to become law without signature28
by the governor, as provided by Article III, Section 18 of the Constitution of Louisiana. If29 SB NO. 281
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vetoed by the governor and subsequently approved by the legislature, this Act shall become1
effective on the day following such approval.2
The original instrument and the following digest, which constitutes no part
of the legislative instrument, were prepared by Cheryl Horne.
DIGEST
Johns (SB 281)
Proposed law prohibits identification of individuals who are the subject of health information
records in the custody of the Department of Insurance (DOI) utilizing the same list of
identifiers listed in the privacy rules for identification under the Health Insurance Portability
and Accountability Act of 1996 and any amendments thereto and the privacy rules for
identification under the Health Information Technology for Economic and Clinical Health
Act of 2009 and any amendments thereto in response to a public records request.
Proposed law provides that it is sufficient for the commissioner to report complaints against
persons and entities under the jurisdiction of DOI by utilizing the same National Association
of Insurance Commissioners (NAIC) Complaint Database System (CDS) categorical
descriptors and any categorical DOI descriptors unique to the state of Louisiana used by DOI
in its routine reporting to the NAIC CDS. Any other unique categorical descriptors used by
the DOI (i.e., response of the respondent) will also be provided with information about
complaints against persons and entities under the jurisdiction of DOI.
Proposed law requires complaint reporting of all persons and entities subject to jurisdiction
of DOI rather than only of insurers and companies.
Proposed law provides requirements for compliance with proposed law for complaint
reporting and the utilization of categorical descriptors established by the NAIC CDS.
Proposed law specifically adds type of coverage as a categorical descriptor for complaint
reporting under proposed law.
Proposed law provides that it is sufficient for the commissioner to report complaints against
persons and entities under the jurisdiction of the department by utilizing the NAIC CDS
categorical descriptors which DOI Information Technology Office is now equipped to utilize
and has mapped to and is pre-staged for implementation with NAIC CDS on a projected
completion date of no later than January 2013.
Proposed law includes examples of categorical descriptors for "completion of corrective
action" such as: policy reinstated, credit report reordered, corrective action plan submitted
to and approved by insurance department, surcharge removed, audit redone, company paid
claim, company reinstated policy, company or producer refunded premium, the company
allowed service as in-network or the company updated system to reflect updated CPT codes.
Proposed law provides that the retention period for records of complaints and the records
utilizing the database is no less than three calendar years.
Proposed law provides that the computer program employed by the commissioner shall, at
a minimum, be able to sort the information in this database on any of the fields described in
proposed law and print a written report no later than 60 days from the effective date of
proposed law.
Proposed law provides that where there was a final disposition of a complaint prior to the
effective date of proposed law and the record of that complaint is in the custody of the
department, it shall be sufficient for the commissioner to report the information required SB NO. 281
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under proposed law utilizing the database described in proposed law. Further provides that
it shall not be necessary for those records of complaints to be reviewed for the purpose of
applying new categorical descriptors or for new categorical descriptors to be applied to those
complaints.
Effective upon signature of the governor or lapse of time for gubernatorial action.
(Amends R.S. 22:42.1 and 43(A) and (B))
Summary of Amendments Adopted by Senate
Committee Amendments Proposed by Senate Committee on Insurance to the original
bill.
1. Makes technical changes.