Current through Register Vol. 35, No. 6, March 26, 2024
A.
Transfer of medical records. Each health care insurer shall
develop and implement a policy for the transfer of medical records of a covered
person whenever the following occur:
(1)
change of physician or other health care professional;
(2) disenrollment of enrollee from the
managed health care plan; or
(3)
other circumstances where requests by covered persons or former covered persons
is reasonable.
B.
Confidentiality of medical records.
(1) Any data or information pertaining to the
diagnosis, treatment, or health of any covered person obtained from the covered
person, from any provider, or from any other source, shall be held in
confidence as otherwise required or permitted by New Mexico or federal
law.
(2) The data or information
shall not be disclosed to any person except:
1) to the extent that it may be necessary to
carry out the purposes of this rule;
2) upon the express consent of the covered
person;
3) pursuant to state or
court order for the production of evidence or the discovery thereof;
4) in the event of claim or litigation
between a covered person and the health care insurer wherein such data or
information is pertinent; or
5)
where otherwise required or permitted by New Mexico or federal law.
(3) A health care insurer shall be
entitled to claim any statutory privileges against such disclosure which the
provider who furnished such information to the health care insurer is entitled
to claim.
C.
Maintenance of medical records.
(1) Any
medical records directly maintained by the health care insurer shall be
organized in a uniform format applicable to all medical records.
(2) The health care insurer shall have
policies governing the contents of medical records including maintenance of
records by electronic means.
D.
Copies of medical records.
(1) Covered persons or their legally
authorized representatives shall have a right to inspect and obtain a copy of
their medical records maintained by the health care insurer.
(2) Charges for copies of medical records
must be based upon actual costs not to exceed the prevailing community market
rates. For photocopying, the cost shall be twenty-five cents ($.25) per page or
less.
E.
Protection of medical records. Medical records maintained by health care
insurers shall be protected by health care insurers against loss, destruction,
or unauthorized use, and shall be retained for at least 10 years or until the
covered person reaches age 21 years, whichever is longer.
F.
Destruction of medical
records. Destruction of medical records must be such that
confidentiality is maintained. Records must be destroyed by shredding,
incinerating (where permitted) or by other method of permanent destruction,
including purging of medical records from a computer hard disk, server hard
disk or other media or disk in accordance with current practices for data
deletion. A log must be kept of all charts destroyed, including the patient's
name and date of record destruction.
