Notice of Privacy Practices
CareFirst takes the privacy of your health information seriously. CareFirst is required by law to maintain that privacy and to provide you with this Notice of Privacy Practices. This Notice is provided to tell you about our duties and practices with respect to your information. CareFirst is required to abide by the terms of this Notice as currently in effect.
The following categories describe different ways that CareFirst uses and discloses your health information. For each category, an explanation of the category is provided, in some cases with examples. Not every use or disclosure in a category will be listed. However, all the ways CareFirst is permitted to use and disclose your health information will fall into one of these categories.
Treatment- CareFirst may use and disclose your health information to coordinate care within CareFirst and with others involved in your care, such as your attending physician, members of the interdisciplinary team and other health care professionals who have agreed to assist in coordinating care. For example, CareFirst may disclose your health information to a physician involved in your care who needs information about your symptoms to prescribe appropriate medications. CareFirst also may disclose health information about you to individuals outside of CareFirst involved in your careincluding family members, other relatives, close personal friends, pharmacists, and suppliers of medical equipment other health care professionals.
Payment- CareFirst may use and disclose your health information to receive payment for the care you receive from CareFirst. For example CareFirst may be required by your health insurer to provide information regarding your health care status, your need for care and the care that CareFirst intends to provide to you so that the insurer will reimburse you or CareFirst.
Health Care Operations- CareFirst may use and disclose health information for its own operations to facilitate the functioning of CareFirst and as necessary to provide quality care to all of its patients. Health care operations include such activities as:
For example: CareFirst may use your health information to evaluate its performance, combine your health information with other CareFirst patients in evaluating how to more effectively serve all CareFirst patients, disclose your health information to members of CareFirst workforce for training purposes, use your health information to contact you as a reminder regarding a visit to you, or contact you as part of general fundraising and community information mailings unless you tell us you do not want to be contacted. (See contact information under the Fundraising Activities).
Fundraising Activities- CareFirst may use information about you, including your name, address, telephone number and the dates you received care in order to contact you to raise money for CareFirst. CareFirst may disclose to a business associate or to an institutionally related foundation for the purpose of raising funds for its own benefit, without a HIPAA compliant authorization. In this context, the additional information that CareFirst may now disclose includes: department of service, the treating physician and outcome information and health insurance status.. If you do not want CareFirst to contact you, you may opt-out of any fundraising activities by notifying the CareFirst Clerical Team at 607.962.3100 or toll free 1.800.734.1570 and indicate that you do not wish to be contacted. Your request will be forwarded to the appropriate staff member.
Sale of PHI—CareFirst does not participate in or initiate the sale of PHI.
Appointment Reminders– CareFirst may use and disclose your health information to contact you as a reminder that you have an appointment for a home visit.
Treatment Alternatives- CareFirst may use and disclose your health information to tell you about or recommend possible treatment options or alternatives that may be of interest to you.
As Required by Law- CareFirst will disclose your health information when it is required to do so by any Federal, State or local law.
Public Health Risks- CareFirst may disclose your health information for public activities and purposes in order to:
Abuse. Neglect Or Domestic Violence- CareFirst is allowed to notify government authorities if CareFirst believes a patient is the victim of abuse, neglect or domestic violence. CareFirst will make this disclosure only when specifically required or authorized by law or when the patient agrees to the disclosure.
Health Oversight Activities- CareFirst may disclose your health information to a health oversight agency for activities including audits, civil administrative or criminal investigations, inspections, licensure or disciplinary action. CareFirst, however, may not disclose your health information if you are the subject of an investigation and your health information are not directly related to your receipt of health care or public benefits.
Judicial And Administrative Proceedings- CareFirst may disclose your health information in the course of any judicial or administrative proceeding 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 process, but only when CareFirst makes reasonable efforts to either notify you about the request or to obtain an order protecting your health information.
Law Enforcement- As permitted or required by State law CareFirst may disclose your health information to a law enforcement official for certain law enforcement purposes as follows:
Coroners And Medical Examiners- CareFirst may disclose your health information to coroners and medical examiners for purposes of determining your cause of death or for other duties, as authorized by law.
Funeral Directors- CareFirst may disclose your health information to funeral directors consistent with applicable law and, if necessary, to carry out their duties with respect to your funeral arrangements. If necessary to carry out their duties, CareFirst may disclose your health information prior to and in reasonable anticipation of your death.
