IC 27-13-31
    Chapter 31. Confidentiality of Medical Information andLimitation of Liability

IC 27-13-31-1
Information treated as confidential; exceptions; privilege againstdisclosure
    Sec. 1. (a) Notwithstanding IC 27-13-30, any information:
        (1) that pertains to the diagnosis, treatment, or health of anyenrollee of a health maintenance organization or limited servicehealth maintenance organization; and
        (2) that is obtained from:
            (A) the enrollee; or
            (B) any provider;
        by any health maintenance organization or limited servicehealth maintenance organization;
is confidential and may not be disclosed to any person, except underthe circumstances set forth in subsection (b).
    (b) Information described in subsection (a) may be disclosed:
        (1) to the extent necessary to carry out this article;
        (2) upon the express consent of the enrollee;
        (3) under a statute or court order for the production of evidenceor the discovery of evidence; or
        (4) in the event of a claim or litigation between:
            (A) the enrollee; and
            (B) the health maintenance organization or limited servicehealth maintenance organization;
        in which the data or information is pertinent.
    (c) A health maintenance organization or limited service healthmaintenance organization is entitled to claim any statutory privilegeagainst the disclosure of information described in subsection (a) thatthe provider who furnished the information to the health maintenanceorganization or limited service health maintenance organization isentitled to claim.
As added by P.L.26-1994, SEC.25.

IC 27-13-31-2
Liability limitations
    Sec. 2. (a) As used in this section, "in good faith and withoutmalice" when used to describe an action taken or a decision orrecommendation made means that:
        (1) a reasonable effort has been taken to obtain the facts of thematter;
        (2) a reasonable belief exists that the action, decision, orrecommendation is warranted by the facts known; and
        (3) if the action is described in IC 34-30-15-7, the action ismade in compliance with IC 34-30-15-7.
    (b) As used in this section, "health care review committee" meansa peer review committee under IC 34-6-2-99 (or IC 34-4-12.6-1(c)before its repeal).    (c) In all actions to which this section applies, good faith shall bepresumed and malice shall be required to be proven by the personaggrieved.
    (d) A person who, in good faith and without malice:
        (1) takes any action or makes a decision or recommendation asa member, an agent, or an employee of a health care reviewcommittee; or
        (2) furnishes any record, information, or assistance to a healthcare review committee;
is not subject to liability for damages in any legal action inconsequence of that action.
    (e) Neither:
        (1) the health maintenance organization or limited servicehealth maintenance organization that established the health carereview committee; or
        (2) the officers, directors, employees, or agents of the healthmaintenance organization or limited service health maintenanceorganization;
are liable for damages in any civil action for the activities of a personwho, in good faith and without malice, takes any action or makes adecision or recommendation as a member, an agent, or an employeeof a health care review committee, or furnishes any record,information, or assistance to a health care review committee.
    (f) This section does not relieve any person of liability arisingfrom treatment of a patient or an enrollee, or from a determination ofthe reimbursement to be provided under the terms of an insurancepolicy, a health maintenance organization contract, or another benefitprogram providing payment, reimbursement, or indemnification forhealth care costs based on the appropriateness of health care servicesdelivered to an enrollee.
    (g) A health care review committee shall comply withIC 34-6-2-99.
As added by P.L.26-1994, SEC.25. Amended by P.L.261-1995,SEC.1; P.L.1-1998, SEC.155.

IC 27-13-31-3
Information and records subject to subpoena or discovery
    Sec. 3. (a) Notwithstanding IC 27-13-30, the informationconsidered by a health care review committee and the record of theactions and proceedings of the committee are confidential forpurposes of IC 5-14-3-4 and not subject to subpoena or order toproduce, except:
        (1) in proceedings before the appropriate state licensing orcertifying agency; and
        (2) in an appeal, if permitted, from the finding orrecommendation of the health care review committee.
    (b) If information considered by a health care review committeeor records of the actions and proceedings of a health care reviewcommittee are used under subsection (a) by a state licensing orcertifying agency or in an appeal, the information or records:        (1) shall be kept confidential; and
        (2) are subject to the same provisions concerning discovery anduse in legal actions as are the original information and recordsin the possession and control of a health care review committee.
As added by P.L.26-1994, SEC.25.

IC 27-13-31-4
Quality management program; access to records
    Sec. 4. To fulfill its obligations under IC 27-13-6 concerning thequality management program of the organization, a healthmaintenance organization is entitled to access to treatment recordsand other information pertaining to the diagnosis, treatment, andhealth status of any enrollee during the period of time the enrollee iscovered by the health maintenance organization.
As added by P.L.26-1994, SEC.25.