Sales of disability insurance, Medicare supplement insurance and long-term care insurance sold to persons aged 65 years or older, shall be registered by the insurer with the commissioner. The commissioner shall provide facilities for the computerized recordkeeping of all registered policies and certificates. The commissioner shall adopt regulations to implement and administer registration pursuant to this section. Regulations shall include criteria for releasing the registered information to parties outside the department.
Access to registered information in a purely statistical format, which neither identifies nor enables identification of a particular policyholder, may be released at the discretion of the commissioner to any party who demonstrates that the information will be used only for other than commercial purposes.
Treatment authorization requests initiated by the adult day health care center shall include a completed history and physical form, a request for adult day health care services signed by the individual's personal health care provider and the participant’s individual plan of care. The adult day health care center shall request an updated history and physical form from the individual's health care provider every 6 months and such update should be maintained in the participant's health record.
If the victim of abuse consents, a long-term care ombudsman may report an abuse incident to the adult protective services agency or law enforcement agency to get assistance with the investigation. The ombudsman must report health care facility neglect to the bureau and must not identify the victim if the victim refuses consent to being identified in the report. The bureau and reporting agency must maintain the confidentiality of the report.
Adult day health care centers shall offer and provide directly on the premises medical services that emphasize prevention treatment, rehabilitation, and continuity of care and also provide for maintenance of adequate medical records.
The Department of Health Services may make rules and regulations governing the custody, use, and preservation of all records, papers, files, and communications pertaining to the administration of the laws relating to the Medi-Cal program, prepaid health plans, and adult day health care programs.
When determining whether a provider has demonstrated that participants meet the medical necessity criteria, the Department of Health Services may enter an adult day health care center and review participants' medical records and observe participants receiving care identified in the individual plan of care, in addition to reviewing the information provided with the treatment authorization requests.
Notwithstanding 5328, information and records of an older adult client may be released with the older adult's consent to multidisciplinary teams in the event of suspected abuse of such elder adult. Such disclosed information shall not include the nature of treatment or services provided. Information may be shared among team members.
