North Dakota Code § 26.1-36-12.4

Confidentiality of medical information
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1. An insurance company, as defined in section 26.1 -02-01, health maintenance 
organization, or any other entity providing a plan of health insurance subject to state 
insurance regulation may not deliver, issue, execute, or renew a health insurance 
policy or health service contract unless confidentiality of medical information is 
assured pursuant to this section. An insurer shall adopt and maintain procedures to 
ensure that all identifiable information maintained by the insurer regarding the health, 
diagnosis, and treatment of persons covered under a policy or contract is adequately 
protected and remains confidential in compliance with all federal and state laws and 
regulations and professional ethical standards. Unless otherwise provided by law, any 
data or information pertaining to the health, diagnosis, or treatment of a person 
covered under a policy or contract, or a prospective insured, obtained by an insurer 
from that person or from a health care provider, regardless of whether the information 
is in the form of paper, is preserved on microfilm, or is stored in computer -retrievable 
form, is confidential and may not be disclosed to any person except:
a. If the data or information identifies the covered person or prospective insured 
upon a written, dated, and signed approval by the covered person or prospective 
insured, or by a person authorized to provide consent pursuant to section 
23-12-13 for a minor or an incapacitated person;
b. If the data or information identifies the health care provider upon a written, dated, 
and signed approval by the provider. However, this subdivision may not be 

construed to prohibit an insurer from disclosing data or information pursuant to 
chapter 23-01.1 or from disclosing, as part of a contract or agreement in which 
the health care provider is a party, data or information that identifies a provider as 
part of mutually agreed-upon terms and conditions of the contract or agreement;
c. If the data or information does not identify either the covered person or 
prospective insured or the health care provider, the data or information may be 
disclosed upon request for use for statistical purposes or research;
d. Pursuant to statute or court order for the production or discovery of evidence; or
e. In the event of a claim or litigation between the covered person or prospective 
insured and the insurer in which the data or information is pertinent.
2. An insurer may claim any statutory privileges against disclosure that the health care 
provider who furnished the information to the insurer is entitled to claim.
3. This section may not be construed to prevent disclosure necessary for an insurer to 
conduct utilization review or management consistent with the standards imposed by 
chapter 26.1 -26.4, to facilitate payment of a claim, to analyze health plan claims or 
health care records data, to conduct disease management programs with health care 
providers, or to reconcile or verify claims under a shared risk or capitation 
arrangement. This section does not apply to data or information disclosed by an 
insurer as part of a biomedical research project approved by an institutional review 
board established under federal law. Nor may this section be construed to limit the 
insurance commissioner's access to records of the insurer for purposes of 
enforcement or other activities related to compliance with state or federal laws; 
however, medical records acquired by the commissioner as part of an examination of 
an insurer's business practices under section 26.1 -03-19.2 or any other regulatory 
action or proceeding commenced by the commissioner are confidential.

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