FlexAbility Handbook
NOTICE OF PRIVACY PRACTICES
    

Flexibility Handbook

 


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PEACEHEALTH HEALTH PLAN 
NOTICE OF PRIVACY PRACTICES

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.

Safeguarding Your Health Information

This Notice of Privacy Practices applies to the PeaceHealth Employee Healthcare Plan, the PeaceHealth Vision Plan, the PeaceHealth Dental Plan, the Prescription Drug Plan, the Retiree Prescription Drug Plan, the Employee Assistance Plan, and the health care spending account benefit of the PeaceHealth Flexible Benefits Plan (together the “Plan”). 

The Plan is committed to protecting the privacy of your health information. The Plan is required by applicable federal and state laws to maintain the privacy of your health information. This notice explains the privacy practices of the Plan, its legal duties, and your rights concerning your health information. The term health information includes any information that is personally identifiable to you and that is transmitted or maintained by the Plan, regardless of form (oral, written, electronic), including information regarding your health care and treatment, and identifiable factors such as your name, age, and address. It does not include health information that is received by your employer for employment-related purposes, such as workman’s compensation or job suitability.

Why does the Plan collect your health information?

The Plan collects health information from you for a number of reasons, including to determine the appropriate benefits to offer you, to pay claims, to provide case management services, and to provide quality improvement services.

How does the Plan collect your health information?

The Plan collects health information through you, your health care providers, and service providers. For example, Healthcare Management Administrators (for WA/AK) and Providence Health Plan (for OR), Business Associates, receive health information from you on your health care enrollment application and from your health care providers, such as through the submission of a claim for reimbursement of covered benefits. 

How does the Plan use and disclose your health information?

The Plan will not disclose your health information unless it is allowed or required by law to make the disclosure, or if you (or your authorized representative) give the Plan permission. If there are other legal requirements under applicable state laws that further restrict the use or disclosure of your health information, the Plan will comply with those legal requirements as well. The following are the different ways the Plan may use or disclose your health information. Not every use or disclosure in a category is listed, but the ways in which the Plan is permitted to use and disclose health information falls within one of the categories. 

  • Treatment: The Plan may use and disclose your health information for the treatment activities of a health care provider. 
    For example, the Plan may disclose your prescription medication information to a pharmacy to identify potential adverse drug reactions.

  • Payment: The Plan may use and disclose your health information for its payment activities, including the payment of claims from physicians, hospitals, and other providers for services delivered to you. For example, the Plan may tell a physician whether you are eligible for benefits or what percentage of the bill will be paid by the Plan.

  • Health Care Operations: The Plan may use and disclose your health information for its internal operations, including its customer service activities. Health care operations include quality assessment and improvement, disease and case management, medical review, auditing functions including fraud and abuse compliance programs and general administrative activities. For example, the Plan may use your health information for case management studies or to perform population-based studies designed to reduce health care costs.

  • To PeaceHealth as Plan Sponsor: The Plan may disclose your health information to designated employees of PeaceHealth to 
    permit it to perform administrative activities on behalf of the Plan, including the uses and disclosures described in this Notice. Such disclosures are to designated employees of PeaceHealth, who are required to safeguard your health information.

  • Individuals Involved in Your Care or Payment of Your Care: The Plan may disclose your health information to a family member or friend to the extent necessary to help with your health care or with payment for your health care, if the Plan determines that the disclosure is in your best interest or has given you an opportunity to object.

  • Research: The Plan may use or disclose your health information for research purposes in limited circumstances. 

  • Coroner, Medical Examiner, Funeral Director; Organ Donation: The Plan may disclose the health information of a deceased person to a coroner, medical examiner, funeral director, or organ procurement organization for certain purposes.

  • Public Health and Safety: The Plan may disclose your health information if it believes disclosure is necessary to avert a serious and imminent threat to your health or safety or the health or safety of others. 

  • Victims of Abuse, Neglect, or Domestic Violence: The Plan may disclose your health information to appropriate authorities if it reasonably believes that you are a possible victim of abuse, neglect, domestic violence, or other crimes.

