 |
|
NOTICE
OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW MEDICAL NFORMATION
ABOUT YOU AS AN EMPLOYEE MAY BE USED AND
DISCLOSED AND HOW YOU CAN GET ACCESSS TO THIS
INFORMATION
PLEASE REVIEW IT CAREFULLY
Effective April 14, 2003, Broward Children’s Center is required by law
to take reasonable steps to
ensure the privacy of your personally identifiable health information
from your personnel medical
file and to inform you about:
|
|




|
-
The Plan’s uses and
disclosures of Protected Health Information (PHI);
-
Your privacy rights with
respect to your PHI; *the Plan’s duties with respect to your PHI;
*your right to file a complaint with the Plan and to the
Secretary of the U.S. Department of
Health and Human Services; and
-
The person or office to
contact for further information about the Plan’s privacy practices.
|
|
The term
“Protected Health Information” (PHI) includes all employee identifiable
health information transmitted or maintained
by the BCC, regardless of form (oral, written, electronic).
SECTION 1. NOTICE OF PHI USES & DISCLOSURES
Upon your request, BCC is required to give you access to certain PHI in
order to inspect and copy it.
Uses & disclosures to carry out payment & health care
operations:
|
-
BCC and it’s business
associates will use PHI without your consent,
authorization or opportunity to agree or object for health
care
operations.
-
Payment includes but is
not limited to actions to make coverage
determinations and payment (including billing, claims
management, subrogation, plan reimbursement)
-
Health care operations
include but are not limited to premium
rating and other insurance activities relating to creating or
renewing insurance contracts. It also includes disease
management, conducting or arranging for
auditing functions including fraud and
abuse compliance programs, business planning and
development, business management and general administrative
activities.
|
|
Uses
and disclosures that require your consent
If you decline to provide consent for the use of your PHI for treatment,
payment and health care operations you will
not be enrolled in the Insurance Plan. Uses
and disclosures for which consent authorization or opportunity to object
is not required Use and disclosure of your PHI
is allowed without your consent, authorization or request under the
following circumstances:
|
-
When required by law.
-
When permitted for
purposes of public health activities if you have
been exposed to a communicable disease or are at risk of
spreading a disease or condition, if
authorized by law.
-
When authorized by law
to report information about abuse, neglect
or domestic violence to public authorities if there exists a
reasonable
belief that you may be a victim of abuse, neglect or domestic
violence. in such case, BCC will promptly
inform you that such a disclosure has been
or will be made unless that notice would cause a risk of serious
harm.
-
BCC may disclose your
PHI to a public health oversight agency for
oversight activities authorized by law. This includes use of
disclosures in civil, administrative or criminal
investigations; inspections, licensure or
disciplinary actions.
-
BCC may disclose your
PHI when required for judicial or
administrative proceedings. For example, your PHI may be
disclosed in response to a subpoena or discovery request
provided certain conditions are met. One
of those conditions is that satisfactory
assurance must be given to BCC that the requesting
party has made a good faith attempt to provide written notice
to you, and the notice provided sufficient information about
the proceeding to permit you to raise an objection and no
objections were raised or were resolved in
favor of disclosure by the court or
tribunal.
-
When authorized by and
to the extent necessary to comply with
Workers’ compensation or other similar programs established by law.
|
|
SECTION 2. RIGHTS OF INDIVIDUALS
Right to Request Restrictions on PHI uses and Disclosures
You may request BCC to restrict uses and disclosures of your PHI for
payments or health care operations. However,
BCC is not required to agree to your request.
BCC will accommodate reasonable requests to receive communications of
PHI by alternative means or at alternative
locations.
You or your personal representative will be required to complete a form
to request restrictions on uses and
disclosures of your PHI. Such requests should
be made to the following officer: Maureen O’Keeffe, privacy/compliance
officer, 200 SE 19th Avenue, Pompano Beach, Fl. 33060
954-941-1228 X113
Right to Inspect and Copy PHI
You have a right to inspect and obtain a copy of your PHI contained in
your employee medical records for as long as
BCC maintains the PHI.
Medical Records includes records and billing records about employees
maintained for enrollment, payment, billing
maintained for a health plan.
The requested information will be provided within 30 days if the
information is maintained on site or within 60
days if the information is maintained offsite. A single 30 day extension
is allowed if BCC is unable to comply with the
deadline.
You or your personal representative will be required to complete a form
to request access to the PHI in your medical
records. Requests for access to PHI should be made to the following
office: Privacy/compliance
officer, Maureen O’Keeffe, 954-941-1228 ext.
113, 200 SE 19th Avenue, Pompano Beach, Fl.
33060
Right to Inspect and Copy PHI
If access is denied, you or your personal representative will be
provided with a written denial setting
forth the basis for the denial.
A Note About Personal Representative
You may exercise your right through a personal representative. Your
personal representative will be required to
produce evidence of his/her authority to act on your behalf before that
person will be given access to your PHI or
allowed to take any action for you. Proof of such authority may take one
of the following forms:
|
-
A power of attorney for
health care purposes, notarized by a
Notary public;
-
A court order of
appointment of the person as the conservator or
Guardian of the individual; or
|
|
BCC’s
Duties
BCC required by law to maintain the privacy of PHI and to provide
individuals (participants and beneficiaries)
with notice of its legal duties and privacy practices.
This notice is effective April 14, 2003 and BCC is required to comply
with the terms of this notice. However, BCC
reserves the right to change its privacy practices and to apply the
changes to any PHI received or maintained by
BCC prior to that date. If a privacy practice is changed, a revised
version of this notice will be provided to all
past and present participants and beneficiaries for whom BCC
still maintains PHI by 1st Class Mail.
Minimum Necessary Standard
BCC may use or disclose “summary health information” to insurance
companies for obtaining premium bids or
modifying, amending or terminating the group health plan, which
summarizes the claims history, claims expense
or type of claims experienced by individuals for whom BCC has been
covered under a group health plan; and from which identifying
information has been deleted in accordance
with HIPAA.
Your Right to File a Complaint With BCC or the HHS Secretary
If you believe that your privacy rights have been violated, you may
complain to BCC in care of the following
officer: Privacy/compliance
officer, Maureen O’Keeffe, 200 SE 19th Avenue, Pompano
Beach, Fl. 33060, 954-941-1228 ext. 113. You may file a complaint
with the Secretary of the U.S. Department of
Health and Human Services, Hubert H. Humphrey Building 200 Independence
Avenue S.W. Washington, D. C. 20201.
BCC will not retaliate against you for filing a complaint.
Whom to Contact at BCC for More Information
If you have any questions regarding this notice or the subjects
addressed in it, you may contact the following
officer: Maureen O’Keeffe, privacy/compliance
officer, 200 SE 19th Avenue, Pompano
Beach, Fl. 33060, 954-941-1228 ext. 113
Conclusion
PHI use and disclosure by BCC is regulated by a feral law known as HIPAA
(the Health Insurance Portability and
Accountability Act). You may find these rules at 45 Code of Federal
Regulations Parts 160 and 164. This notice
attempts to summarize the regulations. The regulations will
supersede any discrepancy between the information in this notice
and the regulations. |
|
|
| |
|
|
|
|
|