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.
Our Obligation to You We value the
privacy of your medical information as an important part of our "patient
first" pledge. We are committed to protecting the privacy of your health
information. We strive to use only the minimum amount of your health
information necessary for the purposes described in this Notice.
We collect information from you and use it to provide you
with quality care, and to comply with certain legal requirements. We are
required by law to maintain the privacy of your health information, and to
give you this Notice of our legal duties, our privacy practices, and your
rights. We are required to follow the terms of our most current Notice.
When we disclose information to other persons and companies to perform
services for us, we will require them to protect your privacy. There are
other laws we will follow that provide additional protections, such as
laws related to mental health, alcohol and other substance abuse, and
HIV/AIDS.
This Notice covers the following sites and people: all
health care professionals authorized to enter information into your chart,
all volunteers authorized to help you while you are here, all our
employees and on- site contractors, all departments and units within the
hospital, all health care students, all health care delivery facilities
and providers within the MedStar Health system, and your personal doctor
and others while they are providing care at this site. Your doctor may
have different policies or notices about the health information that was
created in his or her private office or clinic.
HOW WE MAY USE AND DISCLOSE HEALTH
INFORMATION Treatment: We may use and disclose your health
information to provide treatment or services, to coordinate or manage your
health care, or for medical consultations or referrals. We may disclose
your health information to doctors, nurses, technicians, medical students
and other personnel who are involved in taking care of you. We may share
information about you to coordinate the different services you need, such
as prescriptions, lab work and x-rays. We may disclose information about
you to people outside our facility who may be involved in your care after
you leave, such as family members, home health agencies, therapists,
nursing homes, clergy, and others. We may give information to your health
plan or another provider to arrange a referral or consultation.
Payment: We may use and disclose your
health information so that we can receive payment for the treatment and
services that were provided. We may share this information with your
insurance company or a third party used to process billing information. We
may contact your insurance company to verify what benefits you are
eligible for, to obtain prior authorization, and to tell them about your
treatment to make sure that they will pay for your care. We may disclose
information to third parties who may be responsible for payment, such as
family members, or to bill you. We may disclose information to third
parties that help us process payments, such as billing companies, claims
processing companies, and collection companies.
Healthcare Operations: We may use and
disclose your health information as necessary to operate our facility and
make sure that all of our patients receive quality care. We may use health
information to evaluate the quality of services that you received, or the
performance of our staff in caring for you. We may use health information
to improve our performance or to find better ways to provide care. We may
use health information to grant medical staff privileges or to evaluate
the competence of our health care professionals. We may use your health
information to decide what additional services we should offer and whether
new treatments are effective. We may disclose information to students and
professionals for review and learning purposes. We may combine our health
information with information from other health care facilities to compare
how we are doing and see where we can make improvements. We may use health
information for business planning, or disclose it to attorneys,
accountants, consultants and others in order to make sure we are complying
with the law. We may remove health information that identifies you so that
others may use the de-identified information to study health care and
health care delivery without learning who you are.
Appointment Reminders and Service
Information: We may use or disclose your health information to
contact you to provide appointment reminders, or to let you know about
treatment alternatives or other health related services or benefits that
may be of interest to you.
Patient Directories: We may keep your
name, location in the facility, and your general condition in a directory
to give to anyone who asks for you by name. We may give this information
and your religious affiliation to clergy, even if they do not know your
name. You may ask us to keep your information out of the directory, but
you should know that if you do, visitors and florists will not be able to
find your room.
Individuals Involved In Your Care: We may
give your health information to people involved in your care, such as
family members or friends, unless you ask us not to. We may give your
information to someone who helps pay for your care. We may disclose
information to disaster relief organizations, such as the Red Cross, so
they can contact your family.
Fundraising Activities: We depend
extensively on private fundraising to support our health care missions. We
may use your contact information and the dates of your care, but not your
treatment information, so that we may provide you with an opportunity to
make a donation to our fund raising programs. If we do contact you for
fundraising purposes, you will be told how you may ask us not to contact
you in the future.
