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.
We
at North Oakland Medical Centers are required by law to maintain the privacy of
individually identifiable patient health information (this information is
“protected health information” and is referred to in this document as “PHI”).
We are also required to provide patients with a Notice of Privacy
Practices regarding PHI. We are required
to post this Notice in a prominent place within our facility.
We will only use or disclose your PHI as permitted or required by
applicable state or federal law. This
Notice applies to your PHI in our possession including the medical records
generated by us.
North Oakland Medical Centers understands that health information about you is personal and we are
committed to protecting your privacy.
This
notice applies to all records of your care generated by
North
Oakland
Medical
Centers
and it’s workforce, at the main hospital, outpatient
departments, outpatient facilities, clinics, hospital owned physician
practices, NOMC Physician Services, Inc., Waterford Ambulatory Care Center,
Waterford Ambulatory Surgi-Center, Euro
Peds, RT Services Corporation, and all related services.
This Notice also applies to the utilization review and quality
management activities of the above named entities. Your personal doctor or
consulting doctor(s) may have different policies or notices regarding use and
disclosure of your health information related to their services outside of
North Oakland Medical Centers. North
Oakland Medical Centers will be referred to in this document as NOMC.
I. Permitted Use or
Disclosure
A.
Treatment:
NOMC will use and disclose your PHI in the provision and coordination of
health care to carry out treatment functions.
*
NOMC may
disclose all or any portion of your patient medical record information to your
attending physician, consulting physician(s), nurses, technicians, medical
students and other health care providers who have a legitimate need for such
information in your care and continued treatment.
* Different departments may
share medical information about you in order to coordinate specific services,
such as lab work, x-rays and prescriptions.
*
NOMC may disclose your medical information to people or entities outside
NOMC who will be involved in your medical care after you leave NOMC such as
family members, clergy, home health care services and others who will provide
services that are part of your care.
*
NOMC may share certain information such as your name, address,
employment, insurance carrier, emergency contact information and appointment
scheduling information in an effort to coordinate your treatment with us and
other health care providers.
*
NOMC may use and disclose your PHI to inform you of, or recommend,
possible treatment options or alternatives that may be of interest to you.
*
NOMC may use and disclose PHI to contact you as a reminder that you have
an appointment for treatment or medical care at NOMC.
*
If you are an inmate of a correctional institution or under the custody
of a law enforcement officer, NOMC will disclose your PHI to the correctional
institution or law enforcement official.
B.
Payment:
NOMC may disclose PHI about you for the purposes of determining
coverage, eligibility, funding, billing, claims management, medical data
processing, stop loss/reinsurance and reimbursement.
* The
medical information may be disclosed to an insurance company, third party
payer, third party administrator, health plan or other health care provider (or
their duly authorized representatives) involved in the payment of your medical
bill and may include copies or excerpts of your medical records which are
necessary for payment of your account. It may also include sharing the
necessary information to obtain pre-approval for payment for treatment from
your health plan.
*
NOMC may disclose PHI to collection agencies and other subcontractors to
obtain payment for care.
C.
Health Care Operations:
NOMC will use and disclose your PHI during routine health care
operations including quality assurance, utilization review, medical review,
internal auditing, accreditation, certification, licensing or credentialing
activities of NOMC, and for educational purposes.
*
For example, NOMC may need to share your demographic information,
diagnosis, treatment plan and health status for population based activities
relating to improving health or reducing health care costs, protocol
development, case management and care coordination, and contacting health care
providers and patients with information about treatment alternatives, in order
for us to operate our business in an efficient, safe and legal manner.
D.
Other Uses and Disclosures:
As part of treatment, payment and health care operations, we may also
use your PHI for the following purposes:
* Fundraising
Activities: NOMC may use certain demographic information
(name, address, phone, e-mail, gender, age, type of insurance, date of service)
to contact you in the future to raise money for NOMC.
The money raised will be used to expand and improve the services and
programs provided to our community. In
addition, NOMC may
choose to include information about fundraising practices in newsletters and
may post the information in the NOMC Foundation office. NOMC may disclose
limited PHI to the NOMC Foundation or to a company contracted to conduct
fundraising for NOMC. These entities will use your PHI only for the purposes of
fundraising for NOMC. If you do not wish
to be contacted, you may notify the Marketing Department at: (248) 857-7522.
*
Medical Research:
NOMC may disclose your PHI to medical researchers who request it for
approved medical research projects; however, with very limited exceptions such
disclosures must be cleared through a special approval process before any PHI
is disclosed to the researchers. Researchers will be required to safeguard the
PHI they receive.
