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Regular Session, 2012 ENROLLED
SENATE BILL NO. 281
BY SENATOR JOHNS
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
or copies thereof or related thereto.18
(2) Anyone identified as, or who it is reasonable to believe is, a relative,19
employer, or household member of the individual who is described in20
Paragraph (1) of this Subsection, where the relative, employer, or household21
member is listed in any record described in Paragraph (1) of this Subsection.22
B.(1) All protected health information in the custody of the Department of23
Insurance shall be confidential and privileged, shall not be subject to disclosure24
under Title 44 of the Louisiana Revised Statutes of 1950, and shall not be subject to25
subpoena. Confidentiality and privilege shall be strictly maintained by the26
commissioner of insurance and all employees of the department, except as provided27
ACT No. 642 SB NO. 281 ENROLLED
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in Subsection B of this Section, and the protected health information shall be used1
exclusively for the purpose of discharging the duties and responsibilities of the2
department under this Title. No part of any health information, health3
information record, or the working papers, recorded information, documents,4
or copies thereof or related thereto, produced by, obtained by, or disclosed to5
the commissioner, or any other person, and in the custody of the commissioner6
shall be disclosed under Title 44 of the Louisiana Revised Statutes of 1950.7
(2) "Protected health Health information" as used in this Section means8
either of the following: any information in any form or medium, transmitted or9
maintained in any manner, and in the custody of the department that10
(a) Any health or medical information, documents, or records designated as11
confidential by state or federal law.12
(b) Any information, whether oral, written, electronic, visual, or in any other13
form, including demographic information collected from an individual, that is in the14
department's possession which does both of the following:15
(i) Relates relates to the past, present, or future physical or mental health or16
condition of an individual, the provision of health care, including medications and17
prescriptions, to an individual, or the past, present, or future payment for the18
provision of health care, including medications and prescriptions, to an individual.19
(ii) Reveals the identity of the individual whose health care is the subject of20
the information, or there is a reasonable basis to believe the information could be21
utilized, either alone or with other information that is or should reasonably be known22
to be available to predictable recipients of the information to reveal the identity of23
that individual.24
C. No records, or the working papers, recorded information, documents,25
or copies thereof or related thereto, produced by, obtained by, or disclosed to26
the commissioner, or any other person, in the course of or after the resolution27
of a complaint against any person or entity subject to the jurisdiction of the28
Department of Insurance and which are in the custody of the commissioner,29
shall be disclosed under Title 44 of the Louisiana Revised Statutes of 1950.30 SB NO. 281 ENROLLED
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BD. (1) Nothing in this Section shall prohibit the communication of facts or1
documents that are part of an individual's protected health information to the2
individual or his representative. When authorized in writing by the individual, such3
facts and documents may also be released to the party designated in the written4
authorization. health information or health information records, or copies5
thereof, in the custody of the commissioner to:6
(a) The individual who is the subject of the health information or health7
information record.8
(b) The authorized representative of the individual who is the subject of9
the health information or health information record.10
(c) A third party when written authorization is provided by the11
individual who is the subject of the health information record or by the12
authorized representative of the individual who is the subject of the health13
information or health information record.14
(2) Nothing in this Section shall prohibit the disclosure of copies of the15
complaint filed by the complainant or insured, the response by the person or16
entity subject to the jurisdiction of the department, or the final disposition to:17
(a) The complainant or insured.18
(b) The authorized representative of the complainant or insured.19
(c) A third party when written authorization is provided by the20
complainant or insured or by the authorized representative of the complainant21
or insured.22
(23) Nothing in this Section shall prohibit the communication of facts,23
documents, or other information that is part of an individual's protected health24
information if requested by: a record described in this Section, or the working25
papers, recorded information, documents, or copies thereof or related thereto,26
produced by, obtained by, or disclosed to the commissioner, or any other person27
and in the custody of the commissioner to a federal or state or federal prosecuting28
attorney;, the office of the state police, public safety services, Department of Public29
Safety and Corrections, in the conduct of an insurance fraud investigation, a law30 SB NO. 281 ENROLLED
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enforcement agency, the office of the state inspector general;, the state legislative1
auditor;, or the attorney general of this state in connection with their statutory2
authority, or to any agency or communication district for the purpose of3
achieving coordinated and effective protection of the public health, safety, or4
welfare. The department shall also share information with any state or federal5
agency for the purpose of investigating or determining insurance or tax fraud or the6
offset of any governmental benefit or with any other government entity authorized7
by law to conduct any audit, investigation, or similar activity in connection with the8
administration of any state or federally funded program.9
(34) Nothing in this Section shall prohibit the commissioner from using10
any records or other information in the custody of the department in the11
furtherance of any regulatory or legal action brought as part of the12
commissioner's official duties communication of facts, documents, or other13
information which are part of an individual's protected health information pursuant14
to an order of a court of competent jurisdiction issued after a contradictory hearing15
based upon a finding that the records should be released in the interest of justice.16
(4) Nothing in this Section shall prevent the use of protected health17
information for the compilation of statistical data in which the identity of the18
individual is not disclosed.19
E. The identifiers described in this Section as confidential shall be the20
following:21
(1) Names.22
(2) All geographic subdivisions smaller than a state, including street23
