Indiana § 16-39-4-5 - Information subject to disclosure; exempt institutions; failure of patient to authorize release of information

§ 16-39-4-5. Information subject to disclosure; exempt institutions; failure of patient to authorize release of information

Sec. 5. (a) This section does not apply to the following:

(1) An institution licensed under IC 12-25.

(2) A hospital licensed under IC 16-21.

(3) A treatment facility certified under IC 12-23-1-6.

(4) A state institution listed under IC 12-24-1.

(b) This section applies only to a patient's mental health records.

(c) A patient, or the patient's legal representative if the patient is incompetent, who consents in writing to the release of information to an insurer that has issued a policy of accident and sickness insurance (as defined in IC 27-8-5-1) covering the patient, authorizes the provider to disclose the following information to the insurer:

(1) The patient's name and the policy or contract number.

(2) The date the patient was admitted to a treatment facility or the date the patient began receiving mental health, intellectual disability, or substance abuse (as defined in IC 27-8-5-15.5) services.

(3) The date of the beginning of the patient's illness.

(4) The date the patient was discharged from the treatment facility or the date the services were terminated, if known.

(5) The diagnosis for the patient with concise information substantiating the diagnosis.

(6) A brief description of the services provided to the patient, including the type of therapy used, medications ordered and administered, the total number of hours spent in individual, group, or family treatment, recreational therapy, or rehabilitation activities.

(7) The patient's status as either an inpatient or outpatient.

(8) The patient's relationship to the policyholder or contract subscriber.

(9) The patient's prognosis and plan of treatment.

An insurer's request for the release of additional mental health information relating to subdivisions (1) through (9) does not require a further release in order for the provider to submit the additional information to the insurer. The provider may release to the insurer mental health information in addition to that reasonably related to subdivisions (1) through (9) if an additional written consent is obtained from the patient or the patient's representative authorizing the release of all information necessary for the insurer to adjudicate a claim made by the patient or the patient's representative. If such a release is obtained, no further releases are required in order for the provider to submit additional information in response to subsequent requests for information by the insurer to complete its review of the claim.

(d) Nothing in this section removes the obligation of a patient to pay for services if the patient's failure to authorize the release of information under this section results in the limitation or denial of insurance benefits.

As added by P.L.102-1994, SEC.6. Amended by P.L.117-2015, SEC.33.