HIPAA - Health Insurance Portability And Accountability Act

April 14, 2003                    

Dear Patient,

The Health Center understands the necessity of protecting and safeguarding the personal information of our patients from improper use or disclosure.  In order to ensure this, the Health Center will:

OBTAIN ROUTINE CONSENTS, as necessary, to permit the use of personal health information for future, known and /or routine needs.  These consents will include the use and release of personal information for purposes of payment, treatment and health care operations.

Special consents, (also known as AUTHORIZATIONS) will be obtained, as appropriate, prior to the use or release of information beyond the scope of the routine consent.

When a person is unable to provide consent, an appropriate individual is identified to give consent on his or her behalf.

ACCESS TO HEALTH RECORDS AND INFORMATION

Patients may access their own health records.  The definition of “patient” also includes the surviving spouse, the parents of a deceased patient, or a person the patient appoints in writing as a legally recognized representative.  Patients also have the right to amend their health records.  Patients will be referred to their provider to discuss information maintained in their record.

A person may not access their spouse’s personal information without an authorization (or consent) from the patient.

A parent or legal guardian of a minor may access and authorize the release of the minor’s health information.  However, if the minor is married, emancipated, has borne a child, or if the records in question concern venereal disease, chemical dependency, or pregnancy and related conditions, the parent or legal guardian may not access or release the minor’s health information without the minor’s express written consent.

Health information may be withheld from a person only if a physician or other licensed health care provider reasonably determines that information will be detrimental to his or her physical or mental health or is likely to cause him or her to inflict self-harm or harm to another.  The practitioner must record and state the specific basis for which they are withholding information prior to the request.

A patient may request restrictions on the use and disclosure of their health information.

In order to comply with evolving laws and standards, the Health Center may occasionally modify its privacy practices.  If you have any questions regarding the privacy guidelines please feel free to contact the Privacy Compliance Officer at 320-363-3142.

SAINT JOHN’S UNIVERSITY HEALTH CENTER
Aka:  HEALTH CENTER
Saint John’s University
Collegeville, MN 56321

NOTICE OF PRIVACY PRACTICES

Effective April 14, 2003

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.

The Health Center may use and disclose protected health information for treatment, payment, or health care operations.  The Health Center may also use or disclose protected health information in other situations as prescribed by law.  Listed below are the purposes for which the Health Center may use and disclose protected health information in other situations as prescribed by law.  Listed below are the purposes for which the Health Center may use and disclose protected health information together with one or more examples of how information might be used or disclosed for each purpose.

1. Treatment.  The physician uses information obtained from a personal health history, physical examination and laboratory test results to diagnose your medical condition and prescribe a course of treatment.
2. Payment.  The business office staff disclose information to your insurance company about the services you received at the Health Center so that the Health Center can receive reimbursement from your insurance company.
3. Health Care Operations.  The Health Center reviews individual patient medical records to determine whether or not a patient with a particular diagnosis is receiving all of the recommended courses of treatment for that particular diagnosis.
4. Public health activities.  The Health Center is required to report to government agencies instances of some communicable diseases as well as vital events such as birth and death.
5. Suspected abuse, neglect or domestic violence.  The Health Center is required to report suspected instances of abuse, neglect, or domestic violence to the county social services office and/or county sheriff.
6. Health oversight activities.  The Health Center cooperates with government agencies auditing the appropriateness of claims submitted for reimbursement by government programs.  Such audits require a review of individual medical records and payment claims.
7. Judicial and administrative proceedings.  The clinic responds to court orders to produce medical records or payment records as part of judicial or administrative proceedings.
8. Law enforcement purposes.  The Health Center is required to report certain types of wounds or other injuries, such as gun shot wounds, to appropriate law enforcement officials.
9. Uses and disclosures about decedents.  The Health Center discloses protected health information to coroners or medical examiners for the purpose of identifying a deceased person or determining the cause of death.
10. Cadaveric organ, eye, or tissue donation.  The Health Center discloses protected health information to organizations engaged in procurement, banking, or transplanting organ, eye, or tissue donation.
11. Medical research.  The Health Center may from time to time participate in research studies requiring the review of a large number of medical records of individuals with particular diagnoses or other medical circumstances.
12. Use or disclosures to avert a serious threat to health or safety.  In the event that the Health Center knew that a patient was infected with a very contagious disease that posed a threat to the public, such as small pox, the Health Center would report this information to the local public health agency.
13. Specialized government functions.  The Health Center would disclose protected health information to authorized federal officials for the provision of protective services to the President of the United States or other authorized persons.
14. Workers’ compensation.  The Health center may disclose protected health information to employers or insurance companies who process claims under worker’s compensation programs.
15. Reminders and notices.  The Health Center may contact you to provide appointment reminders or information about treatment alternatives or other health related benefits and services that may be of interest to you.