*
Information and Health Promotion Activities:
NOMC may use and disclose some of your PHI for certain health promotion
activities. For example; your name and address may be used to send you
newsletters or general communications. NOMC
may also send you information based on your own health concerns.
NOMC may send you this information if it has determined that a product
or service may help you. The
communication will explain how the product or service relates to your well
being and can improve your health.
*
Appointment Reminders:
We may use or disclose your health information to provide you with
appointment reminders (such as voicemail messages, postcards, or letters).
E.
More Stringent State and Federal Laws:
The State of
Michigan
is more stringent than HIPAA in several areas.
Michigan
law is more stringent when the individual is entitled to greater access to
records than under HIPAA and when under state law the records are MORE
protected from disclosure than under HIPAA. Certain federal laws are also more
stringent than HIPAA. NOMC will continue to abide by these more stringent state
and federal laws. The federal laws include applicable internet privacy laws,
such as the Children’s Online Privacy Protection Act and the federal laws and
regulations governing the confidentiality of health information regarding
substance abuse treatment.
In Michigan, patients have MORE rights of access to behavioral health
information under Michigan law than under HIPAA and State law defines a minimum
necessary standard for release of mental health information.
Disclosure is permitted with consent and for treatment without consent,
but only in an emergency. Minors in
Michigan
have MORE rights to confidentiality and protection of certain information
(reproductive health, behavioral health and substance abuse) than under HIPAA.
State law genetic and HIV testing and disclosure consents remain in
place.
II.
Permitted Use or Disclosure with an
Opportunity
for You to Agree or Object
A. Family/Friends: NOMC may disclose PHI
about you to a friend or family member who is involved in your medical care.
NOMC may also give information to someone who helps you pay for your
care. In addition, NOMC may disclose PHI
about you to an agency assisting in a disaster relief effort so that your
family can be notified about your condition, status and location. You have a
right to request that your PHI not be shared with some or all of your family or
friends.
B. North Oakland Medical Centers
Patient Information Listing:
NOMC will include certain limited information about you in the NOMC
patient information listing while you are a hospital patient at NOMC.
This information will include your name, location in NOMC, your general
condition (e.g., fair, stable, critical, etc.) and your religious affiliation.
This is so your family and friends can visit you in NOMC and know how you are
doing. The Patient Information Listing,
except for your religious affiliation, will also be disclosed to people who ask
for you by name. You have the right to
request that your name not be included in the NOMC Patient Information Listing.
If you request to opt out of the NOMC Patient Information Listing, we
cannot inform visitors of your presence, location, or general condition.
C.
Spiritual Care:
Patient information listing information including your religious
affiliation may be given to a member of the clergy, such as a minister, priest,
rabbi or other clergy even if they don’t ask for you by name.
Your name, location and general condition may be disclosed to members of
the religious community. You have a right to request that your name not be
given to any member of the clergy.
D.
Promotional Communications:
NOMC does not share or sell your PHI to companies that market health
care products or services directly to consumers for use by those companies to
contact you, such as drug companies. NOMC
does maintain a database of individuals for promotional communications, disease
management, health promotion, and fundraising purposes.
This database includes individuals to whom NOMC may have sent health
improvement materials and news about NOMC previously and also individuals who
have donated to NOMC or who have expressed an interest in donating to NOMC or
other health-related activities. You may
be included in this database. NOMC sends
information to the individuals in this database about the programs and services
of NOMC. If you wish to be deleted for
this database, you may notify the Marketing Department at:
(248) 857-7522.
E. Media
Conditions Reports: NOMC may release information for an
update to the media if the media requests information about you using your full
name and you have not requested that your name and
information be excluded from the NOMC Patient Information Listing. The
following information may then be disclosed: your condition described in
general terms that do not communicate specific medical information, such as
“good”, “fair”, “serious”, or “critical”.
III.
Use or Disclosure Requiring Your Authorization
A.
Marketing:
NOMC is not permitted to provide your PHI to any other person or company
for marketing to you of any products or services other than NOMC’s
products or services unless you have signed an authorization.
B.
Research:
NOMC may use or disclose your PHI as part of research that includes
providing you with treatment. For example, if you are part of a research study
that includes treatment, NOMC may require that you sign an authorization to
allow the researchers to use or disclose your PHI for this research.
C.
Other Uses:
Any uses or disclosures that are not for treatment, payment or
operations and that are not permitted or required for public policy purposes or
by law, will be made only with your written authorization or the written
authorization of your personal representative after positive identification.
Written authorizations will let you know why we are using your PHI.
You have to the right to revoke an authorization at any time.
IV.
Use or Disclosure Permitted by Public Policy or Law without your
Authorization
A.
