Law / United States / 
Colorado
Confidentiality of enrollee and applicant health information held by a health maintenance organization
In force.
A sensitive categories rule binding private bodies.
- Obligation class
- Disclosure, Consent, Prohibition
As of .
What it requires
- If you are a health maintenance organization, hold in confidence any data or information about the diagnosis, treatment or health of an enrollee or applicant that you obtain from that person or from a provider, and do not disclose it to any person except as necessary to carry out part 1 of article 16 of title 10 or part 4, on the express consent of the enrollee or applicant, under a statute or court order for the production of evidence, in a claim or litigation between that person and the organization where the information is pertinent, or as state or federal law otherwise requires or permits (section 10-16-423).
These lines are LexLint's reading of the law's text, as of .
If you get it wrong
Penalty structure
Section 10-3-1108(1)(a): after a hearing the commissioner of insurance may order a monetary penalty of not more than $3,000 for each act or violation, not to exceed $30,000 in the aggregate. The statute raises the ceiling to $30,000 per act and $750,000 annually only for an insurer that violated part 11 of article 3 knowingly.
- Rule
- Per violation only
- As of
- Currency
- USD
- Fixed cap
- 30,000
- Per violation unit
- Violation
- Per violation amount
- 3,000
Who enforces it
Enforcement body
Colorado Commissioner of Insurance, who may order a person that has violated any provision of title 10 to cease and desist, pay a monetary penalty, or suffer suspension or revocation of a license, after a hearing (sections 10-3-1107 and 10-3-1108).
Settledness
- As of
What this law does
Under section 10-16-423, a health maintenance organization must hold in confidence any data or information about the diagnosis, treatment or health of an enrollee or applicant that it obtains from that person or from a provider.
Under section 10-16-423, a health maintenance organization may not disclose that information to any person except as necessary to carry out the insurance code provisions on health maintenance organizations, on the express consent of the enrollee or applicant, under a statute or court order, in a claim or litigation between that person and the organization, or as state or federal law otherwise requires or permits.
Under section 10-16-423, a health maintenance organization may claim any statutory privilege against disclosure that the provider who furnished the information is entitled to claim. Sections 10-3-1107 and 10-3-1108 let the commissioner of insurance hold a hearing when the commissioner has reason to believe a person has violated any other provision of title 10, and order a monetary penalty of not more than $3,000 for each act or violation, up to $30,000 in the aggregate. Section 10-16-423 was reenacted with article 16 of title 10 in 1992 and amended in 2003.
When LexLint raises it
When your app profile says your app handles health records or is an insurer.