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Center Care Health Benefit Programs

NOTICE OF PRIVACY PRACTICES
Effective Date: April 14, 2003

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION
ABOUT YOU MAY BE USED AND DISCLOSED AND
HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY

Each time you visit a hospital, physician, or other healthcare provider, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, a plan for future care or treatment, and billing-related information. This notice applies to all of the records of your care as requested in order to comply with your health plan benefits. Your personal doctor and hospital may have different policies or notices regarding their use and disclosure of your medical information created in the doctor’s office, clinic or hospital. This notice will tell you about the ways in which we may use and disclose medical information about you. We also describe your rights and certain obligations we have regarding the use and disclosure of medical information.

Our Responsibilities

We are required by law to maintain the privacy of your health information and provide you a description of our privacy practices. We will abide by the terms of this notice.

How We May Use and Disclose Medical Information About You:

The following categories describe examples of the way we use and disclose medical information:

For Treatment

  • We may use medical information about you to provide you treatment or services. We may disclose medical information about you to doctors, nurses, technicians, medical students, or other hospital personnel who are involved in taking care of you. For example: a doctor treating you for a broken leg may need to know if you have diabetes because diabetes may slow the healing process. We also may disclose information about you to people outside the hospital, such as family members, and other providers of care.

We may also provide your physician or a subsequent healthcare provider with copies of various reports that should assist him or her in treating you throughout the continuum of care.

For Payment

  • We may use and disclose medical information about your treatment and services to process your medical claim. For example, we may need to give your third party administrator, medical and disease management company and reinsurance carriers information about your surgery so they will reimburse for the treatment.

For Health Care Operations

  • Members of the quality improvement team may use information in your health record to assess the care and outcomes in your case and others like it. The results will then be used to continually improve the quality of care for all patients we serve. For example, we may combine medical information about many patients to evaluate the need for new services. We may disclose information to doctors, nurses, and other students for educational purposes. And we may combine medical statistics we have with that of other health care entities in order to make improvements. We may remove information that identifies you from this set of medical information to protect your privacy.

How We Will Contact You

Unless you tell us otherwise in writing, we may contact you by either telephone or by mail at either your home or your workplace. At either location, we may leave discreet messages for you on the answering machine or voice mail. If you want to request that we communicate to you in a certain way or at a certain location, please inform the Registration staff during the registration process or contact the Director of Member Services. Your request must state how or where you can be contacted. We will accommodate your request. However, we may, when appropriate, require information from you concerning how payment will be handled. We also may require an alternate address or other method to contact you.

We may also use and disclose your medical information in accordance with federal and state laws for the following purposes.

  • Treatment Alternatives
    We may contact you with information about treatment alternatives or other health-related benefits and services that may be of interest to you.


  • Individuals Involved in Your Care or Payment for Your Care
    We may release medical information about you to a friend or family member who is involved in your medical care. We may also give information to someone who helps pay for your care. In addition, we may disclose medical information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location. If there is a family member, other relative or friend that you do not want us to disclose medical information about you to, please request the Opt-out Form from the Director of Member Services.


  • As Required By Law
    We will disclose medical information about you when required to do so by federal, state or local law.


  • To Avert a Serious Threat to Health or Safety
    We may use and disclose medical information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat.


  • Organ and Tissue Donation
    If you are an organ donor, we may release medical information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.


  • Military and Veterans
    If you are a member of the armed forces, we may release medical information about you as required by military command authorities.


  • Workers’ Compensation
    We may disclose medical information about you to the extent necessary to comply with workers’ compensation and similar laws that provide benefits for work-related injuries or illness without regard to fault.


  • Public Health Activities
    We may disclose medical information about you for public health activities and purposes. This includes reporting medical information to a public health authority that is authorized by law to collect or receive the information for purposes of preventing or controlling disease. Or, one that is authorized to receive reports of child abuse and neglect. It also includes reporting for purposes of activities related to the quality, safety or effectiveness of United States Food and Drug Administration regulated product or activity.


  • Victims of Abuse, Neglect or Domestic Violence
    We may disclose your medical information when it concerns abuse, neglect or violence to you in accordance with federal and state law.


  • Health Oversight Activities
    We may disclose medical information about you to a health oversight agency for activities authorized by law, including audits, investigation, inspections, licensure or disciplinary actions. These and similar types of activities are necessary for appropriate oversight of the health care system, government benefit programs, and entities subject to various government regulations.


  • Lawsuits and Disputes
    If you are involved in a lawsuit or dispute, we may disclose medical information about you in response to a court or administrative order. We may also disclose medical information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.


