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Newberry County Memorial Hospital Notice of Privacy Practices
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESSTO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
I. HOW NEWBERRY COUNTY MEMORIAL HOSPITAL MAY USE OR DISCLOSE YOUR HEALTH INFORMATION
Federal law requires Newberry County Memorial Hospital to maintain the privacy of individually identifiable health information and to provide you with notice of its legal duties and privacy practices with respect to such information. Newberry County Memorial Hospital must abide by the terms and conditions of this Privacy Notice, as Newberry County Memorial Hospital may revise this Privacy Notice from time to time.
A. USES OR DISCLOSURES OF HEALTH INFORMATION FOR TREATMENT, PAYMENT, & HEALTH CARE OPERATIONS
When you sign a written consent, you agree that Newberry County Memorial Hospital may use your individually identifiable health information for treatment, payment and health care operations. Examples of treatment, payment and health care operations include:
“Treatment” could include consulting with or referring your case to another health care provider. The type of health information that could be used or disclosed includes such health conditions as HIV status, a diagnosis of AIDS or other communicable diseases that are subject to public health reporting requirements.
“Payment” could include Newberry County Memorial Hospital’s efforts to obtain reimbursement from you or a responsible third party for services that Newberry County Memorial Hospital has provided you.
“Health care operations could include activities such as quality assessment and improvement activities and audits of the process of billing you or a third party for health care services Newberry County Memorial Hospital provides to you. As a part of Newberry County Memorial Hospital’s treatment of you and operation of a health care organization, Newberry County Memorial Hospital may contact you, by phone or by mail, to provide appointment reminders or to provide information about treatment alternatives or other health-related services that may be of interest to you. Newberry County Memorial Hospital may also contact you for patient satisfaction surveys and or fundraising purposes.
B. USES OR DISCLOSURES NEWBERRY COUNTY MEMORIAL HOSPITAL MAY MAKE WITHOUT YOUR CONSENT OR AUTHORIZATION
In addition to treatment, payment and health care operations, and unless this Privacy Notice recites a more stringent restriction in Section C, the law permits or requires Newberry County Memorial Hospital to use or disclose individually identifiable health information without your written consent or authorization to: (i) comply with public health reporting and notification requirements, including reporting of adverse product events to the Food and Drug Administration, (ii) report suspected abuse, neglect or domestic violence, as required by law, (iii) submit information to health oversight agencies for oversight activities, such as audits, authorized by law, (iv) respond to a final order or subpoena of a court or administrative tribunal, (v) assist law enforcement personnel, as required by law, or to fulfill a law enforcement request for certain limited information for the purpose of identifying or locating a suspect, witness, or victim in an investigation, or to report a potential crime, (vi) assist a medical examiner or funeral director, (vii) assist an organ procurement organization or organ bank in facilitating organ or tissue donation and transplantation, (viii) further research, provided that Newberry County Memorial Hospital complies with federal requirements, (ix) avert a serious and imminent threat to public health safety, (x) assist with government activities related to the military, veterans, or national security, (xi) comply with workers’ compensation or similar laws, (xii) allow individuals responsible for your care to assist you in the event of your incapacity or an emergency, and (xiii) as otherwise required by law. With your oral agreement, Newberry County Memorial Hospital may also disclose certain information for purposes of its patient directory or to inform relatives or other individuals directly involved in your care or payment for your care regarding your condition.
C. MORE STRINGENT PROTECTION FOR YOUR HEALTH INFORMATION
In certain cases, South Carolina law provides more stringent privacy protections of your health information than this Privacy Notice recites above. Specifically the following:
If you are a patient with an HIV or Hepatitis B infection, your attending physician may inform a lay healthcare giver who is or soon will be providing health care to you regarding your HIV or Hepatitis B infection. However, your physician must notify you before and after the disclosure is made and must provide you with the name of the person to whom the physician will disclose this information.
