Health insurers must cooperate with the department on data matching and, in some cases, provide quarterly enrollment listings; unauthorized disclosure can trigger civil liability.
§236.1.11. Family and child support programs; insurance companies; data matching and cooperation; responsibilities A.(1) The department shall be authorized to obtain health insurance enrollment data currently being provided in accordance with federal law and R.S. 44:14, through data sharing agreements between the department and health insurers, as defined in R.S. 46:446.6, or through an interagency agreement with the Louisiana Department of Health, at the discretion of the department. (2) As a condition of conducting business in Louisiana, health insurers, defined as any insurance company or other entity who is authorized to transact and is currently transacting health insurance business in this state, including self-insured plans, group health plans as defined in Section 607(1) of the Employee Retirement Income Security Act of 1974, service benefit plans, managed care organizations, pharmacy benefit managers, third party administrators and any other parties that are, by statute, contract, or agreement, legally responsible for payment of a claim for a health care item or service, shall permit and participate in data matching with the department to assist in determining the availability of other sources of health care insurance or coverage for beneficiaries of the child support program. If not providing data through the Louisiana Department of Health, health insurers shall provide to the department or its designee, no less than quarterly, an electronic listing of all individuals who may be covered by a health insurer and the nature of coverage that is provided, their social security numbers, addresses, dates of birth, policy holder, policy identification number, group number and effective dates for purposes of identifying coverage and enforcing medical child support orders administered by the department. (3) The provisions of Paragraphs (1) and (2) of this Subsection shall not apply to the following types of insurance: limited benefit health and accident; TRICARE; dental; disability income; fixed indemnity; long-term care; Medicare supplement; Medicare Advantage; specified disease; vision; basic hospital expense; and basic medical-surgical expense. B.(1) If any state employee or any person working under a contract with the state knowingly, or by reason of gross negligence, discloses data match information of an individual in violation of any provision of this Section, the aggrieved individual may bring a civil action for damages against such person in any court of competent jurisdiction of this state in accordance with Subsection C of this Section. (2) No liability shall arise under this Section with respect to any disclosure which results from a good faith, but erroneous, interpretation of this Section except in cases of gross negligence. C. In any action brought under this Section for unauthorized disclosure, upon a finding of liability on the part of the defendant, the defendant shall be liable to the aggrieved individual in an amount equal to the greater of one thousand dollars for each act of unauthorized disclosure of data match information with respect to which such defendant is found liable or the actual damages sustained by the aggrieved individual as a result of such unauthorized disclosure. In the case of a willful disclosure or a disclosure which is the result of gross negligence, the defendant shall be liable for punitive damages and all costs and attorney fees. Acts 2008, No. 578, §2; Acts 2009, No. 241, §1.