  • Disclosures for Law Enforcement Purposes
    We may disclose medical information about you to law enforcement officials for law enforcement purposes.


  • We may also use and disclose health information for the following:
    • National Security and Intelligence Activities
    • Protective Services for the President
    • Security Clearance

  • Inmates: Persons in Custody
    If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release medical information about you to the correctional institution or law enforcement official. This release would be necessary (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) for the safety and security of the correctional institution.


  • Business Associates
    There are some services provided in our organization through contracts with business associates. Examples include medical and disease management companies, payers, insurance and financial service providers such as workers compensation insurers, automobile liability insurers, pharmacy benefit managers, insurance agents and brokers, subrogation companies and reinsurance companies. . When these services are contracted, we may disclose your health information to our business associate so that they can perform the job we have asked them to do and bill you or your third-party payer for services rendered. To protect your health information, however, we require the business associate to appropriately safeguard your information.


  • Affiliated Covered Entity
    Protected health information will be made available to health care providers as necessary to carry out treatment, payment and health care operations. Health care providers may have access to protected health information at their locations to assist in reviewing past treatment information as it may affect treatment at this time.

Your Health Information Rights

Although your health record is the physical property of the healthcare practitioner or facility that compiled it, you have the following rights.

  • Right to Inspect and Copy
    You have the right to inspect and copy medical information that may be used to make decisions about your care. Usually, this includes medical and billing records, but does not include psychotherapy notes. We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to medical information, you may request that the denial be reviewed. Another health care professional chosen by Center Care will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review. You must submit your request in writing to the HIPAA Compliance Coordinator. If you request a copy of the information, we may charge a fee for the cost of copying, mailing or others supplies associated with your request.


  • Right to Amend
    If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by us. We may deny your request for an amendment and, if this occurs, you will be notified of the reason for the denial. To request an amendment, your request must be made in writing to the Director of Member Services.


  • Right to an Accounting of Disclosures
    You have the right to request an accounting of disclosures. This is a list of certain disclosures we make of your medical information for purposes other than treatment, payment or health care operations. To request this list or accounting of disclosures, you must submit your request in writing to the Director of Member Services. . Your request must state a time period that may not be longer than six years and may not include dates before April 14, 2003.


  • Right to Request Restrictions
    You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment or health care operations. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. For example, you could ask that we not use or disclose information about a surgery you had. To request restrictions, your request must be made to the Registration staff or send your request in writing to the Director of Member Services.

    We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment.


  • Request Confidential Communications
    You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you may ask that we contact you at work or by U.S. Mail. The facility will grant requests for confidential communications at alternative locations and/or via alternative means only if the request is submitted in writing and the written request includes a mailing address where the individual will receive bills for services rendered by the facility and related correspondence regarding payment for services. Please realize, we reserve the right to contact you by other means and at other locations if you fail to respond to any communication from us that requires a response. We will notify you in accordance with your original request prior to attempting to contact you by other means or at another location. To request confidential communications, your request must be made to the Director of Member Services.


  • A Paper Copy of This Notice
    You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice.

    You may obtain a copy of this notice at our website, which is www.centercare.com.


  • CHANGES TO THIS NOTICE
    We reserve the right to change this notice and the revised or changed notice will be effective for information we already have about you as well as any information we receive in the future. The current notice will be posted in the Center Care office and include the effective date. In addition, we will offer you a copy of the current notice in effect with your summary plan description, through distribution by your employer, or via the Center Care directory.

COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint with the Commonwealth Health Corporation / Medical Center HIPAA Compliance Coordinator at the below address or with the Secretary of the Department of Health and Human Services, Washington, D.C. All complaints should be submitted in writing.

  • To file a complaint with us, contact:

    Neil Shields
    Vice President of Corporate Compliance and HIPAA Privacy Officer
    Commonwealth Health Corporation d.b.a. Center Care
    800 Park Street
    Bowling Green, KY 42102
    270-745-1851
     
  • To file a complaint with the United States Secretary of Health and Human Services, send your complaint in care of:

    Director, Office for Civil Rights
    U.S. Department of Health and Human Services
    200 Independence Avenue SW
    Washington, D.C. 20201

You will not be penalized in any way for filing a complaint.

OTHER USES OF MEDICAL INFORMATION

  • Other uses and disclosures of medical information not covered by this notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose medical information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you.
     
  • If you have any additional questions or comments about this Notice of Privacy Practices, please contact Neil Shields, HIPAA Privacy Officer at (270) 745-1851.