  • Required by Law: The Plan may disclose your health information as required to do so by federal, state, or local law. 

  • Process and Proceedings: The Plan may disclose your health information in response to a court or administrative order, subpoena, discovery request, or other lawful process. 

  • Law Enforcement: The Plan may disclose limited information to law enforcement officials in certain circumstances. 

  • Military and National Security: The Plan may disclose to military authorities the health information of Armed Forces personnel under certain circumstances. The Plan may disclose to authorized federal officials health information required for lawful intelligence, counterintelligence, protective services, and other national security activities. 

  • Correctional Institutions: The Plan may disclose your health information to correctional institutions or law enforcement if the individual is in custody.

  • Health Oversight Agency: The Plan may disclose health information to a health oversight agency for audits, investigations, inspections, and licensure needed for the government to monitor the health care system.

  • Workers’ Compensation: The Plan may disclose your health information to the extent necessary to comply with worker’s compensation laws or other similar programs.

  • Treatment Alternatives and Health-Related Benefits and Services: The Plan may use or disclose your health information to tell you about possible treatment options or alternatives and health-related benefits that may be of interest to you. 

  • Other Uses and Disclosures: Other uses and disclosures will be made only with your authorization. Generally, if you authorize the Plan to use or disclose your health information, you may revoke the authorization, in writing, at any time, except to the extent that the Plan already has relied on your authorization. 

What rights do you have as an individual regarding our use and disclosure of your Health Information?

You have the following rights with regard to your health information. If you wish to exercise any of your rights, please contact your Human Resources Department, for more information.

  • Access to your Health Information: You have the right to look at and get a copy of your health information, except in certain limited circumstances. The Plan may charge you a nominal fee for providing you with copies of your health information.

  • Amendment: You have the right to request that the Plan amend your health information. Your request must be in writing, and it must identify the information that you think is incorrect and explain why the information should be amended. In certain circumstances, the Plan may deny your request to amend your health information.

  • Accounting of Disclosures: You have the right to receive a list of certain disclosures of your health information. You are entitled to such an accounting for the 6 years prior to your request, although not for disclosure made prior to April 14, 2003. 

  • Restriction Requests: You have the right to request that the Plan place additional restrictions on its use or disclosure of your health information for treatment, payment, health care operations or to persons involved in your care or payment for your care. For example, you could request that the Plan not disclose information about a specific surgery that you had. The Plan is not required to agree to these additional restrictions, but if it does, it will abide by its agreement (except in an emergency). 

  • Confidential Communication: You have the right to request that the Plan communicate with you about your health information by alternative means or to an alternative location. For example, you can request that the Plan only contact you by mail. If you advise the Plan that disclosure of all or any part of your health information could endanger you, the Plan will comply with any reasonable request provided it specifies an alternative means or location of communication.

  • Electronic Notice: You are entitled to receive a copy of this Notice in written form. 

What are the Plan’s duties?

The Plan is required by law to maintain the privacy of your health information, give you this Notice of its legal duties and privacy practices with respect to health information, and to follow the terms of the Notice that is currently in effect.

When is this notice effective?

This notice takes effect April 14, 2003 and will remain in effect until it is revised. 

What if the Plan changes its notice of privacy practices?

The Plan reserves the right to change its privacy practices and the terms of this Notice at any time. The Plan will send you a revised Notice if it makes a material revision. For your convenience, a copy of the current Notice of Privacy Practices is always available on the Human Resources website on Crossroads, and you may request a copy at any time by contacting the Plan at the number set forth below.

How can you reach us?

If you want additional information regarding the Privacy Practices of the Plan, or if you believe the Plan has violated any of your rights listed in this notice, please contact the Privacy Officer at Director of Human Resources, 15325 S.E. 30 Place, Ste. 300, Bellevue, WA 98007, (425) 649-3830, skent@peacehealth.org. If you have a complaint, you also may submit a written complaint to the U.S. Department of Health and Human Services. For contact information for the U.S. Department of Health and Human Services, please contact the Privacy Officer. Your privacy is one of the Plan’s greatest concerns and neither the Plan nor your employer will penalize or retaliate against you in any way if you choose to file a complaint.