Organ, Eye Or Tissue Donation- CareFirst may use or disclose your health information to organ procurement organizations or other entities engaged in the procurement, banking or transplantation of organs, eyes or tissue for the purpose of facilitating the donation and transplantation.
Research Purposes- CareFirst may, under certain circumstances, use and disclose your health information for research purposes. Before CareFirst discloses any of your health information for research purposes, the project will be subject to an extensive approval process. This process includes evaluating a proposed research project and its use of health information and trying to balance the research needs with your need for privacy. Before CareFirst uses or discloses health information for research, the project will have been approved through this research approval process. Additionally, when it is necessary for research purposes and so long as the health information does not leave CareFirst, it may disclose your health information to researchers preparing to conduct a research project, for example, to help the researchers look for individuals with specific health needs. Lastly, if certain criteria are met, CareFirst may disclose your health information to researchers after your death when it is necessary for research purposes.
Limited Data Set - CareFirst may use or disclose a limited data set of your health information, that is, a subset of your health information for which all identifying information has been removed, for purposes of research, public health, or health care operations. Prior to our release, any recipient of that limited data set must agree to appropriately safeguard your health information. Birth dates and zip codes may not be included in a limited data set.t5
Serious Threat To Health Or Safety - CareFirst may, consistent with applicable law and ethical standards of conduct, disclose your health information if CareFirst, in good faith, believes that such disclosure is necessary to prevent or lessen a serious and imminent threat to your health or safety or to the health and safety of the public.
Specified Government Functions - In certain circumstances, the Federal regulations authorize CareFirst to use or disclose your health information to facilitate specified government functions relating to military and veterans, national security and intelligence activities, protective services for the President and others, medical suitability determinations and inmates and law enforcement custody.
Worker's Compensation - CareFirst may release your health information for worker's compensations or similar program.
OTHER USES OR DISCLOSURES OF HEALTH INFORMATION
CareFirst will not use or disclose your health information unless you provide written authorization, except as otherwise permitted or required by this Notice of Privacy Practice. If you or your representative authorizes CareFirst to use or disclose your health information, you may revoke that authorization, in writing, at any time. If you revoke your authorization CareFirst will no longer use or disclose health information about you for the reasons covered by your written authorization, except to the extent that CareFirst has taken action in reliance thereon. You understand that CareFirst is unable to take back any disclosures it has already made under the authorization, and that CareFirst is required to retain our records of the care that it has provided you.
Decedents – CareFirst can disclose a decedent’s Protected Health Information to family members or other individuals who were involved in the care or payment of a deceased individual prior to his or her death, unless doing so is inconsistent with the prior, express wishes of the deceased. Protection of PHI of deceased individuals is limited to 50 years following the individual’s death.
USE AND DISCLOSURES NEEDING AUTHORIZATION
The following uses and disclosures will be made only with authorization from the individual:
YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION
You have the following rights regarding your health information that CareFirst maintains:
CHANGES TO THIS NOTICE
CareFirst reserves the right to change this Notice. CareFirst reserves the right to make the revised Notice effective for health information we already have about you, as well as any health information we receive in the future. We will post a copy of the current Notice in a clear and prominent location and on our website to which you have access. The Notice also is available to you upon request. The Notice will contain, at the end of this document, the effective date. In addition, if CareFirst revises the Notice, CareFirst will offer you a copy of the current Notice in effect.
You or your personal representative has the right to express complaints to CareFirst and to the Secretary of the U.S. Department of Health and Human Services if you or your representative believes that your privacy rights have been violated (See name and address of the contact person at the end of this notice). CareFirst encourages you to express any concerns you may have regarding the privacy of your information. You will not be retaliated against in any way for filing a complaint.
IF YOU HAVE ANY QUESTIONS REGARDING THIS NOTICE PLEASE USE THE FOLLOWING CONTACT INFORMATION
CareFirst designated the contact person for all issues regarding patient privacy and your rights under Federal privacy standards. The Privacy Officer is Alice Stewart RN, at CareFirst, 3805 Meads Creek Road, Painted Post, NY 14870. Phone- 607.962.3100 or toll free: 800.734.1570.
EFFECTIVE DATE: This Notice is effective April 14, 2003 - Revised 2009, Revised 2010, Revised 2011. Revised 2013.
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