Al l other uses and disclosures of protected health information will be made only with your written authorization and you may revoke that authorization at any time by providing notice, in writing, to the Health Center Privacy Official except that you cannot revoke an authorization or consent to the extent that the Health Center has already taken action relying on the authorization or consent.

You have certain rights as explained below.

1. Restrictions.  You have the right to request that there be restrictions on the use or disclosure of protected health information for treatment, payment, or health care operations. Your request must be submitted in writing to the Health Center Privacy Official.  The Health Center is not required to agree to any such request.  However, if the Health Center does agree to any such request, then the Health Center is obligated to honor that agreement.
2. Other restrictions.  In the event that you are not able to give your authorization or are not available, the Health Center may use or disclose to a family member, other relative, or a close personal friend protected health information directly relevant to their involvement with your care or payment for your care; to assist in notifying such a person in an emergency; or to assist in disaster relief efforts.  You have the right to request that there be restrictions on such use or disclosure.  Your request must be submitted in writing to the Health Center Privacy Official.  The Health Center is not required to agree to any such requests.  However, if the Health Center does agree to any such request, the Health Center is obligated to honor that agreement.
3. Alternative communications.  You may request that communications regarding protected health information be made at a different location than that listed as your primary address.  The Health Center is obligated to honor all reasonable requests.  Your request must be submitted in writing to the Health center Privacy Official.
4. Inspection and Copying.  You have the right to inspect or obtain a copy of your protected health information. Your request must be submitted in writing on forms provided by the Health Center.  These forms are available at the Health Center or by contacting the Health Center Privacy Official.  There may be a charge for obtaining copies of your protected health information.
5. Amendment.  You have the right to request that your protected health information which you feel is incorrect or incomplete be amended.  Your request must be submitted in writing to the Health Center Privacy Official.  Your request must provide a reason to support your request.
6. Accounting of Disclosures.  You have the right to request an accounting of all disclosures of protected health information during the past six years or after April 14, 2003, whichever is the shorter period or time, other than for treatment, payment or health care operations: disclosures which you have authorized in writing; or for which the Health Center is prohibited by law to report to you, such as a request by law enforcement agencies investigating fraud or abuse.  Your request must be submitted in writing to the Health Center Privacy Official.
7. Notice of Privacy Practices.  You have a right to have your own copy of this Notice of Privacy Practices.  To obtain your copy, ask the Health Center receptionist.

The Health Center has certain duties as explained below.

1. The Health Center is required by law to maintain the privacy of protected health information and to provide individuals with notice of its legal duties and privacy practices with respect to health information. The Health Center does this by posting and distributing this Notice of Privacy Practices. 
2. The Health Center is obligated to abide by the terms of the Notice of Privacy Practices currently in effect at the Health Center.
3. The Health Center reserves the right to change the terms of its Notice of Privacy Practices and to make the new notice provisions effective for all protected health information that it maintains.  Any new Notice of Privacy Practices would be posted in the Health Center and would be made available at the reception desk to all patients who come to the Health Center.
4. The Health Center must designate a contact person who is responsible for receiving complaints.  That person is the Health Center Privacy Official. You may complain to the Health Center as well as to the Secretary of Health and Human Services if you believe that your privacy rights have been violated. If you wish to submit a complaint to the Health Center, you must do so in writing to the Health Center Privacy Official.  You will not be retaliated against for submitting a complaint.

For further information or to submit documents in writing as prescribed anywhere above, contact:

Health Center Privacy Official
Saint John’s Health Center
Collegeville, MN  56321

 Tel: 320-363-3142

For Privacy and Your Health Information see this US Department of Health & Human Services Office for Civil Rights link or phone 1-866-627-7748.