 businesspractices.kaiserpapers.info
Link
for Translation of this Kaiser Papers page from Google
Translation Service
Notice
of Privacy Practices
Download
a printable version of this Notice of Privacy Practices. (non functioning link)
(You will need the free Adobe
Acrobat Reader to read this file.)
KAISER
PERMANENTE - COLORADO REGION
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.
In
this notice, we use the terms "we," "us" and "our"
to describe Kaiser Permanente - Colorado Region. For more details, please
refer to section IV. of this notice.
I.
WHAT IS "PROTECTED HEALTH INFORMATION?"
Your protected health information ("PHI") is health information
that contains identifiers, such as your name, social security number,
or other information that reveals who you are. For example, your medical
record is PHI because it includes your name and other identifiers.
If you are a Kaiser
Foundation Health Plan member and also an employee of any Kaiser Permanente
company, PHI does not include the health information in your employment
records.
II.
ABOUT OUR RESPONSIBILITY TO PROTECT YOUR PHI
By law, we must
- protect the privacy
of your PHI;
- tell you about
your rights and our legal duties with respect to your PHI; and
- tell you about
our privacy practices and follow our notice currently in effect.
We take these responsibilities
seriously and, as in the past, we will continue to take appropriate
steps to safeguard the privacy of your PHI.
III.
YOUR RIGHTS REGARDING YOUR PHI
This section tells you about your rights regarding your PHI, for example,
your medical and billing records. It also describes how you can exercise
these rights.
Your right to
see and receive copies of your PHI
In general, you have a right to see and receive copies of your PHI in
designated record sets, such as your medical record or billing record.
If you would like to see or receive a copy of such a record, please
write to us at Kaiser Foundation Health Plan of Colorado, Release
of Information Department, 14701 E. Exposition Avenue, Aurora, CO 80012.
After we receive your written request, we will let you know when and
how you can see or obtain a copy of your record. In certain circumstances,
if you agree, we will give you a summary or explanation of your PHI
instead of providing copies. We are permitted to charge you a fee for
the copies, summary, or explanation. If we don't have the record you
asked for but we know who does, we will tell you who to contact to request
it.
In limited situations,
we may deny some or all of your request to see or receive copies of
your records, but if we do, we will tell you why in writing and explain
your right, if any, to have our denial reviewed.
Your right to
choose how we send PHI to you
You may ask us to send your PHI to you at a different address (for example,
your work address) or by different means (for example, fax instead of
regular mail). When we can reasonably and lawfully agree to your request,
we will. However, we are permitted to charge you for any additional
cost of sending your PHI to different addresses or by different means.
Your right to
correct or update your PHI
If you believe there is a mistake in your PHI or that important information
is missing, you may request that we correct or add to the record. Please
write to us and tell us what you are asking for and why we should make
the correction or addition. Send your requests to Kaiser Foundation
Health Plan of Colorado, Medical Record Department, 16601 East Centretech
Pkwy, Aurora, CO 80011. We will respond in writing after receiving
your request. If we approve your request, we will make the correction
or addition to your PHI. If we deny your request, we will tell you why
and explain your right to file a written statement of disagreement.
Your right to
an accounting of disclosures of PHI
You may ask us for a list of our disclosures of your PHI. Write to us
at Kaiser Foundation Health Plan of Colorado, Release of Information
Department, 14701 E. Exposition Avenue, Aurora, CO 80012. The list
we give you will include disclosures made in the last six years, unless
you request a shorter time or if less than six years have passed since
April 14, 2003. For example, if you requested a list of disclosures
on April 14, 2005, the list would cover only two years.
You are entitled
to one disclosure accounting in any 12-month period at no charge. If
you request any additional accountings less than 12 months later, we
may charge a fee.
An accounting does
not include certain disclosures, for example, disclosures to carry out
treatment, payment and health care operations; disclosures that occurred
prior to April 14, 2003; disclosures for which KP had a signed authorization;
disclosures of your PHI to you; disclosures from a KP facility directory;
disclosures for notifications for disaster relief purposes; or disclosures
to persons involved in your care and persons acting on your behalf.
Your right to
request limits on uses and disclosures of your PHI
You may request that we limit our uses and disclosures of your PHI for
treatment, payment, and health care operations purposes. However, by
law, we do not have to agree to your request. Because we strongly believe
that this information is needed to appropriately manage the care of
our members/patients, it is our policy not to agree to requests for
restrictions.
