§ 26.1-36-30 — Individual or group accident and health insurer or nonprofit health service corporation responsibility - Release of information to department of health and human services

corporation responsibility - Release of information to department of health and human
services.
1. Any individual or group accident and health insurer or nonprofit health service
corporation, upon request of the department of health and human services, shall
provide any information contained in its records pertaining to an individual who is an
applicant for or recipient of medical assistance under chapter 50-24.1, and who is
covered under an accident and health insurance policy or a health service contract
issued by the insurer or nonprofit health service corporation or the medical benefits
paid by or claims paid to the insured or subscriber under a policy or contract. The

insurer or nonprofit health service corporation shall make the requested records or
information available upon receipt of a certification by the department of health and
human services that the individual is an applicant for or recipient of medical assistance
under chapter 50-24.1, or is a person who is legally responsible for the applicant or
recipient.
2. The information required to be made available pursuant to this section is limited to
information necessary to determine whether benefits under the policy or contract have
been or should have been claimed and paid pursuant to an accident and health
insurance policy or health service contract with respect to items of medical care and
services received by a particular individual for which medical assistance coverage
would otherwise be available.
3. The department of health and human services shall, in consultation with the
commissioner, establish guidelines:
a. For the method of requesting and furnishing appropriate information, the time in
which the information is to be provided, and method of reimbursing insurance
companies and nonprofit health service corporations for necessary costs incurred
in furnishing the requested information.
b. To assure that information relating to an individual certified to be an applicant for
or recipient of medical assistance under chapter 50-24.1, furnished to an insurer
or subscriber pursuant to this section, is used only for the purpose of identifying
the records or information requested in such manner so as not to violate section
50-06-15.