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
Effective Date: April 14, 2003
Revised Date: January 30, 2010
St. Peter's Hopsital and all of its affiliated entities (collectively referred to as SPH) understand that information about you and your health care treatment is personal. We are committed to protecting your health information, and we are required by law to maintain the privacy of your protected health information; give you a notice of our legal duties and privacy practices with respect to your protected health information; and follow the terms of the notice currently in effect.
PROTECTED HEALTH INFORMATION
Protected Health Information (PHI) is information about a patient's age, race, sex, and other personal health information that may identify the patient. The information relates to the patient's physical or mental health in the past, present, or future, and to the care, treatment, and services needed by a patient because of his or her health.
This Notice of Privacy Practices applies to all of your protected health information used to make decisions about your care that we generate or maintain, including sensitive information such as mental health, communicable disease and drug and alcohol abuse information.
THE FOLLOWING CATEGORIES DESCRIBE THE WAYS THAT WE MAY USE AND DISCLOSE PHI. NOT EVERY USE OR DISCLOSURE IN A CATEGORY WILL BE LISTED.
We will use and disclose your PHI to provide you with health care treatment and services.
Example: Your PHI may be disclosed to doctors, nurses, technicians, students or other personnel who are involved in taking care of you. We may disclose your PHI for the treatment activities of any other health care providers.
Example: We may send a copy of your medical records to a physician who needs to provide follow-up care or we may send a copy of your health care instructions to a nursing home to which you have been transferred to facilitate coordination of care.
We may use PHI about you for our payment activities. Common payment activities include, but are not limited to, determining eligibility or coverage under a plan and/or billing and collection activities.
(1) Your PHI may be released to an insurance company to obtain payment for services.
(2) We may tell your health plan about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment.
We may disclose PHI about you to another health care provider or covered entity for its payment activities.
Example: We may send your health plan coverage information to an outside laboratory that needs the information to bill for tests that it provided to you.
OPERATIONS We may use your PHI for operational or administrative purposes. These uses are necessary to run our hospital/clinic practice and to make sure patients receive quality care. We may use the information to review our treatment and services in order to evaluate the performance of our staff and to support training and education of staff. Common operation activities include, but are not limited to, conducting quality assessment and improvement activities; reviewing the competence of health care professionals; arranging for legal or auditing services and business planning and development.
Example: We may use your PHI to conduct internal audits to verify that billing is being conducted properly. We may disclose your PHI to another health care provider or covered entity for its operation activities under certain circumstances.
Example: We may disclose your PHI to your health plan for its utilization review analysis.
BUSINESS ASSOCIATES We may disclose your PHI to other entities that provide a service to us or on our behalf that requires the disclosure of PHI. However, we only will make these disclosures if we have received satisfactory assurance that the other entity will properly safeguard your PHI.
Example: We may contract with another entity to provide transcription or billing services.
We may use and disclose your PHI to contact you as a reminder that you have an appointment.
We may use and disclose your PHI to tell you about recommended or possible treatment options or alternatives to treatment.
INDIVIDUALS INVOLVED IN YOUR CARE OR PAYMENT FOR YOUR CARE
We may disclose your protected health information to a friend, family member or legal guardian who is involved in your medical care. We may tell your family or friends your location and general condition. If you are able and available to agree or object, we will give you the opportunity to object prior to making any such disclosures. If you are unable or unavailable to agree or object, our health professionals will use their best judgment in communicating with your family and others. Additionally, we may disclose your PHI to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location.
INFORMATION PROVIDED TO YOU
We may release information to you regarding your own health care.
We may include certain information about you in our directory while you are a patient at SPH. This information may include your name, location in the hospital, your general condition and your religious affiliation. The directory information, except for your religious affiliation, may also be disclosed to people who ask for you by name. Your religious affiliation may be given to a member of the clergy, such as a minister, priest or rabbi, even if they do not ask for you by name. This is so your family, friends and clergy can visit you in the hospital and generally know how you are doing. If you do not want to be in our directory, you will need to notify SPH personnel at registration.
We may use and disclose your PHI to researchers conducting research that has been approved by an Institutional Review Board.
ORGAN AND TISSUE DONATION
If you are an organ donor, we may disclose your PHI to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.
We may provide your contact information (name, address and phone number) and the dates you received services from us, to St. Peter's Hospital's Foundation, which handles fundraising efforts.
To Opt Out, you must notify our Foundation Office in writing by regular mail or e-mail at email@example.com. Additionally, any written fundraising communications from the Foundation must state, clearly and conspicuously, your opportunity and the manner in which you may elect not to receive further communications.
REQUIRED BY LAW
We may disclose your PHI when required to do so by federal, state or local law.
Example: We are required by law to report cases of suspected abuse and neglect. These reports may include your PHI.
We may use and disclose your PHI when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure would only be to someone able to help prevent the threat.
We may disclose your PHI for public health activities intended to: prevent or control disease, injury or disability; report births and deaths; report abuse, neglect or violence as required by law; report reactions to medications or problems with products; notify people of recalls of products they may be using; or notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition.
FOOD AND DRUG ADMINISTRATION (FDA)
We may disclose to the FDA and to manufacturers health information relative to adverse events with respect to food, supplements, product and product defects, or post-marketing surveillance informa-tion to enable product recalls, repairs or replacements.