Research: We may disclose your health
information for medical research that has been approved by one of our
official research review boards, which has evaluated the research proposal
and established standards to protect the privacy of your health information.
We may disclose your health information to a researcher preparing to
conduct a research project.
Organ and Tissue Donation: We may use or
disclose your health information in connection with organ donations, eye
or tissue transplants or organ donation banks, as necessary to facilitate
these activities.
Public Health Activities: We may disclose
your health information to public health or legal authorities whose
official activities include preventing or controlling disease, injury, or
disability. For example, we must report certain information about births,
deaths, and various diseases to government agencies. We may disclose
health information to coroners, medical examiners, and funeral directors
as allowed by the law to carry out their duties. We may use or disclose
heath information to report reactions to medications, problems with
products, or to notify people of recalls of products they may be using. We
may use or disclose health information to notify a person who may have
been exposed to a disease or may be at risk for contracting or spreading a
disease.
Serious Threat to Health and Safety: We
may disclose your health information when necessary to prevent a serious
threat to your health and safety, or the health and safety of the public
or another person. We will only disclose health information to someone
reasonably able to help prevent or lessen the threat, such as law
enforcement or government officials.
Required by Law, Legal Proceedings, Health
Oversight Activities, and Law Enforcement: We will disclose your
health information when we are required to do so by federal, state and
other law. For example, we are required to report victims of abuse,
neglect or domestic violence, as well as patients with gunshot and other
wounds. We will disclose your health information when ordered in a legal
or administrative proceeding, such as a subpoena, discovery request,
warrant, summons, or other lawful process. We may disclose health
information to a law enforcement official to identify or locate suspects,
fugitives, witnesses, victims of crime, or missing persons. We may
disclose health information to a law enforcement official about a death we
believe may be the result of criminal conduct, or about criminal conduct
that may have occurred at our facility. We may disclose health information
to a health oversight agency for activities authorized by law, such as
audits, investigations, inspections and licensure.
Specialized Government Functions: If you
are in the military or a veteran, we will disclose your health information
as required by command authorities. We may disclose health information to
authorized federal officials for national security purposes, such as
protecting the President of the United States or the conduct of authorized
intelligence operations. We may disclose health information to make
medical suitability determinations for Foreign Service.
Correctional Facilities: If you are an
inmate of a correctional institution or under the custody of a law
enforcement official, we may release your health information to the
correctional institution or law enforcement official. We may release your
health information for your health and safety, for the health and safety
of others, or for the safety and security of the correctional
institution.
Workers Compensation: We may disclose
your health information as required by applicable workers compensation and
similar laws.
Your Written Authorization: Other uses
and disclosures of your health information not covered by this Notice, or
the laws that govern us, will be made only with your written
authorization. You may revoke your authorization in writing at any time,
and we will discontinue future uses and disclosures of your health
information for the reasons covered by your authorization. We are unable
to take back any disclosures that we already made with your authorization,
and we are required to retain the records of the care that we provided to
you.
YOUR PRIVACY RIGHTS REGARDING YOUR HEALTH
INFORMATION Right to Obtain a Copy of This Notice of
Privacy Practices We will post a copy of our current Notice
in our facilities and on our website, www. medstarhealth. org. A copy of
our current Notice will be available at our registration areas or upon
request. To request a copy of our current Notice of Privacy Practices,
please call 877-277-4822 (toll free).
Right to See and Copy Your Health Record
You have the right to look at and receive a copy of your health record
or your billing record. To do so, please contact the facility where you
received treatment, or the Privacy Office listed below. You may be
required to make your request in writing. If you would like a copy of your
health record, a fee may be charged for the cost of copying or mailing
your record, as permitted by law. In certain situations, we may deny
your request. If we do, we will tell you, in writing, our reasons for the
denial and explain your right to have the denial reviewed.
Right to Update Your Health Record If
you believe that a piece of important information is missing from your
health record, you have the right to request that we add an amendment to
your record. Your request must be in writing, and it must contain the
reason for your request. To submit your request, please contact the
facility where you received treatment, or the Privacy Office listed
below.
We may deny your request to amend your record if the
information being amended was not created by us, if we believe that the
information is already accurate and complete, or if the information is not
contained in records that you would be permitted by law to see and copy.
Even if we accept your amendment, we will not delete any information
already in your records.
Right to Get a List of the Disclosures We Have
Made You have the right to request a list of the
disclosures that we have made of your health information. The
list will not contain disclosures we have made for the purposes of treatment,
payment and health care operations. It will not contain disclosures that
were authorized by you, and certain other disclosures excluded by law. The list will
not contain disclosures that were made before April 14, 2003.
Your request must be in writing. To request a list of
disclosures, please contact the facility where you received treatment, or
the Privacy Office listed below. The first list you request in a 12- month
period is free. For additional lists, we may charge a fee, as permitted by
law.
Right to Request a Restriction On Certain Uses or
Disclosures You have the right to request that we limit
how we use and disclose your health information. We will consider your
request, but we are
not legally required to accept it. If we do accept it, we
will comply with your request, except if you need emergency
treatment.
Your request must be in writing. To submit a request,
please contact the facility where you received treatment, or the Privacy
Office listed below.
Right to Choose How You Receive Your Health
Information You have the right to request that we communicate
with you in a certain way, such as by mail or fax, or at a certain
location, such as a home address or post office box. We will try to honor
your request if we reasonably can. Your request must be in writing, and it
must specify how or where you wish to be contacted. To submit a request,
please contact the facility where you received treatment, or the Privacy
Office listed below.
CONTACT PERSON If you believe your
privacy rights have been violated, you may file a complaint in writing
with the contact person listed below. We will take no retaliatory action
against you if you file a complaint about our privacy practices. If you
would like to file a complaint with us or with the Secretary of the
Department of Health and Human Services, please contact our Privacy Office
listed below.
If you have questions about this Notice, or would like to
exercise your Privacy Rights, please contact the facility where you
received treatment, or contact our Privacy Office:
Privacy Officer MedStar Health, Inc. 5565
Sterrett Place Columbia, MD 21044 1- 877- 277- 4822 (toll
free) PrivacyOfficer@MedStar.net
CHANGES TO THIS NOTICE OF PRIVACY
PRACTICES We reserve the right to change this notice. We
reserve the right to make the revised notice effective for medical
information we already have about you as well as any information we
receive in the future.
El Aviso sobre Prácticas de Privacidad está
disponible en español.
Footnote: MedStar Health, Inc., as the parent company,
is located in Columbia, Maryland. In addition, the system is made up of a
number of wholly owned subsidiaries, including Franklin Square Hospital,
Georgetown University Hospital, Good Samaritan Hospital, Harbor Hospital,
MedStar Physician Partners, MedStar Research Institute, National
Rehabilitation Hospital, Union Memorial Hospital, VNA, Washington Hospital
Center, and MedStar Health Diversified businesses. While these businesses
operate independently of one another and as separate employers, they also
work toward common missions and values, with the ultimate goal to be the
health care provider of choice in the Baltimore- Washington region. In
working to achieve this goal, it is the responsibility of each subsidiary
to enforce its privacy policies and to take appropriate disciplinary or
other actions for employee violations. Please note that for purposes of
this Notice of Privacy Practices, the MedStar Health parent company and
all of its subsidiaries will be referred to collectively as "MedStar
Health." For privacy purposes only, MedStar Health is organized as an
Affiliated Covered Entity, as described in 45 CFR § 164.504( d)( 1);
legally separate entities that are affiliated may designate themselves as
a single covered entity.
©2003 MedStar Health, Inc.
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