Section R9-1-302. Medical Records or Payment Records Disclosure

A.      Except as provided in subsection (B), an employee or volun- teer shall not disclose to a third person medical records or pay- ment records containing individually identifiable health information that the employee or volunteer obtained or accessed as a result of the employment or volunteering.

B.       Unless otherwise prohibited by law, an employee or volunteer may disclose to a third person medical records or payment records containing individually identifiable health informa- tion:

1.        With the valid authorization of the individual identified by the information in the medical records or payment records, if the individual:

a.        Is at least age 18 or an emancipated minor, and

b.        Is not an incapacitated person;

2.        With the valid authorization of the parent, legal guardian, or other health care decision maker of the individual iden- tified by the information in the medical records or pay- ment records, if the individual is:

a.        Less than age 18, other than an emancipated minor; or

b.        An incapacitated person;

3.        With the valid authorization of the individual identified by the information in the medical records or payment records, regardless of age, if:

a.        The information to be disclosed resulted from the consent given by the individual under A.R.S. § 44-

132.01 or A.R.S. § 36-663; and

b.        The individual is not an incapacitated person;

4.        With the valid authorization of the individual identified by information in the medical records or payment records if:

a.        The information to be disclosed resulted from the individual’s treatment under A.R.S. § 44-133.01;

b.        The individual was at least age 12 at the time of the treatment under A.R.S. § 44-133.01 as established by documentation, such as a copy of the individ- ual’s:

i.         Driver license issued by a state, or

ii.        Birth certificate; and

c.        The individual is not an incapacitated person;

5.        If the individual identified by the information in the med- ical records or payment records is deceased, upon the written request to the Department according to subsection

(D) for disclosure of the deceased individual’s medical records or payment records to:

a.        The deceased individual’s health care decision maker at the time of death;

b.        The personal representative of the deceased individ- ual’s estate; or

c.        If the deceased individual’s estate has no personal representative, a person listed in A.R.S. §§ 12- 2294(D)(1) through 12-2294(D)(6);

6.        At the direction of the Human Subjects Review Board, if the medical records or payment records are sought for research and the disclosure meets the requirements of 45 CFR 164.512(i)(2); or

7.        As required by an order issued by a court of competent jurisdiction.

C.      For purposes of subsection (B)(1), an individual less than age 18 who claims emancipated minor status shall submit to the Department a valid authorization signed by the individual less than age 18 and:

1.        A copy of an order emancipating the individual issued by the Superior Court of Arizona;

2.        If the individual was an emancipated minor in a state other than Arizona:

a.        Documentation establishing that the individual is at least age 16, such as a copy of the individual’s:

i.         Driver license issued by a state, or

ii.        Birth certificate; and

b.        Documentation of the individual’s emancipation, such as a copy of:

i.         An order emancipating the individual issued by a court of competent jurisdiction of a state other than Arizona,

ii.        A real property purchase agreement signed by the individual as the buyer or the seller in a state other than Arizona,

iii.      An order for the individual to pay child support issued by a court of competent jurisdiction of a state other than Arizona, or

iv.      A financial institution loan agreement signed by the individual as the borrower in a state other than Arizona;

3.        A copy of the individual’s marriage certificate issued by a state;

4.        If the individual is a homeless minor, documentation such as:

a.        A statement on the letterhead of a homeless shelter or halfway house that:

i.         Is  dated  within   10  days  before  the  date  the Department receives the document,

ii.        States the homeless shelter or halfway house is the individual’s primary residence,

iii.      Is signed by an authorized signer for the home- less shelter or halfway house, and

iv.      States the authorized signer’s title or position at the homeless shelter or halfway house; or

b.        A statement signed by the individual that:

i.         The individual does not live with the individ- ual’s parents, and

ii.        The  individual  lacks  a  fixed   nighttime  resi- dence;

5.        If the individual is a U.S. armed forces enlisted member, a copy of the individual’s U.S. armed forces:

a.        Enlistment document, or

b.        Identification card; or

6.        If the individual is a U.S. armed forces veteran, a copy of the individual’s discharge certificate.

D.      A request to the Department under subsection (B)(5) to dis- close medical records or payment records shall include:

1.        The name of the individual identified by the information in the medical records or payment records;

2.        A statement that the individual identified by the informa- tion in the medical records or payment records is deceased;

3.        The description and dates of the medical records or pay- ment records requested;

4.        The name, address, and telephone number of the person requesting the medical records or payment records disclo- sure;

5.        Whether the person requesting the medical records or payment records disclosure:

a.        Was the deceased individual’s health care decision maker at the time of death,

b.        Is the personal representative of the deceased indi- vidual’s estate, or

c.        Is a person listed in A.R.S. § 12-2294(D);

6.        The signature of the individual requesting the medical records or payment records disclosure;

7.        Documentation that the individual identified by the infor- mation in the medical records or payment records is deceased, such as a copy of:

a.        The individual’s death certificate,

b.        A published obituary notice for the individual, or

c.        Written notification of the individual’s death; and

8.        Documentation establishing the relationship to the deceased individual indicated under subsection (D)(5), such as a copy of:

a.        Appointment as the deceased individual’s legal guardian by a court of competent jurisdiction,

b.        Appointment as the personal representative of the deceased individual’s estate by a court of competent jurisdiction,

c.        The deceased individual’s birth certificate naming the person requesting the medical records or pay- ment records as a parent,

d.        The birth certificate of the person requesting the medical records or payment records naming the deceased individual as a parent, or

e.        If the person requesting the medical records or pay- ment records disclosure is the deceased individual’s surviving spouse:

i.         A copy of the person’s marriage certificate naming the deceased individual as spouse, and

ii.        The person’s statement that the person and the deceased individual were not divorced  or legally separated at the time of the deceased individual’s death, or

iii.      A copy of the deceased individual’s probated will naming the person as the deceased individ- ual’s surviving spouse.

E.       The Department shall send a response to a request for medical records or payment records disclosure under subsection (B)(5) that meets the requirements of subsection (D):

1.        By regular mail,

2.        To the address provided under subsection (D)(4), and

3.        Within 30 days after the date the Department receives the request.

Historical Note

New Section made by final rulemaking at 12 A.A.R. 3699, effective November 11, 2006 (Supp. 06-3).