Current through Register Vol. 56, No. 18, September 16, 2024
(a) A
CODS shall maintain confidentially any data or information relating to the
diagnosis, treatment, or health of a carrier's covered persons, or prospective
covered persons, obtained from the carrier, a provider, or from the individual,
and shall not disclose such information to any person except:
1. To the extent it may be necessary to carry
out the purposes of the Act or this chapter, including investigation of
complaints by a carrier, the Department, and adjudication of claims or other
reimbursement by a carrier or its agent;
2. Upon the express consent of the covered
person or prospective covered person, or his or her legal representative, if
the covered person or prospective covered person is incapacitated or a
minor;
3. Pursuant to statute or
court order for the production of evidence or the discovery thereof;
4. In the event of a claim or litigation
between a covered person or prospective covered person and the CODS or carrier
wherein the data or information is relevant to the claim or litigation. A CODS
shall be entitled to claim any statutory privilege against disclosure that a
provider or carrier that furnished the information to the CODS is entitled to
claim;
5. For epidemiological and
outcomes research when the identity of the covered person, prospective covered
person, or contract holder is protected through the use of anonymized
information, as defined at
N.J.S.A.
17:48H-30e; or
6. Upon the informed consent of the covered
person, prospective covered person, or contract holder (but only when the
contract holder is a natural person, and is providing consent solely on his or
her own behalf), which consent has been obtained for research approved by an
institutional review board in accordance with Federal requirements for informed
consent pursuant to 21 CFR Part 50 or 45 CFR Part 46.
(b) The Department and carriers shall
maintain any information obtained from a CODS relating to the diagnosis,
treatment or health of a covered person, or prospective covered person,
confidentially to the same extent as the information is required by this
subsection to be maintained confidential by the CODS, and shall not make any
public disclosure of such information.
(c) Notwithstanding (a) and (b) above,
nothing in this chapter shall be construed to prohibit the collection and
dissemination of data that has been aggregated and otherwise stripped of
personal identifiers of former, current and prospective covered
persons.
