N.J. Admin. Code § 13:42-8.4
Current through Register Vol. 56, No. 21, November 4, 2024
Section 13:42-8.4 - Access by a managed health care plan to information in client record(a) With regard to a client whose treatment cost is covered by a wholly insured health insurance plan, or a multiple employer welfare arrangement (MEWA), including a managed health care plan, a licensee shall make available, on request of the client or duly authorized representative with the client's consent, all information required, but only pursuant to 13:42-11.4.(b) A psychologist whose client has explicitly waived the psychologist-client privilege established by 45:14B-28 may release requested information deemed professionally appropriate, not limited by the constraints of the Peer Review Law, 45:14B-31 et seq., to a third-party payor whose benefit plan is qualified under the Federal Employee Retirement Income Security Act (ERISA); that is: 1. The plan of a self-insured employer or an entity providing administrative services to that employer for the purposes of determining entitlement to benefits; or2. An employer's "stop-loss" plan (i.e., a plan in which an employer self-insures up to a certain amount and then purchases excess insurance beyond that amount from an insurance company).N.J. Admin. Code § 13:42-8.4
Amended by R.2009 d.241, effective 8/3/2009.
See: 41 N.J.R. 712(a), 41 N.J.R. 2975(a).
In the introductory paragraph of (b), inserted "N.J.S.A. 45:14B-31 et seq.,".