Your right to
receive a paper copy of this notice
You also have a right to receive a paper copy of this notice upon request.
Please refer to section VII of this notice on how to request a copy.
IV.
KAISER PERMANENTE COMPANIES SUBJECT TO THIS NOTICE
This notice applies to the Kaiser Permanente Colorado Region, which
includes:
- The Colorado
Permanente Medical Group (CPMG);
- Kaiser Foundation
Health Plan of Colorado, including its health plan and provider operations;
- Kaiser Foundation
Hospitals (KFH), as discussed below; and
- Kaiser Foundation
Health Plan, Inc. (KFHP, Inc.), as discussed below.
Our health care
delivery sites include the Kaiser Permanente medical offices, the Kaiser
Ambulatory Surgery Center, the member call center and our member web
site.
To provide you with
the health care you expect, to treat you, to pay for your care and to
conduct our operations, such as quality assurance, accreditation, licensing
and compliance, these Kaiser Permanente companies share your PHI with
each other.
Our personnel may
have access to your PHI either as employees, physicians, volunteers
or persons working with us in other capacities. Our region may share
your PHI with KFH and KFHP, Inc., in connection with shared services
and other national Kaiser Permanente activities for treatment, payment,
or health care operations purposes. For example, if you are being considered
for a transplant, we will share your PHI with our Kaiser Permanente
National Transplant Network.
This Notice of Privacy
Practices does not apply to our contracted providers who are not part
of Kaiser Permanente's workforce. Please contact those providers directly
for information about their privacy practices.
For Colorado
Springs members: Please note that this Notice of Privacy Practices
does not apply to our affiliated providers in Colorado Springs. Please
contact your provider for information about your provider's privacy
practices.
V.
HOW WE MAY USE AND DISCLOSE YOUR PHI
Your confidentiality is important to us. Our physicians and employees
are required to maintain the confidentiality of the PHI of our members/patients,
and we have policies and procedures and other safeguards to help protect
your PHI from improper use and disclosure. Sometimes, we are allowed
by law to use and disclose certain PHI without your written permission.
We briefly describe these uses and disclosures below and give you some
examples.
How much PHI is
used or disclosed without your written permission will vary depending,
for example, on the intended purpose of the use or disclosure. Sometimes
we may only need to use or disclose a limited amount of PHI, such as
to send you an appointment reminder or to confirm that you are a health
plan member. At other times, we may need to use or disclose more PHI
such as when we are providing medical treatment.
- Treatment:
This is the most important use and disclosure of your PHI. For example,
our physicians, nurses, and other health care personnel, including
trainees, involved in your care use and disclose your PHI to diagnose
your condition and evaluate your health care needs. Our personnel
will use and disclose your PHI in order to provide and coordinate
the care and services you need, for example: prescriptions; X-rays;
and lab work. If you need care from health care providers who are
not part of Kaiser Permanente, such as community resources to assist
with your health care needs at home, we may disclose your PHI to them.
- Treatment
alternatives and health-related benefits and services:
In some instances, the law permits us to contact you: 1) to describe
our network or describe the extent to which we offer and pay for various
products and services; 2) for your treatment; 3) for case management
and care coordination; or 4) to direct or recommend available treatment
options, therapies, health care providers, or care settings. For example,
we may tell you about a new drug or procedure or about educational
or health management activities.
Payment:
Your PHI may be needed to determine our responsibility to pay for,
or to permit us to bill and collect payment for, treatment and health-related
services that you receive. For example, we may have an obligation
to pay for health care you receive from an outside provider. When
you or the provider sends us the bill for health care services, we
use and disclose your PHI to determine how much, if any, of the bill
we are responsible for paying.
- Health care
operations: We may use and disclose your PHI for certain health
care operations, such as: quality assessment and improvement; training
and evaluation of health care professionals; licensing; accreditation;
activities relating to the creation, renewal or replacement of health
insurance or health benefits; conducting medical review; legal services;
auditing functions, including fraud and abuse detection and compliance
programs; customer services; and determining premiums and other costs
of providing health care. We may also disclose your PHI for certain
health care operations of other health plans and health care providers.
- Business associates:
We may contract with business associates to perform certain functions
or activities on our behalf, such as payment and health care operations.
