HB2450 - 532R

Be it enacted by the Legislature of the State of Arizona:

Section 1. Section 12-2802, Arizona Revised Statutes, is amended to read:

START_STATUTE12-2802. Confidentiality of genetic testing results; disclosure

A. Except as otherwise provided in this article, genetic testing and information derived from genetic testing are confidential and considered privileged to the person tested and shall be released only to:

1. The person tested.

2. Any person who is specifically authorized in writing by the person tested or by that person's health care decision maker to receive this information.

3. The health care decision maker of the person tested.

4. A researcher for medical research or public health purposes only if the research is conducted pursuant to applicable federal or state laws and regulations governing clinical and biological research or if the identity of the individual providing the sample is not disclosed to the person collecting and conducting the research.

5. A third person if approved by a human subjects review committee or a human ethics committee, with respect to persons who are subject to an Arizona cancer registry.

6. An authorized agent or employee of a health care provider if all of the following are true:

(a) The health care provider performs the test or is authorized to obtain the test results by the person tested for the purposes of genetic counseling or treatment.

(b) The agent or employee provides patient care, treatment or counseling.

(c) The agent or employee needs to know the information in order to conduct the test or provide patient care, treatment or counseling.

6. A health care provider who is providing care to the person tested and an agent or employee of the health care provider.

7. A health care provider that procures, processes, distributes or uses:

(a) A human body part from a deceased person with respect to medical information regarding that person.

(b) Semen or ova for the purpose of artificial insemination.

8. A health care provider to conduct utilization review, peer review and quality assurance pursuant to section 36‑441, 36‑445, 36‑2402 or 36‑2917.

9. The authorized agent of a federal, state or county health department to conduct activities specifically authorized pursuant to the laws of this state for the birth defects registry, children's rehabilitative services, newborn screening and sickle cell diagnosis and treatment programs and chronic, environmentally provoked and infectious disease programs.

10. To obtain legal advice, the legal representative of a health care provider or clinical laboratory that is in possession of the medical record.

11. A health care provider that assumes the responsibility to provide care for, or consultation to, the patient from another health care provider that had access to the patient's genetic records.

11. A person or entity that provides services to a health care provider or clinical laboratory if the health care provider or clinical laboratory has an agreement requiring the person or entity to protect the confidentiality of the genetic testing and information and as required by the health insurance portability and accountability act of 1996 privacy standards (45 Code of Federal Regulations part 160 and part 164, subpart E).

12. A statewide health information exchange.

13. The health insurance carrier of the person tested.

14. A nationally recognized accreditation organization.

15. A health professional licensing board in this state.

16. An entity that is responsible for the payment of a health care provider's charges and that uses the information only for the purpose of the payment of those charges.

B. A person shall not disclose or be compelled to disclose the identity of any person on whom a genetic test is performed or the results of a genetic test in a manner that allows identification of the person tested except to the persons specified in the circumstances set forth in subsection A of this section.

C. If genetic testing information is subpoenaed, a health care provider shall respond pursuant to section 12‑2294.01, subsection E. In determining whether to order production of the genetic testing information, the court shall take all steps necessary to prevent the disclosure or dissemination of that information.

D. Except as provided in this section, chapter 13, article 7.1 of this title does not apply to genetic testing information that is contained within a patient's medical record.

E. Following the death of a person who had genetic testing performed, the release of the testing information is governed by section 12‑2294, subsection D, except that the person may deny, release or limit release of the genetic testing results by adopting a provision in a testamentary document.

F. Except as specifically provided in this article, a person to whom test results have been disclosed pursuant to this article, other than the person tested, shall not disclose the test results to any other person.

G. A health care provider and the provider's agents and employees that act in good faith and that comply with this article are not subject to civil liability. The good faith of a health care provider that complies with this article is presumed. The presumption may be rebutted by a preponderance of the evidence.

H. This article does not limit the effect of title 20 provisions governing the confidentiality and use of genetic testing information. END_STATUTE

Sec. 2. Section 20-448, Arizona Revised Statutes, is amended to read:

START_STATUTE20-448. Unfair discrimination; definitions

A. A person shall not make or permit any unfair discrimination between individuals of the same class and equal expectation of life in the rates charged for any contract of life insurance or of life annuity or in the dividends or other benefits payable or in any other of the terms and conditions of the contract.

