Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 22 - PRIVACY › Subchapter B - INSURANCE CONSUMER HEALTH INFORMATION PRIVACY › Section 22.52 - Definitions

Current through Reg. 49, No. 28; July 12, 2024
The following words and terms, when used in this
					 subchapter, shall have the following meanings, unless the context clearly
					 indicates otherwise. Unless otherwise defined in this subchapter, each term
					 that is used in this subchapter that is defined in subchapter A of this chapter
					 shall have the meaning assigned by subchapter A of this chapter.
(1) Authorization--Executed document that
				  signifies that the signer of the authorization is providing informed permission
				  that nonpublic personal health information held by a covered entity and
				  described in the document may be released to other parties pursuant to the
				  terms of the document.
(2)
				  Authorization form--A form provided by a covered entity which, if signed and
				  dated by a consumer as set forth in this subchapter, constitutes an
				  authorization under this subchapter.
(3) Consumer--An individual or that
				  individual's representative who seeks to obtain, obtains or has obtained an
				  insurance product or service from a covered entity, and about whom the covered
				  entity has nonpublic personal health information.
(4) Covered entity--A person who holds or is
				  required to hold a license, registration, certificate of authority, or other
				  authority under the Insurance Code or another insurance law of this state. The
				  term includes, but is not limited to, an insurance company, group hospital
				  service corporation, mutual insurance company, local mutual aid association,
				  statewide mutual assessment company, stipulated premium insurance company,
				  health maintenance organization, reciprocal or interinsurance exchange, Lloyd's
				  plan, fraternal benefit society, county mutual insurer, farm mutual insurer,
				  viatical or life settlement provider or broker, or insurance agent. For
				  purposes of this subchapter, "covered entity" has the same meaning as
				  "licensee" as used in Article 28B.01(2), Insurance Code.
(5) Health care operations--As set forth in
				  the Health Insurance Portability and Accountability Act and Privacy Standards.
				  The term does not include marketing as described in
				  45
				  C.F.R. §164.514(e) and
				  any subsequent amendments.
(6)
				  Health Insurance Portability and Accountability Act and Privacy Standards--The
				  privacy requirements of the Administrative Simplification subtitle of the
				  Health Insurance Portability and Accountability Act of 1996 (42 U.S.C. Section
				  1320d et seq.) and the final rules adopted on
				  December 28, 2000, and published at 65 Fed. Reg.82798 et seq., and any
				  subsequent amendments.
(7)
				  Marketing--The promotion or advertisement, by a covered entity, of specific
				  products or services if the covered entity receives, directly or indirectly, a
				  financial incentive or remuneration for the use, access, or disclosure of
				  protected health information. Marketing includes, but is not limited to,
				  communications to an individual based on prescription patterns or protected
				  health information intended to encourage or discourage the individual's use of
				  prescription or non-prescription medicine, medical devices or any other
				  product. Marketing does not include a communication, by a covered entity,
				  health care provider, or participants in an organized health care arrangement
				  or their affiliated covered entities or business associates, necessary to
				  provide treatment or perform health care operations.
(8) Nonpublic personal health
				  information--Has the same meaning as "protected health information."
(9) Prescription information--Any
				  information, whether oral or recorded in any form or medium, that:
(A) relates to or concerns a prescription
				  created or received by a covered entity, health care provider, public health
				  authority, employer, school or university, or health care clearinghouse;
				  and
(B) relates to the past,
				  present, or future physical or mental health or condition of an individual, the
				  provision of health care to the individual, or the utilization of health care
				  by the individual.