With respect to your prescription drug information, Newberry County Memorial Hospital will not transfer or receive your information without your written release, except when the transfer or receipt involves: (1) the lawful transmission of a prescription drug order in accordance with all state and federal laws pertaining to the practice of pharmacy; (2) information necessary to effect the recall of a defective drug or device or other information necessary to protect the health and welfare of an individual or the public generally; (3) other state or federal laws, court order, or subpoena, or regulations including, but not limited to, accreditation or licensure requirements that mandate release or transfer of information; (4) information that an institutional review board uses to monitor clinical research; (5) information which does not identify you by name, or that is encoded in a manner that information identifying you by name or address is not generally obtainable, and that Newberry County Memorial Hospital uses for epidemiological studies, research, statistical analysis, medical outcomes, or pharmacoeconomic research; and (6) information that Newberry County Memorial Hospital may reveal to a party who, on your behalf, obtains a dispensed prescription from a pharmacy. When you sign a written consent, you are agreeing that the practitioner may disclose your confidential information for purposes of payment, treatment or healthcare operations. If the practitioner discloses information for any purpose other than payment, treatment or health care operations, you must sign a different permission form.
If you are a patient of a psychologist, professional counselor, marriage and family therapist, psycho-educational specialist, licensed master social worker, licensed independent social worker, or a registered nurse who meets the requirements of a clinical nurse specialist and who works in the field of mental health, South Carolina law requires these professionals to limit their uses and disclosures of the information to the amount of information and recipients necessary to accomplish the purpose of the disclosure.
NOTE: References in this Privacy Notice to health care professionals include only those professionals that Newberry County Memorial Hospital employs.
D. NO OTHER USES OR DISCLOSURES WITHOUT YOUR WRITTEN AUTHORIZATION
Newberry County Memorial Hospital will not make any other uses and disclosures of your individually identifiable health information without your written authorization. Your authorization may be revoked at any time if you provide notice to Newberry County Memorial Hospital.
II. YOUR RIGHTS
Federal and state law protects your rights to keep your individually identifiable health information private. You may request restrictions on certain uses and disclosures of protected health information for purposes of treatment, payment, health care operations; however, the law does not require Newberry County Memorial Hospital to agree to the requested restrictions. You may also request that you receive communications from Newberry County Memorial Hospital regarding individually identifiable health information by alternative means or at alternative locations. You must make your request for confidential communications in writing and must submit this request to the office listed below. Newberry County Memorial Hospital reserves the right to condition your request on the receipt of information regarding how you desire Newberry County Memorial Hospital to handle payment and/or on the availability of an alternative address or method of contact that you may request.
You generally have the right to inspect and obtain a copy of any individually identifiable health information in your medical record, or, under certain circumstances, your attending physician may provide you with only a summary of your medical record. You also have the right to amend the health information that you inspect, unless Newberry County Memorial Hospital did not create such information or unless Newberry County Memorial Hospital determines that your medical record is accurate and complete in its existing form.
You have the right to request and receive an accounting of disclosures of your individually identifiable health information that Newberry County Memorial Hospital has made in the six (6) years prior to the request date, or during the period between the request date and April 14, 2003. Such an accounting will not include disclosures made to carry out treatment, payment or health care operations, to create an accurate patient directory or notify persons involved in your care, to ensure national security, to comply with the authorized requests of law enforcement, or to inform you of the content of your medical records. If you would like more information on how to exercise these rights, please contact Newberry County Memorial Hospital’s Chief Privacy Officer at (803) 405-7415.
III. GRIEVANCES OR FURTHER INQUIRIES
If you believe that Newberry County Memorial Hospital has violated your privacy rights with respect to individually identifiable health information, you may file a complaint with Newberry County Memorial Hospital and the Department of Health and Human Services. To file a complaint with Newberry County Memorial Hospital, please contact the Healthcare Valuesline at 1-800-273-8452. Newberry County Memorial Hospital will not retaliate against your for filing a complaint. You may also contact Newberry County Memorial Hospital’s Chief Privacy Officer for further information regarding the Privacy Notice.
IV. AMENDNDMENTS
Newberry County Memorial Hospital reserves the right to amend the terms of this Privacy Notice at any time and to apply the revised Privacy Notice to all individually identifiable health information that it maintains. If Newberry County Memorial Hospital amends this Privacy Notice, you will be provided with a revised copy at your next visit to Newberry County Memorial Hospital, or upon request.
HEALTHCARE VALUESLINE 1-800-273-8452
NCMH CHIEF PRIVACY OFFICER
(803) 405-7415
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