address, city, county or parish, precinct, zip code, and any equivalent geocodes,24
except for the initial three digits of a zip code if, according to the current25
publicly available data from the Bureau of the Census:26
(a) The geographic unit formed by combining all zip codes with the same27
three initial digits contains more than 20,000 people; and28
(b) The initial three digits of a zip code for all such geographic units29
containing 20,000 or fewer people is changed to 000.30 SB NO. 281 ENROLLED
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(3) All elements of dates, except year, for dates directly related to an1
individual, including birth date, admission date, discharge date, date of death,2
and all ages over eighty-nine and all elements of dates, including year, indicative3
of such age, except that such ages and elements may be aggregated into a single4
category of age ninety or older.5
(4) Telephone numbers.6
(5) Facsimile numbers.7
(6) Electronic mail addresses.8
(7) Social security numbers.9
(8) Medical record numbers.10
(9) Health plan beneficiary numbers.11
(10) Account numbers.12
(11) Certificate and license numbers.13
(12) Vehicle identifiers and serial numbers, including license plate14
numbers.15
(13) Device identifiers and serial numbers.16
(14) Web Universal Resource Locators (URLs).17
(15) Internet Protocol (IP) address numbers.18
(16) Biometric identifiers, including finger- and voice-prints.19
(17) Full face photographic images and any comparable images.20
(18) Any other unique identifying number, characteristic, or code.21
F. The retention period for records described in this Section shall be no22
less than three calendar years, and the records may be disposed of thereafter23
according to R.S. 44:401 et seq.24
§43. Complaints against insurers persons and entities subject to the jurisdiction25
of the Department of Insurance; file by company person or entity26
subject to jurisdiction; public information27
A. The department shall file all complaints which it receives against any28
named insurer a person or entity subject to the jurisdiction of the department in29
a separate file for each such person or entity subject to the jurisdiction of the30 SB NO. 281 ENROLLED
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department insurer. This record shall be maintained in such a manner as to permit1
the public to readily ascertain information concerning complaints against any person2
or entity subject to the jurisdiction of the department insurance companies,3
without the necessity of reviewing each individual complaint. The retention period4
for each record described in this Section shall be no less than three calendar5
years, and any record may be disposed of thereafter according to R.S. 44:4016
et seq. The commissioner shall avail himself of such computer equipment as he has7
available to perform this task.8
B.(1) The record required by this Section shall contain the following9
information including but not limited to the following:10
(a) Date of complaint.11
(b) Name of the company respondent person or entity against whom the12
complaint is lodged.13
(c) Name Category of the complainant or insured.14
(d) Category of the respondent person or entity against whom the15
complaint is lodged.16
(de) Nature of Reason for the complaint.17
(ef) Action and findings by the department Disposition.18
(fg) Date of any such action disposition.19
(gh) The response of the insurance company respondent, person or entity20
against whom the complaint is lodged in addition to the type of coverage.21
(i) Type of coverage.22
(2) It shall be sufficient for compliance with this Section that the23
commissioner uses the same coded categorical descriptors established by the24
National Association of Insurance Commissioners (NAIC) Complaint Database25
System (CDS) for the commissioner's database fields for the following26
categorical descriptors:27
(a) Category of the complainant or insured.28
(b) Category of the respondent person or entity.29
(c) Type of coverage.30 SB NO. 281 ENROLLED
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(d) Reason for complaint.1
(e) Disposition.2
(3) Where a categorical descriptor for the category of the complainant3
or insured, category of the respondent person or entity, type of coverage, reason4
for complaint, or disposition is unique to the state of Louisiana, that unique5
categorical descriptor shall be reported, and the commissioner shall be in6
compliance with this Section when using that unique categorical descriptor.7
(4) Where the response of the person or entity against whom the8
complaint is lodged is reported, it shall be sufficient for the commissioner to9
disclose the following applicable categorical descriptors:10
(a) Respondent agreed with complainant.11
(b) Respondent disagreed with complainant.12
(c) Respondent asserted that insufficient information was provided in13
the complaint.14
(d) No response was provided by respondent.15
(e) Respondent did not contest the complaint.16
(f) Respondent completed corrective action.17
(g) Respondent provided information.18
(h) Respondent provided an incomplete response.19
(i) Respondent appealed the disposition.20
(5) If respondent completes corrective action, the commissioner shall21
disclose the applicable categorical descriptor for the specific corrective action22
completed by reporting that categorical descriptor in the categorical descriptor23
database field for corrective actions.24
(6) If an appeal is taken, the final disposition on appeal shall be provided25
subject to any decision of the appellate tribunal.26
(27) The computer program employed by the commissioner shall, at a27
minimum, be able to sort the information in this the database on any of the fields28
described in Paragraph (1) of this Subsection and print out a written report thereof29
no later than sixty days from the effective date of the Act which originated as30 SB NO. 281 ENROLLED
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Senate Bill 281 of the 2012 Regular Session of the Louisiana Legislature.1
(8) Where there was a final disposition of a complaint prior to the2
effective date of the Act which originated as Senate Bill 281 of the 2012 Regular3
Session of the Louisiana Legislature and the record of that complaint is in the4
custody of the department, it shall be sufficient for the commissioner to report5
the information required under this Section utilizing the database described in6
this Section. It shall not be necessary for those records of complaints to be7
reviewed for the purpose of applying new categorical descriptors or for new8
categorical descriptors to be applied to those complaints.9
* * *10
Section 2. This Act shall become effective upon signature by the governor or, if not11
signed by the governor, upon expiration of the time for bills to become law without signature12
by the governor, as provided by Article III, Section 18 of the Constitution of Louisiana. If13
vetoed by the governor and subsequently approved by the legislature, this Act shall become14
effective on the day following such approval.15
PRESIDENT OF THE SENATE
SPEAKER OF THE HOUSE OF REPRESENTATIVES
GOVERNOR OF THE STATE OF LOUISIANA
APPROVED: