HIPAA notice
This notice describes how medical information about you may be used and disclosed, how you may gain access to this information and the measures taken to safeguard your information. The Health Insurance Portability and Accountability Act of 1996 requires health plans to notify plan participants and beneficiaries about its policies and practices to protect the confidentiality of their health information. For purposes of this notice, health information refers to any information that is considered Protected Health Information as defined in the Privacy Rule of the Administrative Simplification provision of HIPAA.
How the plan may use and disclose health information
To make or obtain payment or collect payment from third parties, such as other health plans or providers, for the care you receive.
To conduct health care operations and, as necessary, to provide coverage and services to all participants. Healthcare operations include activities such as:
- accreditation, certification, licensing or credentialing activities
- activities designed to improve health or reduce health care costs
- business management and general administrative activities, including customer service and resolution of internal grievances
- clinical guideline and protocol development, case management and care coordination
- contacting health care providers and participants with information about treatment alternatives and other related functions
- health care professional competence or qualifications review and performance evaluation
- quality assessment and improvement activities
- underwriting, premium rating or related functions to create, renew or replace health insurance or health benefits
- reviews and auditing, including compliance reviews, medical reviews, legal services and compliance programs; and business planning and development including cost management, planning analyses and formulary development. In addition, summary health information may be provided to third parties in connection with the solicitation of health plans or the modification or amendment of the existing plan
For treatment alternatives: To tell you about or recommend possible treatment options or alternatives that may be of interest to you.
For distribution of health-related benefits and services that may be of interest to you.
When legally required by any federal, state or local law.
To conduct health oversight activities for authorized activities including audits, civil administrative or criminal investigations, inspections, licensure or disciplinary action. However, we may not disclose your health information if you are the subject of an investigation and the investigation does not arise out of or is not directly related to your receipt of health care or public benefits.
In connection with judicial and administrative proceedings in response to an order of a court or administrative tribunal as expressly authorized by such order or in response to a subpoena, discovery request or other lawful processes.
For law enforcement purposes for certain law enforcement purposes, including but not limited to, if there is a suspicion that your death was the result of criminal conduct or in an emergency to report a crime.
In the event of a serious threat to your health or safety or to the health and safety of the public.
For specified government functions related to the military and veterans, to national security and intelligence activities, to protective services for the president and others, and to correctional institutions and inmates.
For workers’ compensation to the extent necessary to comply with laws related to workers compensation or similar programs.
Your rights with respect to your health information
Right to authorize the use or disclosure of health information
Other than as previously stated, your health information will not be disclosed without your written authorization; you may revoke that authorization in writing at any time.
Right to request restrictions
You may request restrictions on certain uses and disclosures of your health information. You have the right to request a limit on disclosure of your health information to someone involved in the payment of your care. However, your request is subject to approval.
Right to receive confidential communications
To safeguard the confidentiality of your health information, you may request that communication be conducted in a specified manner or at a specified location. Alternatively, for example, you may request that all health information be mailed to your work location rather than your home. If you wish to receive confidential communications, please make your request in writing. Your reasonable requests will be accommodated when possible.
Right to inspect and copy your health information
You have the right to inspect and copy your health information. If you request a copy of your health information, a reasonable fee may be charged for copying, assembling costs and, if applicable, postage associated with your request.
Right to amend your health information
If you believe that your health information records are inaccurate or incomplete, you may request that the records be amended. That request may be made as long as the information is maintained by the State of Arizona Department of Administration. Your request may be denied if it does not include a reason to support the amendment. The request also may be denied if your health information records were not created by ADOA, if the health information you are requesting to amend is not part of ADOA’s records, if the health information you wish to amend falls within an exception to the health information you are permitted to inspect and copy, or if it is determined the records containing your health information are accurate and complete.
Right to request accounting
You have the right to request a list of disclosures of your health information made for any reason other than for treatment, payment or health operations. The request should specify the time period for which you are requesting the information, but may not start earlier than April 14, 2003. Accounting requests may not be made for periods of time going back more than six years. The first accounting you request during any 12-month period will be without charge. Subsequent accounting requests may be subject to a reasonable cost-based fee.
Right to a paper copy of this notice
You have a right to request and receive a paper copy of this notice at any time, even if you have received this notice previously or agreed to receive the notice electronically.
The privacy of your health information as set forth in this notice is required by law. The terms of this notice may be changed and revised provisions will be effective for all health information maintained. If policies and procedures are changed, this notice will be revised and you will be provided a copy of the revised notice within 60 days of the change. You have the right to express complaints to the Secretary of the Department of Health and Human Services if you believe that your privacy rights have been violated. You will not be penalized or retaliated against in any way for filing a complaint.