TITLE 27

Insurance

CHAPTER 27-41

Health Maintenance Organizations

SECTION 27-41-53



   § 27-41-53  Genetic testing. –

(a) Except as provided in chapter 37.3 of title 5, insurance administrators,

health plans and providers shall be prohibited from releasing genetic

information without prior written authorization of the individual. Written

authorization shall be required for each disclosure and include to whom the

disclosure is being made. An exception shall exist for those participating in

research settings governed by the federal policy for the protection of human

research subjects (also known as "The Common Rule"). Tests conducted purely for

research are excluded from the definition, as are tests for somatic (as opposed

to heritable) mutations, and testing for forensic purposes.



   (b) No health maintenance organization subject to the

provisions of this chapter shall:



   (1) Use a genetic test or request for genetic test the

results of a genetic test to reject, deny, limit, cancel, refuse to renew,

increase the rates of, affect the terms or conditions of, or affect a group or

an individual's health insurance policy contract, or plan;



   (2) Request or require a genetic test for the purpose of

determining whether or not to issue or renew an individual's health benefits

coverage, to set reimbursement/co-pay levels or determine covered benefits and

services;



   (3) Release the results of a genetic test without the prior

written authorization of the individual from whom the test was obtained, except

in a format where individual identifiers are removed, encrypted, or encoded so

that the identity of the individual is not disclosed. A recipient of

information pursuant to this section may use or disclose the information solely

to carry out the purpose for which the information was disclosed. Authorization

shall be required for each re-disclosure. An exception shall exist for

participation in research settings governed by the federal policy for the

protection of human research subjects (also known as "The Common Rule"); or



   (4) Request or require information as to whether an

individual has ever had a genetic test, or participated in genetic testing of

any kind, whether for clinical or research purposes.



   (c) For the purposes of this section, "genetic testing" is

the analysis of an individual's DNA, RNA, chromosomes, protein and certain

metabolites in order to detect heritable inheritable disease-related genotypes,

mutations, phenotypes or karyotypes for clinical purposes. Those purposes

include predicting risk of disease, identifying carriers, establishing prenatal

and clinical diagnosis or prognosis. Prenatal, newborn and carrier screening,

and testing in high risk families may be included provided there is an approved

release by a parent or guardian. Tests for metabolites are covered only when

they are undertaken with high probability that an excess or deficiency of the

metabolite indicates the presence of heritable mutations in single genes.

"Genetic testing" does not mean routine physical measurement, a routine

chemical, blood, or urine analysis or a test for drugs or for HIV infections.



History of Section.

(P.L. 1998, ch. 380, § 4; P.L. 2001, ch. 38, § 7; P.L. 2001, ch. 54,

§ 7.)