The NHIP uses the mechanisms listed below to govern confidentiality, integrity, and availability of protected health information (PHI) in written and electronic form.
• Policies prohibiting NHIP employees and contractors from voluntarily disclosing any peer review information, except where permitted or required by law.
• Policies prohibiting NHIP employees from disclosing members’ personally identifiable information (PII) or PHI, except for: treatment, payment, or healthcare operations; where permitted or required by law; or pursuant to written member authorization explicitly allowing such disclosure.
• Policy mandating the disclosure of only the minimum necessary amount of member and provider information to perform payment, treatment, and healthcare functions and meet the legal obligations of the health plan.
• Policies restricting access to member and provider information to only those employees who need access to perform each employee’s job and controlled through the use of individual user identification and passwords.
Conflict of Interest
NHIP does not award bonuses, rewards, or financial incentives to any Medical Director, physician advisor, or utilization management employee based on the number of adverse initial and appeal determinations made.