Law Enforcement Purposes:
NOMC will disclose your PHI for law enforcement purposes as required by
law, such as responding to a court order or subpoena, identifying a criminal
suspect or a missing person, or providing information about a crime victim or
criminal conduct.
B.
Required by Law:
NOMC will disclose PHI about you when required by federal, state or
local law to make reports or other disclosures.
NOMC also will make disclosures for judicial and administrative proceedings
such as lawsuits or other disputes in response to a court order or subpoena.
NOMC will disclose your medical information to government agencies
concerning victims of abuse, neglect or domestic violence.
NOMC will report drug diversion and information relating to fraudulent
prescription activity to law enforcement and regulatory agencies.
Specialized government functions will warrant the use and disclosure of
PHI. These government functions will
include military and veteran’s activities, national security and intelligence
activities, and protective services for the President and others.
NOMC will make certain disclosures that are required in order to comply
with workers’ compensation or similar programs.
C.
Coroners, Medical Examiners, Funeral Directors: NOMC may disclose
your PHI to a coroner or medical examiner.
For example, this may be necessary to identify a deceased person or to
determine a cause of death. NOMC will
also disclose your medical information to funeral directors as necessary to
carry out their duties.
D.
Organ Procurement:
NOMC may disclose PHI to an organ procurement organization or entity for
organ, eye or tissue donation purposes.
E.
Health or Safety:
NOMC may use or disclose PHI to avert a serious threat to health and
safety of a person or the public. NOMC
may use or disclose PHI to Public Health Agencies for immunizations,
communicable diseases, etc. NOMC may use
and disclose PHI for activities related to the quality, safety or effectiveness
of FDA-regulated products or activities, including collecting and reporting
adverse events, tracking and facilitating product recalls, etc. Any patient
receiving a medical device subject to FDA tracking requirement may refuse to
disclose, or refuse permission to disclose, their name, address, telephone
number and social security number, or other identifying information for the
purpose of tracking. If you wish to opt-out, you may do so by contacting the
NOMC Director of Patient Relations/Customer Services at:
(248) 857-7539.
V.
Your Health Information Rights
Although we at NOMC must maintain all records concerning your
hospitalization and treatment by NOMC, you have the following rights concerning
your PHI:
A.
Right to Inspect and Copy:
You have the right to access your PHI and to inspect and copy your PHI,
as long as, we maintain it except for:
information that will be used in a civil, criminal or administrative action or
proceeding, and where prohibited or protected by law.
NOMC may deny your request for access to your PHI without giving you an
opportunity to review that decision if:
* You don’t
have the right to inspect the information; or it is otherwise prohibited or
protected by law;
* You are
an inmate at a correctional institution and obtaining a copy of the information
would risk the health, safety, security, custody or rehabilitation of yourself
or other inmates;
* The disclosure
of the information would threaten the safety of any officer, employee or other
person at the correctional institution or who is responsible for transporting
you;
*
NOMC obtained the information that you seek access to from someone other
than the health care provider under a promise of confidentiality and your
access request is likely to reveal the source of the information;
* Under other limited
circumstances. In these instances,
however, NOMC will allow the review of its decision by a health care
professional that NOMC has chosen. This
person will not have been involved in the original decision to deny your
request.
You must agree to pay a reasonable copying charge.
You must make your requests to access and copy your PHI in writing to
NOMC and supply an appropriate authorization as required by Michigan Law. NOMC
will supply you with an authorization form upon request.
NOMC will respond to your request within 30 days of its receipt. If NOMC
cannot respond to your request within 30 days of its receipt, it will notify
you in writing to explain the delay and the date by which we will act on your
request. In any event, NOMC will act on
your request within 60 days of its receipt.
B. Right to Amend:
You have the right to amend your PHI for as long as NOMC maintains it.
However, NOMC may deny your request for amendment if:
* NOMC
did not create the information;
* The
information is not part of the designated record set;
* The
information would not be available for your inspection (due to its condition or
nature); or
* The
information is accurate and complete.
If NOMC denies your request for changes in your PHI, NOMC will notify
you in writing with the reason for the denial.
NOMC will also inform you of your right to submit a written statement
disagreeing with the denial. You may ask
that NOMC include your request for amendment and the denial any time that NOMC
discloses the information that you wanted changed. NOMC may prepare a rebuttal
to your statement of disagreement and will provide you with a copy.
You must make your request for amendment of your PHI in writing to NOMC.
NOMC will respond to your request within 60 days of its receipt.
