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Private Insurance Data Requirements in Indiana

Indiana law requires that health insurance companies obtain a patient’s written consent before receiving the patient’s medical records or health information.1  Other important private insurance data requirements include the requirement that health maintenance organizations (HMOs) maintain quality assurance programs.2  The law is very specific as to the structure of the HMO quality program.  The law requires a written statement of purpose, confidentiality policies, an evaluation system, and a peer review system.3  The HMO is also required to establish a reporting protocol on its quality management activities,4 and allow access to records and quality management data to the Commissioner of Health.5

 

Footnotes

  • 1. Ind. Code §16-39-5-2
  • 2. Ind. Code §27-13-6-2
  • 3. Ind. Code §27-13-6-3
  • 4. Ind. Code §27-13-6-7
  • 5. Ind. Code §27-13-6-9

 

Private Insurance Data Requirements in Indiana

Subtopic Statute/Regulation Description
Disclosure of information held by health plan, including notice requirements Requirements for Disclosure of Patient Information to Locate or Identify a Missing Person – Ind. Code Ann.§ 16-39-10-4 A provider or health plan may disclose protected health information to a law enforcement official who requests the protected health information for...
Access to individual’s own records (Cross reference Medical Records Collection) Requirements for Patient’s Written Consent to Insurer to Obtain Records or Medical Information – Ind. Code Ann.§ 16-39-5-2 An accident and sickness insurance company may obtain health records or medical information about a patient with a written consent executed at the...
Health plan required reporting Requirements for Reporting of Quality Management Activities by Health Maintenance Organizations – Ind. Code Ann.§ 27-13-6-7 A health maintenance organization (HMO) must establish a mechanism of reporting on quality management activities. Related Laws: Ind. Code § 27-...
Requirements for the Establishment and Utilization of Patient Record Systems by Health Maintenance Organizations – Ind. Code Ann.§ 27-13-6-6 A health maintenance organization (HMO) must use a patient record system that allows for retrieval of patient records easily in order to evaluate the...
Private Insurance Data Requirements Requirements for the Inspection of Records by the Commissioner of Health – Ind. Code Ann.§ 27-13-6-9 The Commissioner of Health may inspect a health maintenance organization’s (HMO) records related to quality management activities and maintain...