Preemption Analysis of Texas Laws Relating to the Privacy of Health ...

Texas Administrative Code
Section
Path
Related/
Contrary
Explanation
Preemption
Exception
Is State Law
Preempted?
Recommendation
28 TAC § 19.1721
Independent
Review of Adverse
Determinations
Part 1 (Tex. Dept. of
Insurance) - Ch. 19
(Agents' Licensing)
- Subch. R
Related/Not
Contrary
(1) Independent Review Org. (IRO) is agent of TDI,
and is not a covered entity or business associate.
(2) Ins. Code art. 21.58A, 6A(2) requires a
utilization review agent to provide information to
IRO, and HIPAA permits appropriately limited
disclosure of PHI that is required by law. 45 C.F.R. §
164.512(a)(1).
No
28 TAC § 19.1723
Preauthorization
Part 1 (Tex. Dept. of
Insurance) - Ch. 19
(Agents' Licensing)
- Subch. R
Related/Not
Contrary
HIPAA permits the use and disclosure of IIHI in the
course of certain treatment, payment, and health
care operations. 45 C.F.R. § 164.506.
No
28 TAC § 19.1724
Verification
Part 1 (Tex. Dept. of
Insurance) - Ch. 19
(Agents' Licensing)
- Subch. R
Not Related
HIPAA permits the use and disclosure of IIHI in the
course of certain treatment, payment, and health
care operations. 45 C.F.R. § 164.506.
No
28 TAC §
19.2001-19.2020
General Provisions
- Specialty
Utilization Review
Agent
Part 1 (Tex. Dept. of
Insurance) - Ch. 19
(Agents' Licensing)
- Subch. U
Related/Not
Contrary
(1) The definition of "health plans" in 45 C.F.R. §
164.103, does not include workers' compensation
insurers.
(2) Even if a workers' compensation insurer were a
covered entity,45 C.F.R. § 164.512(l) provides that a
covered entity may disclose protected health
information to the extent necessary to comply with
workers' compensation programs.
No
54