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.
We are required by law to maintain the privacy of your health information; to provide you this detailed Notice of our legal duties and privacy practices relating to your health information; to notify affected individuals following a breach of unsecured protected health information; and to abide by the terms of the Notice that are currently in effect.
1. USES AND DISCLOSURES FOR TREATMENT, PAYMENT AND HEALTH CARE OPERATIONS.
The following lists various ways in which we may use or disclose your health information for purposes of treatment, payment and health care operation.
For Treatment. We will use and disclose your health information in providing you with treatment and services and coordinating your care and may disclose information to other providers involved in your care. Your health information may be used by doctors involved in your care and by nurses and C.N.As, as well as by physical, occupational and speech therapists, dietitian, pharmacists, suppliers of medical equipment or other persons involved in your care. For example, we will contact your physician to discuss your plan of care.
For Payment. We may use and disclose your health information for billing and payment purposes. We may disclose your health information to an insurance or managed care company, Medicare, Medicaid or another third party payor. For example, we may contact Medicare or your health plan to confirm your coverage or to request prior approval for services that will be provided to you.
For Health Care Operations. We may use and disclose your health information as necessary for health care operations, such as management, personnel evaluation, education and training and to monitor our quality of care. We may disclose your health information to another entity with which you have or had a relationship if that entity requests your information for certain of its health care operations or health care fraud and abuse detection or compliance activities. For example, health information of many patients may be combined and analyzed for purposes such as evaluating and improving quality of care and planning for services.
2. SPECIFIC USES AND DISCLOSURES OF YOUR HEALTH INFORMATION THAT MAY BE MADE WITHOUT YOUR AUTHOZIATION.
Facility Directory. Unless you object, we will include certain limited information about you in our facility directory. This information may include your name, your location in the facility and your general condition and your religious affiliation. Our directory does not include specific medical information about you. We may release information in our directory, except for your religious affiliation, to people who ask for you by name. We may provide the directory information, including your religious affiliation, to any member of the clergy.
Individuals Involved in Your Care or Payment for Your Care. Unless you object, we may disclose health information about you to a family member, close personal friend or other persons you identify, including clergy, who is involved in your care.
Emergencies. We may use or disclose your health information as necessary in emergency treatment situations.
As Required by Law. We will disclose health information about you when required to do so by Federal, State or local law.
Public Health Activities. We may disclose your health information for public health activities. These activities may include, for example, reporting to a public health authority for preventing or controlling disease, injury or disability; reporting elder abuse or neglect; or reporting deaths.
Reporting Victims of Abuse, Neglect or Domestic Violence. If we believe that you have been a victim of abuse, neglect or domestic violence, we may use and disclose your health information to notify a government authority, if authorized by law or if you agree to the report.
Health Oversight Activities. We may disclose your health information to a health oversight agency for activities authorized by law, such as audits, investigations, inspections and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.
To Avert a Serious Threat to Health or Safety. When necessary to prevent a serious threat to your health or safety or the health or safety of the public or another person, we may use or disclose health information, limiting disclosures to someone able to help lessen or prevent the threatened harm.
Judicial and Administrative Proceedings. We may disclose your health information in response to a court or administrative order. We also may disclose information in response to a subpoena, discovery request or other lawful process; efforts must be made to contact you about the request or to obtain an order or agreement protecting the information.
Law Enforcement. We may disclose your health information for certain law enforcement purposes, including, for example, to comply with reporting requirements; to comply with a court order, subpoena, warrant, summons or similar legal process; or to answer certain requests for information concerning crimes.
Research. We may use or disclose your health information for research purposes if the privacy aspects of the research have been reviewed and approved, if the researcher is collecting information in preparing a research proposal, if the research occurs after your death or if you authorize the use or disclosure. Information, which identifies you as the patient, will be removed.
Coroners, Medical Examiners, Funeral Directors, Organ Procurement Organizations. We may release your health information to a coroner, medical examiner, funeral director or, if you are an organ donor, to an organization involved in the donation of organs and tissue.
Disaster Relief. We may disclose health information about you to a disaster relief organization.
Military, Veterans and Other Specific Government Functions. If you are a member of the armed forces, we may use and disclose your health information as required by military command authorities. We may disclose health information for national security purposes or as needed to protect the President of the United States or certain other officials or to conduct certain special investigations.
Workers’ Compensation. We may use or disclose your health information to comply with laws relating to workers’ compensation or similar programs.
Inmates/Law Enforcement Custody. If you are under the custody of a law enforcement official or a correctional institution, we may disclose your health information to the institution or official for certain purposes including the health and safety of you and others.
Fundraising Activities. We may use your health Information to contact you in an effort to raise money for The Cedars. You have the right to opt out of receiving such communications. We will only release contact information, such as your name, address and phone number and the dates health care was provided to you. The money raised will be used to expand and improve the services and programs we provide the community.
Appointment Reminders. We may use or disclose health information to remind you about appointments.
Treatment Alternatives and Health-Related Benefits and Services. We may use or disclose your health information to inform you about treatment alternatives and health-related benefits and services that may be of interest to you.
To the U.S. HHS. We must disclose your health information to the Secretary of the U.S. Department of Health & Human Services to investigate or determine our compliance with the federal privacy laws and regulations.