HEALTH OVERSIGHT ACTIVITIES
We may disclose your PHI to a health oversight agency for activities authorized by law. These oversight activities include, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.
LAWSUITS AND DISPUTES
If you are involved in a lawsuit or a dispute, we may disclose your PHI in response to a court or administrative order. In limited circumstances, we may disclose your PHI in response to a subpoena or discovery request.
We may disclose your PHI if asked to do so by a law enforcement official in response to a court order, warrant, summons or other similar process; to identify or locate a suspect, fugitive, material witness, or missing person; to provide information about the victim of a crime if, under certain limited circumstances, we are unable to obtain the person's agreement; about a death we believe may be the result of criminal conduct; about criminal conduct at the hospital; and in emergency circumstances to report a crime; the location of the crime or victims; or the identity, description or location of the person who committed the crime.
DECEASED PERSON INFORMATION
We may disclose PHI to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death.
NATIONAL SECURITY AND INTELLIGENCE ACTIVITIES
We may disclose your PHI to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.
PROTECTIVE SERVICES FOR THE PRESIDENT AND OTHERS
We may disclose your PHI to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or conduct special investigations.
We may disclose your PHI as required by military command authorities, if you are a member of the armed forces.
If you are an inmate of a correctional facility or under the custody of law enforcement official or agency, we may disclose your PHI to the correctional facility or law enforcement official or agency. This disclosure may be necessary to: (1) enable the correctional facility to provide you with health care; or (2) protect the health and safety of you and/or other people.
YOU HAVE THE RIGHTS DESCRIBED BELOW IN REGARD TO YOUR PHI MAINTAINED BY US
You are required to submit a written request to exercise any of these rights. You may contact our Health Information Management/Medical Records department or Privacy Official for assistance. To obtain an Authorization for Disclosure of Healthcare Information form you can visit www.stpetes.org contact the above department.
RIGHT TO INSPECT AND COPY
You have the right to inspect and copy health information used to make decisions about your care and maintained by SPH. If you want a copy of your health information, we may charge a reasonable for the cost of the copies we provide you. You have the right to obtain a copy of your health information in an electronic format and, if you chose, you have the right to direct SPH to transmit an electronic copy of your records directly to an entity or person designated by you, provided that you give SPH clear, conspicuous and specific instructions identifying those records to be sent and to whom they should be sent. Your request must be submitted in writing to the HIM/Medical Records Department. We may deny your request to inspect and/or copy your health information in certain circumstances. If you are denied access, you may request that the denial be reviewed. A licensed health care professional chosen by us will review your request and the denial. The person conducting the review will not be the person who denied your original request. We will comply with the outcome of the review.
RIGHT TO AMEND
If you feel that the health information that we created is incorrect or incomplete, you may submit a request for an amendment for as long as we maintain the information. You must provide a reason that supports your amendment request.
We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask to amend information that: we did not create, unless the person or entity that created the information is not available to make the amendment; the information is not part of the health information that we maintain; is not part of the information that you would be permitted to inspect and copy; or is accurate and complete.
RIGHT TO AN ACCOUNTING OF DISCLOSURES
You have the right to request one free "accounting of disclosures" every 12 months. This is a list of certain disclosures we made of your health information. There are several categories of disclosures that we are not required to list in the accounting. For example, we do not have to keep track of disclosures that are authorized. You must make your request in writing to the HIM/Medical Records Department. Your request must state a time period, which may not be longer than 6 years and may not include dates before April 14, 2003.
If you request more than one accounting in a 12-month period, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.
RIGHT TO REQUEST RESTRICTIONS
You have the right to request a restriction or limitation on the PHI we use or disclose about you unless our use and/or disclosure is required by law. You must make any such requests in writing to the HIM/Medical Records Department You must indicate: The type of restriction you want and the information you want restricted; and to whom you want the limits to apply, for example your spouse.
We are not required to agree to your request unless you are requesting a restriction on the disclosure of information to your health plan and you are willing to pay out of pocket for the health care treatment provided. If we agree, we will comply with your request unless the information is needed to provide emergency treatment to you.
RIGHT TO REQUEST CONFIDENTIAL COMMUNICATIONS
You have the right to request that we communicate with you about health care matters in a certain way or at a certain location.
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.
RIGHT TO A PAPER COPY OF THIS NOTICE
You have the right to a paper copy of this notice. Copies of this notice will always be available in our Admissions Department or HIM/Medical Records Department.
We reserve the right to amend this notice. We reserve the right to make the revised or changed notice effective for PHI we already have about you as well as any information we receive in the future. Copies of the current notice will be posted at St. Peter's Hospital, its clinics and affiliated facilites, are available online at www.stpetes.org, and will be available for you to pick up on each visit to SPH. If you believe your privacy rights have been violated, you may file a complaint with us or with the Office of Civil Rights of the Department of Health and Human Services.
To file a complaint with us, or if you would like more information about our privacy practices, contact our Privacy Officer at 406-447-2566.
Our mailing address is:
Helena, MT 59601
Attn: Privacy Officer
To file a complaint with the Office of Civil Rights of the Department of Health and Human Services, you must submit the complaint within 180 days of when you knew or should have known of the circumstance that led to the complaint. The complaint must be submitted in writing. Information on how to file a complaint can be located on the Office of Civil Rights website at: http://www.hhs.gov/ocr/privacy/index.html or our Privacy Officer can provide you with current contact information. You will not be penalized for filing a complaint.