If NOMC cannot respond to your request within 60 days it will notify you
in writing to explain the delay and the date by which NOMC will act on your
request. In any event, NOMC will act on
your request within 90 days of its receipt.
C. Right to an Accounting:
You have a right to receive an accounting (listing) of the disclosures
of your PHI that NOMC made, except for the following disclosures:
* To
carry out treatment, payment or health cares operations;
* To
you;
* To
persons involved in your care;
* For
national security or intelligence purposes;
* To
correctional institutions or law enforcement officials; or
* That
occurred prior to April 14, 2003.
For each disclosure, you will
receive; the date of the disclosure, the name of the receiving organization and
address if known, a brief description of the PHI disclosed and a brief
statement of the purpose of the disclosure or a copy of the written request for
the information, if there was one. You
must make your request for an accounting of disclosure of your PHI in writing
to NOMC. You must include the time period
of the accounting, which may not be longer than 6 years before the request.
NOMC will respond to your request within 60 days from its receipt.
If NOMC cannot respond to your request within 60 days it will notify you
in writing to explain the delay and the date by which NOMC will act on your
request. In any event, NOMC will act on your request within 90 days of its
receipt.
In any given 12 month period, NOMC will provide you with an accounting
of the disclosures of your PHI at no charge. Any additional requests for an
accounting within that time period will be subject to a reasonable fee for
preparing the accounting.
D.
Right to Request Restrictions: You have the right to
request a restriction or limitation on the health information we use or
disclose about you for treatment, payment or health care operations. You also
have the right to request a limit on the health information we disclose about
you to someone who is involved in your care or payment for your care, like a
family member or friend. For example, you could ask that we not use or disclose
information about a surgery you had.
NOMC will consider your request but is not required to agree to your
request if the request involves treatment, payment, health care operations or
disclosures we are required to make by law. In general, due to the cost
of additional resources necessary to comply with such requests, NOMC is unable
to grant requests for restrictions on the health information we use or disclose
about you for treatment, payment, health care operations, or to someone who is
involved in your care or the payment for your care.
We will, however, consider requests for a limit on the health information we
disclose about you to someone who is involved in your care, like a family
member or friend. If we do agree, we will
comply with your request unless the information is needed to provide you
emergency treatment.
E.
Right to Confidential Communications:
You have the right to request that we communicate with you about medical
matters in a certain way or at a certain location. For example, you can ask
that we only contact you at work or by mail. We will accommodate all reasonable
requests. Your request must specify how or where you wish to be contacted.
F.
Right to Receive a Paper Copy of This Notice.
You have the right to receive a paper copy of this Notice of Privacy
Practices upon request.
VI.
Complaints
If
you believe your privacy rights have been violated, you may file a complaint
with NOMC or with the Secretary of the Department of Health and Human Services.
To file a complaint with NOMC, you must put it in writing and address it to
Director of Patient Relations/Customer Service,
North
Oakland
Medical
Center, 461 West Huron,
Pontiac, Michigan 48341.
NOMC will not retaliate against you for filing a complaint.
VII. Sharing and joint use of your Health Information
In the course of providing care to you and in furtherance of NOMC’s
mission to improve the health of the community, NOMC will share your PHI with
other organizations as described below who have agreed to abide by the terms
described below:
A. Medical Staff:
The medical staff and NOMC participate together in an organized health
care arrangement to deliver health care to you in NOMC facilities. Both NOMC
and its medical staff have agreed to abide by the terms of this Notice with
respect to PHI created or received as part of delivery of health care services
to you in NOMC facilities. Physicians and allied health care providers who are
members of NOMC’s medical staff will have access to
and use your PHI for their treatment, payment and health care operations
purposes related to your care within NOMC.
NOMC will disclose your PHI to the medical staff for their payment, treatment
and health care operations.
B. Business Associates:
NOMC may use and disclose your PHI to business associates contracted to
perform business functions on its behalf.
Whenever an arrangement to perform a NOMC function between NOMC and another
company involves the use or disclosure of your PHI, that business associate
will be required to keep your information confidential.
VIII. Changes to this Notice
We may change our Notice of Privacy Practices from time to time.
The changes will apply to all medical information about you that we have
at the time of the change, and to all medical information about you that we
keep in the future. Generally, the changes will take effect when they appear in
a revised Notice of Privacy Practices. A copy of our current notice will be
posted in our facilities and be available to all patients. NOMC will provide
you with the revised Notice at your first visit following the revision of the
Notice.
IF
YOU HAVE QUESTIONS ABOUT THIS PRIVACY NOTICE CONTACT THE NOMC DIRECTOR OF
PATIENT RELATIONS/CUSTOMER SERVICE AT: (248) 857-7539