Introduced By: Representatives Costantino, Benoit, Cicilline, Slater and Henseler
Date Introduced : January 29, 1998
It is enacted by the General Assembly as follows:
SECTION 1. Section 5-37.3-3 of the General Laws in Chapter 5-37.3 entitled "Confidentiality of Health Care Communications and Information Act" is hereby amended to read as follows:
5-37.3-3. Definitions. -- As used in this chapter:
(1) "Authorized representative" means:
(i) A person empowered by the patient/client to assert or to waive the confidentiality, or to disclose or consent to the disclosure of confidential information, as established by this chapter. That person shall not, except by explicit authorization, be empowered to waive confidentiality or to disclose or consent to the disclosure of confidential information;
(ii) A guardian or conservator, if the person whose right to confidentiality is protected under this chapter is incompetent to assert or waive that right; or
(iii) If the patient/client is deceased, his or her personal representative or, in the absence of that representative, his or her heirs-at-law.
(2) "Board of medical licensure and discipline" means the board created under chapter 37 of this title, as amended.
(3) (a) "Confidential health care communication" means a communication of health care information by an individual to a health care provider, including a transcription of any such information, not intended to be disclosed to third persons except if those persons are: (i) present to further the interest of the patient in the consultation, examination or interview; (ii) reasonably necessary for the transmission of the communication; or (iii) participating in the diagnosis and treatment under the direction of the health care provider, including members of the patient's family.
(b) "Confidential health care information" means all information relating to a patient's health care history, diagnosis, condition, treatment or evaluation obtained from a health care provider who has treated the patient.
(4) "Health care provider" means any person licensed by this state to provide or otherwise lawfully providing health care services, including, but not limited to, a physician, hospital, intermediate care facility or other health care facility, dentist, nurse, optometrist, podiatrist, physical therapist, psychiatric social worker, {ADD pharmacist ADD} or psychologist, and any officer, employee or agent of that provider acting in the course and scope of his or her employment or agency related to or supportive of health services.
(5) "Health care services" means acts of diagnosis, treatment, medical evaluation or counselling or such other acts as may be permissible under the health care licensing statutes of this state.
(6) "Medical peer review board" means a peer review board under chapter 37 of this title, as amended.
(7) "Nurse" means a registered nurse or licensed practical nurse licensed to practice nursing in the state.
(8) "Patient" means a person who receives health care services from a health care provider.
(9) "Personally identifiable confidential health care information" means confidential health care information which explicitly or by implication identifies a particular patient.
(10) "Physician" means a person registered or licensed to practice allopathic or osteopathic medicine in this state under Rhode Island general laws.
(11) "Psychiatric social worker" means a person holding a Master's or further advanced degree from a school of social work accredited by the council of social work education.
(12) "Psychologist" means a certified psychologist under chapter 44 of this title, as amended.
(13) "Qualified personnel" means persons whose training and experience are appropriate to the nature and level of the work in which they are engaged and who, when working as part of an organization, are performing that work with published and adequate administrative safeguards against disclosure unauthorized under this article.
(14) "Third party" means a person other than the patient to whom the confidential health care information relates and other than a health care provider.
(15) "Managed care plan" means a plan operated by a managed care entity as described in subparagraph (16), that provides for the financing and delivery of health care services to persons enrolled in such plan through:
(A) Arrangements with selected providers to furnish health care services;
(B) Explicit standards for the selection of participating providers;
(C) Organizational arrangements for ongoing quality assurance, utilization review programs, and dispute resolution; and
(D) Financial incentives for persons enrolled in the plan to use the participating providers and procedures provided for by the plan.
(16) "Managed care entity" includes a licensed insurance company, hospital or medical service plan, health maintenance organization, an employer or employee organization, or a managed care contractor as described in subparagraph (17), that operates a managed care plan.
(17) "Managed care contractor" means a person that:
(1) Establishes, operates or maintains a network of participating providers;
(2) Conducts or arranges for utilization review activities; and
(3) Contracts with an insurance company, a hospital or medical service plan, an employer, an employee organization, or any other entity providing coverage for health care services to operate a managed care plan.
(18) "Participating provider" means a physician, hospital, pharmacy, laboratory, dentist, or other state licensed or other state recognized provider of health care services or supplies, that has entered into an agreement with a managed care entity to provide such services or supplies to a patient enrolled in a managed care plan.
SECTION 2. This act shall take effect upon passage.
