La. Admin. Code tit. 50 § I-8311

Current through Register Vol. 50, No. 11, November 20, 2024

Section I-8311 - General Provisions

A. All insurance companies authorized to issue a hospital or medical expense policy, a hospital or medical service contract, an employee welfare benefit plan, a health and accident insurance policy, or any other insurance contract of this type in this state shall provide a monthly list of information to the Department of Health and Hospitals on all members who hold a comprehensive health contract.

B. The payor shall submit to DHH an initial, secure, encrypted electronic file of all members who hold comprehensive health contracts with:

1. effective dates as of the date of promulgation of this Subchapter C; and

2. processed dates before that same date.

C. The department shall treat all data in a confidential manner and protect it in accordance with the Health Insurance Portability and Accountability Act (HIPAA) of 1996 privacy and security rules. Further, the Department shall, in a manner compliant with the HIPAA privacy and security rules, return or destroy all copies of the payor's data immediately following the match process.

D. The department shall provide a standard protocol in accordance with nationally accepted standards, and in a manner compliant with the Health Insurance Portability and Accountability Act of 1996, by which the electronic file shall be transmitted between DHH and the payor.

E. The provisions of this §8325 shall not apply to any insured whose indemnity policy benefits pay less than $25 a day in hospital or medical benefits.

La. Admin. Code tit. 50, § I-8311

Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 32:849 (May 2006).

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254, R.S. 44:14, and Title XIX of the Social Security Act.