3. USES AND DISCLOSURES WITH YOUR AUTHORIZATION
Except as described in this Notice; other uses and disclosures of your health information will only be made with your written Authorization. The types of uses and disclosures of your health information that require your Authorization include the following: (i) any use or disclosure of psychotherapy notes, except to carry out treatment, payment or health care operations, or use by the originator of the notes for treatment. (ii) for marketing, except if the communication is in the form of a face-to-face communication between us and an individual or involves a promotional gift of nominal value; and (iii) the sale of protected health information.
You may revoke an Authorization in writing at any time, provided the revocation is in writing, except to the extent we have taken action in reliance on your Authorization, or the Authorization was obtained as a condition of obtaining insurance coverage, or other law provides the insurer with the right to contest a claim under the policy or the policy itself. If you revoke an Authorization, we will no longer use or disclose your health information for the purposes covered by that Authorization, except where we have already relied on the Authorization.
4. YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION.
Listed below are your rights regarding your health information. These rights may be exercised by submitting a request in writing to The Cedars. Each of these rights is subject to certain requirements, limitations and exceptions. At your request, The Cedars will supply you with the appropriate form to complete. You have the right to:
Request Restrictions. You have the right to request restrictions on our use or disclosure of your health information for treatment, payment or health care operations. You also have the right to restrict the health information we disclose about you to a family member, friend or other person who is involved in your care or the payment of your care. The Cedars is not required to agree to your requested restriction, except if the request is to restrict disclosure of health information to a health plan if (i) the disclosure is for purposes of carrying out payment or health care operations (not treatment) and is not otherwise required by law and (ii) the health information pertains solely to an item or service for which, you or a person on your behalf, other than the health plan has paid The Cedars in full.
We are required to agree to your requested restriction with respect to release of your health information to any individual outside The Cedars unless you are being transferred to another health care institution, the release of records is required by law, third party payment or to provide you with emergency care.
- Access Protected Health Information. You have the right to request, orally or in writing, your medical or billing records or other written information that may be used to make decisions about your care. We must allow you to inspect your records within 24 hours of your request (excluding weekends and holidays). If you request copies of the records, we must provide you with copies within two working days of that request. We may charge a reasonable fee consistent with state law for our costs in copying and mailing your requested information.
- Request Amendment. You have the right to request amendment of your health information maintained by The Cedars for as long as the information is kept by or for The Cedars. Your request must be made in writing and must state the reason for the requested amendment.
We may deny your request for amendment if the information (a) was not created by The Cedars, unless the originator of the information is no longer available to act on your request; (b) is not part of the health information maintained by or for The Cedars; (c) is not part of the information to which you have a right of access; or (d) is already accurate and complete, as determined by The Cedars.
If we deny your request for amendment, we will give you a written denial including the reasons for the denial and the right to submit a written statement disagreeing with the denial.
- Request an Accounting of Disclosures. You have the right to request an “accounting” of certain disclosures of your health information. This is a listing of disclosures made by The Cedars or by others on our behalf, but this does not include disclosures for treatment, payment and health care operations or certain other exceptions.
To request an accounting of disclosures, you must submit a request in writing, stating a time period beginning after April 13, 2003 that is within six years from the date of your request. The first accounting provided within a 12-month period will be free; for further requests, we may charge you our costs.
Request a Paper Copy of This Notice. You have the right to obtain a paper copy of this Notice, even if you have agreed to receive this Notice electronically. You may ask us to provide a copy of this Notice at any time. In addition, you may obtain a copy of this Notice at our web site, www.thecedarsportland.org.
Request Confidential Communications. You have the right to request that we communicate with you concerning your health matters in a certain manner. We will accommodate your reasonable requests.
- Request an Electronic Copy of your Medical Record. In the event The Cedars converts to an electronic medical record and you request a copy of your medical record, you may request that this be done in disc form.
6. MORE STRINGENT LAWS
Some of your health information may be subject to other laws and regulations and afforded greater protection than what is outlined in this Notice. For instance, HIV/AIDS, substance abuse and mental health information are often given more protection. In the event your health information is afforded greater protection under Federal or State law, we will comply with the applicable law.
7. FOR FURTHER INFORMAION OR TO FILE A COMPLAINT
If you have any questions about this Notice or would like further information concerning your privacy rights, please contact The Cedars Privacy Officer, (207) 221-7000.
If you believe that your privacy rights have been violated, you may file a complaint with The Cedars or with the Office for Civil Rights in the U.S. Department of Health and Human Services.
To file a complaint with The Cedars, contact the Privacy Officer, 630 Ocean Ave., Portland, ME 04103 (207) 221-7000. All complaints must be submitted in writing. We will not retaliate against you if you file a complaint.
8. CHANGES TO THIS NOTICE
We reserve the right to change this Notice. We reserve the right to make the revised or changed Notice effective for all health information already received and maintained by The Cedars as well as for all health information we receive in the future. We will post a copy of the current Notice in our facility and on our website. In addition, if material changes are made to this Notice, the Notice will contain an effective date for the revisions. We will provide a copy of the revised Notice upon request.
Revised: March 26, 2013