Terms Used In Louisiana Revised Statutes 22:265

  • Discovery: Lawyers' examination, before trial, of facts and documents in possession of the opponents to help the lawyers prepare for trial.
  • Enrollee: means an individual who is enrolled in a health maintenance organization. See Louisiana Revised Statutes 22:242
  • Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
  • Health maintenance organization: means any corporation organized as either a business corporation or a nonprofit corporation and domiciled in this state which undertakes to provide or arrange for the provision of basic health care services to enrollees in return for a prepaid charge. See Louisiana Revised Statutes 22:242
  • Litigation: A case, controversy, or lawsuit. Participants (plaintiffs and defendants) in lawsuits are called litigants.
  • person: includes a body of persons, whether incorporated or not. See Louisiana Revised Statutes 1:10
  • Provider: means any physician, hospital, or other person, organization, institution, or group of persons licensed or otherwise authorized in this state to furnish health care services. See Louisiana Revised Statutes 22:242
  • Statute: A law passed by a legislature.

A.  Any data or information pertaining to the diagnosis, treatment, or health of any enrollee or potential enrollee obtained from such persons or from any provider by any health maintenance organization shall be held in confidence and shall not be disclosed to any person except:

(1)  To the extent that it may be necessary to carry out the purposes of this Subpart or as otherwise permitted by law.

(2)  Upon the express consent of the enrollee or potential enrollee.

(3)  Pursuant to statute or court order for the production of evidence or the discovery thereof.

(4)  In the event of a claim or litigation between such person and the health maintenance organization, wherein such data or information is pertinent.

B.  A health maintenance organization shall be entitled to claim any statutory privileges against such disclosure which the provider who furnished such information to the health maintenance organization is entitled.

Acts 1986, No. 1065, §1; Redesignated from La. Rev. Stat. 22:2020 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.