§ 7-1202.07 — Limited disclosure to 3rd-party payors.

District of Columbia § 7-1202.07

• Jurisdiction: District of Columbia
• Title 7: Human Health Care and Safety.
• Ch. 12: Mental Health Information.
• Subch. II: Disclosures With the Client’s Consent.

Text

(a) A mental health professional or mental health facility may disclose to a 3rd-party payor mental health information necessary to determine the client’s entitlement to, or the amount of, payment benefits for professional services rendered; provided, that the disclosure is pursuant to a valid authorization, or for participating providers, a joint consent, and that the information to be disclosed is limited to:

(1) Administrative information;

(2) Diagnostic information;

(3) The status of the client (voluntary or involuntary);

(4) The reason for admission or continuing treatment; and

(5) A prognosis limited to the estimated time during which treatment might continue.

(b) In the event the 3rd-party payor questions the client’s entitlement to or the amount of payment benefits following disclosure under subsection (a) of this section, the 3rd-party payor may, pursuant to a valid authorization, or for participating providers, a joint consent, request an independent review of the client’s record of mental health information by a mental health professional or professionals. Mental health information disclosed for the purpose of review shall not be disclosed to the 3rd-party payor.

Legislative History

Mar. 3, 1979, D.C. Law 2-136, § 207, 25 DCR 5055; Dec. 18, 2001, D.C. Law 14-56, § 116(f)(3), 48 DCR 7674