These business associates must agree to safeguard your PHI.
- Appointment
reminders: Your
PHI allows us to contact you about appointments for treatment or other
health care you may need.
- Specific types
of PHI: There are stricter requirements for use and disclosure
of some types of PHI, for example, information about drug and alcohol
abuse, AIDS and HIV, mental health, genetic testing, and artificial
insemination. However, there are still circumstances in which these
types of information may be used or disclosed without your authorization.
If you become a patient in our chemical dependency program, we will
give you a separate written notice, as required by law, about your
privacy rights for your chemical dependency program PHI.
Communications
with family and others when you are present: Sometimes a family
member or other person involved in your care will be present when
we are discussing your PHI with you. If you object, please tell us
and we won't discuss your PHI or we will ask the person to leave.
- Communications
with family and others when you are not present: There may be
times when it is necessary to disclose your PHI to a family member
or other person involved in your care because there is an emergency,
you are not present, or you lack the decision making capacity to agree
or object. In those instances, we will use our professional judgment
to determine if it's in your best interest to disclose your PHI. If
so, we will limit the disclosure to the PHI that is directly relevant
to the person's involvement with your health care. For example, we
may allow someone to pick up a prescription for you.
- Disclosure
in case of disaster relief:
We may disclose your name, city of residence, age, gender, and general
condition to a public or private disaster relief organization to assist
disaster relief efforts, unless you object at the time.
- Disclosures
to parents as personal representatives of minors: In most cases,
we may disclose your minor child's PHI to you. In some situations,
however, we are permitted or even required by law to deny your access
to your minor child's PHI - for example, information about drug use
or addiction, certain mental health services, and venereal disease.
Facility directories:
When you are a patient in one of our facilities, we may create a directory
that includes your name, room location, and your general condition.
This information may be disclosed to a person who asks for you by
name. In addition, we may provide your religious affiliation, if any,
to clergy. You may object to the use or disclosure of some or all
of this information. If you do, we will not disclose it to visitors
or other members of the public.
- Research:
Kaiser Permanente engages in extensive and important health research.
Some of our research may involve medical procedures and some is limited
to collection and analysis of health data. Research of all kinds may
involve the use or disclosure of your PHI. Your PHI can generally
be used or disclosed without your permission if an Institutional Review
Board (IRB) approves such use or disclosure. An IRB is a committee
that is responsible, under federal law, for reviewing and approving
human subjects research to protect the safety of patients and confidentiality
of PHI.
- Organ donation:
We may use or disclose PHI to organ procurement organizations to assist
with organ, eye or other tissue donations.
- Public health
activities:
Public health activities cover many functions performed or authorized
by government agencies to promote and protect the public's health
and may require us to disclose your PHI.
- For example,
we may disclose your PHI as part of our obligation to report to
public health authorities certain diseases, injuries, conditions,
and vital events such as births or abortions. Sometimes we may
disclose your PHI to someone you may have exposed to a communicable
disease or who may otherwise be at risk of getting or spreading
the disease.
- The Food
and Drug Administration (FDA) is responsible for tracking and
monitoring certain medical products, such as pacemakers and hip
replacements, to identify product problems and failures and injuries
they may have caused. If you have received one of these products,
we may use and disclose your PHI to the FDA or other authorized
persons or organizations, such as the maker of the product.
- We may use
and disclose your PHI as necessary to comply with federal and
state laws that govern workplace safety.
- Health oversight:
As health care providers and health plans, we are subject to oversight
conducted by federal and state agencies. These agencies may conduct
audits of our operations and activities and in that process, they
may review your PHI.
- Disclosures
to your employer or your employee organization: If you are enrolled
in Kaiser Foundation Health Plan of Colorado through your employer
or an employee organization, we may share certain PHI with them without
your authorization, but only when allowed by law. For example, we
may disclose your PHI for a workers' compensation claim or to determine
whether you are enrolled in the plan or whether premiums have been
paid on your behalf. For other purposes, such as for inquiries by
your employer or employee organization on your behalf, we will obtain
your authorization when necessary under applicable law.
- Workers' compensation:
In order to comply with workers' compensation laws, we may use and
disclose your PHI. For example, we may communicate your medical information
regarding a work-related injury or illness to claims administrators,
insurance carriers, and others responsible for evaluating your claim
for workers' compensation benefits.
