Section 17-1736-18 - Confidential communications and disclosure requirements for physician and psychologist providers(a) There is no privilege under this section in any administrative proceeding where the: (2) Practitioner's license;(4) Practice; of the physician is an issue, including fair hearing criminal cases involving fraud, or civil cases involving over-payment under the medicaid program. However, the identifying data of a patient whose records are admitted into evidence at an administrative hearing shall be kept confidential among the parties to the hearing unless waived by the patient. The administrative agency, board, or commission may close its proceedings to the public to protect a patient's confidentiality.
(b) The DHS director may require providers of health care goods and services, including physicians and psychotherapists, to seek written authorization from the med-QUEST administration to provide care, goods, or services to medicaid patients. A provider's request for authorization shall include: (2) A diagnosis of the patient's psychiatric, physical, or psychological condition;(3) Whether or not the patient can work, either part-time or full-time;(4) The number of times the patient has seen the provider over a given prior period;(5) The number of future visits the doctor anticipates needing in order to properly treat the patient;(6) Information on whether the patient is working and if so, whether on a full-time or part-time basis; and(7) Any other information requested by the med-QUEST division which properly relates to the patient's present or prior condition or appropriate care to be rendered to the patient.(c) For purposes of this section, confidential communication shall consist only of the statements made between a physician or psychologist and a patient during a therapy session. The provider's diagnosis, finding, and treatment plan shall not be considered confidential communications.(d) Whenever a provider refuses to disclose unprivileged information to the med-QUEST division, then payment of claims for which the information is lacking may, at the discretion of the director, be denied, or if payment is already made, recovery may be initiated by the department.Haw. Code R. § 17-1736-18
[Eff 08/01/94] (Auth: HRS § 346-14) (Imp: 42 C.F.R. §431.10 )