(a) Any data or information pertaining to the diagnosis, treatment or health of any enrollee or applicant obtained from the person or from any provider by any HMO shall be held in confidence by the HMO and shall not be disclosed by the HMO to any person, except upon any one (1) of the following circumstances:

Terms Used In Tennessee Code 56-32-125

  • 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 an HMO. See Tennessee Code 56-32-102
  • Litigation: A case, controversy, or lawsuit. Participants (plaintiffs and defendants) in lawsuits are called litigants.
  • person: includes an individual, insurer, company, association, organization, Lloyds, society, reciprocal insurer or interinsurance exchange, partnership, syndicate, business trust, corporation, agent, general agent, broker, solicitor, service representative, adjuster, and every legal entity. See Tennessee Code 56-32-102
  • Provider: means any physician, hospital or other person that is licensed or otherwise authorized in this state to furnish health care services. See Tennessee Code 56-32-102
  • Statute: A law passed by a legislature.
  • Subpoena: A command to a witness to appear and give testimony.
(1) To the extent that it may be necessary to carry out the purposes of this chapter;
(2) Upon the express consent of the enrollee or applicant;
(3) In the event of a claim or litigation between an enrollee or applicant and the HMO wherein the data or information is pertinent;
(4) To implement the purposes of title 71, chapter 5; or
(5) When the data or information is required to be disclosed by the authority of another statute.
(b) Nothing in this section shall be construed to amend § 63-1-150 regarding confidentiality of records and statements relating to quality improvement committees of the HMO that shall remain privileged and not subject to subpoena or discovery.
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