- Military activity
and national security:
We may sometimes use or disclose the PHI of armed forces personnel
to the applicable military authorities when they believe it is necessary
to properly carry out military missions. We may also disclose your
PHI to authorized federal officials as necessary for national security
and intelligence activities or for protection of the President and
other government officials and dignitaries.
- Marketing:
Kaiser Permanente may use and, in some instances, disclose your PHI
to contact you about benefits, services or supplies that we can offer
you in addition to your KP coverage.
- Fundraising:
We may use or disclose PHI to contact you to raise funds for our organization.
- Required by
law:
In some circumstances federal or state law requires that we disclose
your PHI to others. For example, the Secretary of the Department of
Health and Human Services may review our compliance efforts, which
may include seeing your PHI.
- Lawsuits and
other legal disputes:
We may use and disclose PHI in responding to a court or administrative
order, a subpoena, or a discovery request. We may also use and disclose
PHI to the extent permitted by law without your authorization, for
example, to defend a lawsuit or arbitration.
- Law enforcement:
We may disclose PHI to authorized officials for law enforcement purposes,
for example, to respond to a search warrant, report a crime on our
premises, investigate fraud, or help identify or locate someone.
- Serious threat
to health or safety: We may use and disclose your PHI if we believe
it is necessary to avoid a serious threat to your health or safety
or to someone else's.
- Abuse or neglect:
By law, we may disclose PHI to the appropriate authority to report
suspected child abuse or neglect or to identify suspected victims
of abuse, neglect, or domestic violence.
- Coroners and
funeral directors: We may disclose PHI to a coroner or medical
examiner to permit identification of a body, determine cause of death,
or for other official duties. We may also disclose PHI to funeral
directors.
- Inmates: Under
the federal law that requires us to give you this notice, inmates
do not have the same rights to control their PHI as other individuals.
If you are an inmate of a correctional institution or in the custody
of a law enforcement official, we may disclose your PHI to the
correctional institution or the law enforcement official for certain
purposes, for example, to protect your health or safety or someone
else's.
VI.
ALL OTHER USES AND DISCLOSURES OF YOUR PHI REQUIRE YOUR PRIOR WRITTEN
AUTHORIZATION
Except for those uses and disclosures described above, we will not use
or disclose your PHI without your written authorization. When your authorization
is required and you authorize us to use or disclose your PHI for some
purpose, you may revoke that authorization by notifying us in writing
at any time. Please note that the revocation will not apply to any authorized
use or disclosure of your PHI that took place before we received your
revocation. Also, if you gave your authorization to secure a policy
of insurance, including health care coverage from us, you may not be
permitted to revoke it until the insurer can no longer contest the policy
issued to you or a claim under the policy.
VII.
HOW TO CONTACT US ABOUT THIS NOTICE OR TO COMPLAIN ABOUT OUR PRIVACY
PRACTICES
If you have any questions about this notice, want to request a copy
of the notice, or want to lodge a complaint about our privacy practices,
please let us know by calling the Customer Service Department at:
- Denver/Boulder
area: 1-888-313-2329 or (303) 338-3820 TTY/TDD
- Colorado Springs
area: 1-888-313-2329 or (719) 867-2132 TTY/TDD
You may also e-mail
the Customer Service Department at colorado.cs@kp.org, or write
to the Customer Service Department at: Kaiser Foundation Health Plan
of Colorado, Customer Service Department, 2500 South Havana Street,
Aurora, CO 80014-1622. You also may notify the Secretary of the Department
of Health and Human Services (HHS) to lodge a complaint about our privacy
practices.
We will not take
retaliatory action against you if you file a complaint about our privacy
practices.
VIII.
CHANGES TO THIS NOTICE
We may change this notice and our privacy practices at any time, as
long as the change is consistent with state and federal law. Any revised
notice will apply both to the PHI we already have about you at the time
of the change, and any PHI created or received after the change takes
effect. If we make an important change to our privacy practices, we
will promptly change this notice and post a new notice at the following
Internet address: www.kp.org. Except for changes required by
law, we will not implement an important change to our privacy practices
before we revise this notice.
IX.
EFFECTIVE DATE OF THIS NOTICE
This notice is effective on April 14, 2003.
To
return to the page you were viewing, please click the back button on
your browser (Netscape, Internet Explorer, etc.)
.
|