B. A person shall not make or permit any unfair discrimination respecting hemophiliacs or between individuals of the same class and of essentially the same hazard in the amount of premium, policy fees or rates charged for any policy or contract of disability insurance or in the benefits payable or in any of the terms or conditions of the contract, or in any other manner whatever. The provisions of this subsection regarding hemophiliacs do not apply to any policy or subscription contract which that provides only benefits for specific diseases or for accidental injuries or which that provides only indemnity for blood transfusion services or replacement of whole blood products, fractions or derivatives.

C. As to kinds of insurance other than life and disability, a person shall not make or permit any unfair discrimination in favor of particular persons or between insureds or subjects of insurance having substantially like insuring, risk and exposure factors, or expense elements, in the terms or conditions of any insurance contract, or in the rate or amount of premium charged.

D. An insurer shall not refuse to consider an application for life or disability insurance on the basis of a genetic condition, developmental delay or developmental disability.

E. The rejection of an application or the determining of rates, terms or conditions of a life or disability insurance contract on the basis of a genetic condition, developmental delay or developmental disability constitutes unfair discrimination, unless the applicant's medical condition and history and either claims experience or actuarial projections establish that substantial differences in claims are likely to result from the genetic condition, developmental delay or developmental disability.

F. In addition to the provisions in subsection E of this section, the rejection of an application or the determination of rates, terms or conditions of a disability an individual or group health insurance policy or contract on the basis of a genetic condition constitutes unfair discrimination in the absence of a diagnosis of the condition related to information obtained as a result of a genetic test.

G. An insurer that offers life, disability, property or liability insurance contracts shall not deny a claim incurred or deny, refuse, refuse to renew, restrict, cancel, exclude or limit coverage or charge a different rate for the same coverage solely on the basis that the insured or proposed insured is or has been a victim of domestic violence or is an entity or individual that provides counseling, shelter, protection or other services to victims of domestic violence. If an insurer that offers life, disability, property or liability insurance contracts denies a claim incurred or denies, refuses, refuses to renew, restricts, cancels, excludes or limits coverage or charges a different rate for the same coverage on the basis of a mental or physical condition and the insured or the proposed insured is or has been a victim of domestic violence, the insurer shall submit a written explanation to the insured or proposed insured of the reasons for the insurer's actions, in accordance with section 20‑2110. The fact that an insured or proposed insured is or has been the victim of domestic violence is not a mental or physical condition. Nothing contained in This subsection is not intended to provide any private right or cause of action to or on behalf of any applicant or insured. It is the specific intent of this subsection to provide solely an administrative remedy to the director for any violation of this section. Nothing in this subsection prevents an insurer from refusing to issue a life insurance policy insuring a person who has been the victim of domestic violence if either of the following is true:

1. The family or household member who commits the act of domestic violence is the applicant for or prospective owner of the policy or would be the beneficiary of the policy and any of the following is true:

(a) The applicant or prospective beneficiary of the policy is known, on the basis of police or court records, to have committed an act of domestic violence.

(b) The insurer has knowledge of an arrest or conviction for a domestic violence related offense by the family or household member.

(c) The insurance company has other reasonable grounds to believe, and those grounds are corroborated, that the applicant or proposed beneficiary of a policy is a family or household member committing acts of domestic violence.

2. The applicant or prospective owner of the policy lacks an insurable interest in the insured.

H. Nothing in subsection G of this section prevents an insurer that:

1. Offers life or disability insurance contracts from underwriting coverage on the basis of an insured's or proposed insured's mental or physical condition if the underwriting:

(a) Does not consider whether or not the mental or physical condition was caused by an act of domestic violence.

(b) Is the same for an insured or proposed insured who is not the victim of domestic violence as it is for an insured or proposed insured who is the victim of domestic violence.

2. Offers property or liability insurance contracts from underwriting coverage on the basis of the insured's claims history or characteristics of the insured's property and using rating criteria consistent with section 20‑384.

I. Any determination made pursuant to section 20‑2537 by the external independent review organization shall not be considered in connection with the evaluation of whether any person subject to this article has complied with this section.

