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Health
Insurance Portability and Accountability Act
NOTICE
OF PRIVACY PRACTICE
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.
I.
How UDS and the Commonwealth of PA Uses and Discloses Your Health
Information :
UDS
and the Commonwealth of Pennsylvania provide a broad range of services
through a wide variety of health and human services programs. If
you receive services from a Commonwealth program (United Disabilities
Services), the Commonwealth program may use your protected health
information (PHI) and disclose it to other Commonwealth health and
human services programs and outside the Commonwealth, to:
a)
Plan and provide your care and treatment
b)
Communicate with health care professionals who care for you
c)
Describe the care you receive
d)
Obtain reimbursement from private insurers or other government
programs
e)
Verify that services billed were actually provided
f)
Educate health professionals
g)
Inform public health officials charged with improving healthcare,
administer the Commonwealth's programs which provide public benefits,
and/or health or human services
h)
Assess and improve the services provided and the outcomes achieved
pay for services you receive,
i)
Inform you about other public programs and services
**UDS,
the Commonwealth, and its programs will not use or disclose your
protected health information except as described in this notice,
or otherwise authorized by law**
II.
Your Health Information Rights :
You
have the right to:
a)
Request a restriction on certain uses and disclosures of your protected
health information
b)
Obtain a paper copy of this Notice of Information Practices upon
request
c)
Inspect and copy your protected health information
d)
Request amendments to your protected health information
e)
Obtain an accounting of disclosures of your protected health information
f)
Request communications of your protected health information by alternative
means or at an alternative address
g)
Revoke your consent to use or disclose protected health information
to the extent that it has not already been relied upon
h)
File a complaint to the United Disabilities Services and/or the
Secretary of the U.S. Department of Health
III.
UDS and the Commonwealth Program Duties :
UDS
and the Commonwealth's health and human services programs each have
a duty to:
a)
Maintain the privacy of your protected health information
b)
Provide you with a notice as to our legal duties and privacy practices
with respect to protected health information we collect and maintain
about you
c)
Abide by the terms of this notice
d)
Notify you if we are unable to agree to a requested restriction
e)
Accommodate reasonable requests you may have to communicate health
information by alternative means
f)
Provide an accounting of disclosures of your protected health information
**UDS,
the Commonwealth, or any Commonwealth health and human services
program may change its privacy practices and make the new privacy
practices effective for all protected health information we maintain.
Should our privacy practices change, we will mail a revised notice
to the address you have supplied us**
IV.
For More Information or to Report a Problem :
If
you have questions and would like additional information, you may
contact your Program Manager at: (717) 397-1841. If you believe
your privacy rights have been violated, you can file a complaint
with Jeremy Wolfe (UDS), or with the Secretary of the United States
Department of Health and Human Services. There will be no retaliation
for filing a complaint.
V.
Examples of Disclosures for Treatment, Payment and Health Operations
:
We
will use your health information for treatment.
For
example: Information obtained by
a nurse, physician, or other member of your healthcare team will
be recorded in your record and used to determine the course of treatment
that should work best for you.
We
will use your health information for payment.
For
example: A bill may be sent to you
or any private or public source of health coverage you have identified.
The information on or accompanying the bill may include information
that identifies you, as well as your diagnosis, procedures, and
supplies used.
We
will use your health information for regular health operations.
For
example: Members of a quality assurance
team may use information in your health record to assess the care
and outcomes in your case and others like it. This information will
be used in an effort to continually improve the quality and effectiveness
of the healthcare service we provide.
VI.
Others who may receive your health information
Fundraising:
Authorization is not required when the fundraising
entity (United Disabilities Services) is using only the demographic
piece of the protected health information or date of service.
According to the regulations permissible protected health information
does not require authorization for fundraising purposes. Protected
health information that UDS can use for fundraising purposes include,
date of service, name, address, phone number, email, age, gender
and insurance status. Individuals who do not wish to be included
in United Disabilities Services fundraising activities may elect
to opt-out by sending written notice to the organization's Development
Department.
Business
Associates : there
are some services provided in our organization through contracts
with business associates. When these services are contracted, we
may disclose your health information to our business associate so
that they can perform the job we've asked them to do. However, we
require the business associate to appropriately safeguard your information.
Research
: We
may disclose information to researchers when the information is
de-identified or when their research has been approved by an institutional
review board that has reviewed the research proposal and established
protocols to ensure the privacy of your health information.
Organ
procurement organizations :
Consistent with applicable law, we may
disclose health information to organ procurement organizations or
other entities engaged in the procurement, banking, or transplantation
of organs for the purpose of tissue donation and transplant.
Funeral
Directors: We may disclose health
information to funeral directors to carry out their duties, as required
by law.
Public
health : We
may disclose your health information to public health or legal authorities
charged with preventing or controlling disease, injury, or disability.
Correctional
institution : Should
you be an inmate of a correctional institution, we may disclose
to the institution or agents thereof any health information necessary
for your health and the health and safety of other individuals,
or for the administration of the institution.
Law
enforcement: We may disclose
health information for law enforcement purposes.
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