J. A property or liability insurer may exclude coverage for losses caused by an insured's intentional or fraudulent act. The exclusion shall not deny an insured's otherwise covered property loss if the property loss is caused by an act of domestic violence by another insured under the policy and the insured who claims the property loss cooperates in any investigation relating to the loss and did not cooperate in or contribute to the creation of the property loss. The insurer may apply reasonable standards of proof for claims filed under this subsection. The insurer may limit the payment to the insured's insurable interest in the property minus any payment made to any mortgagee or other party with a secured interest in the property. This subsection does not require an insurer to pay any amount that is more than the amount of the loss or property coverage limits. An insurer who pays a claim under this subsection has the right of subrogation against any person except the victim of the domestic violence.

K. All insurers shall adopt and adhere to written policies that are consistent with chapter 11 of this title and that specify the procedures to be followed by employees, contractors, producers, agents and brokers to ensure the privacy of and to help protect the safety of a victim of domestic violence when taking an application, investigating a claim, pursuing subrogation or taking any other action relating to a policy or claim involving a victim of domestic violence. Insurers shall distribute the written policies to employees, contractors, producers, agents and brokers who have access to personal or privileged information regarding domestic violence.

L. For the purposes of this section:

1. "Developmental delay" means a delay of at least one and one‑half standard deviations from the norm.

2. "Developmental disability" has the same meaning prescribed in section 36‑551.

3. "Domestic violence" means any act that is a dangerous crime against children as defined in section 13-705 or an offense defined in section 13‑1201 through 13‑1204, 13‑1302 through 13‑1304, 13‑1502 through 13‑1504 or 13‑1602, section 13‑2810, section 13‑2904, subsection A, paragraph 1, 2, 3 or 6, section 13‑2916 or section 13‑2921, 13‑2921.01, 13‑2923 or 13‑3623, if any of the following applies:

(a) The relationship between the victim and the defendant is one of marriage or former marriage or of persons residing or having resided in the same household.

(b) The victim and the defendant have a child in common.

(d) The victim is related to the defendant or the defendant's spouse by blood or court order as a parent, grandparent, child, grandchild, brother or sister, or by marriage as a parent‑in‑law, grandparent‑in‑law, stepparent, step‑grandparent, stepchild, step‑grandchild, brother‑in‑law or sister‑in‑law.

(e) The victim is a child who resides or has resided in the same household as the defendant and is related by blood to a former spouse of the defendant or to a person who resides or has resided in the same household as the defendant.

4. "Gene products" means gene fragments, nucleic acids or proteins derived from deoxyribonucleic acids that would be a reflection of or indicate DNA sequence information.

5. "Genetic condition" means a specific chromosomal or single‑gene genetic condition.

6. "Genetic test" means an analysis of an individual's DNA, gene products or chromosomes that indicates a propensity for or susceptibility to illness, disease, impairment or other disorders, whether physical or mental, or that demonstrates genetic or chromosomal damage due to environmental factors, or carrier status for a disease or disorder. END_STATUTE

Sec. 3. Section 20-448.02, Arizona Revised Statutes, is amended to read:

START_STATUTE20-448.02. Genetic testing; informed consent; definitions

A. Except as otherwise specifically authorized or required by this state or by federal law, a person shall not order or require the performance of a genetic test without first receiving the specific written informed consent of the subject of the test who has the capacity to consent or, if the person subject to the test lacks the capacity to consent, of a person authorized pursuant to law to consent for that person. Written consent shall be in a form prescribed by the director. Except as authorized in section 12‑2802, the results of a genetic test performed are privileged and confidential and may not be released to any party without the express consent of the subject of the test or the person authorized pursuant to law to consent for that person.

B. For the purposes of this section:

1. "Gene products" means gene fragments, nucleic acids or proteins derived from deoxyribonucleic acids that would be a reflection of or indicate DNA sequence information.

2. "Genetic test" means an analysis of an individual's DNA, gene products or chromosomes that indicates a propensity for or susceptibility to illness, disease, impairment or other disorders, whether physical or mental, or that demonstrates genetic or chromosomal damage due to environmental factors, or carrier status for a disease or disorder. END_STATUTE