Privacy Policy
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NOTICE OF PRIVACY PRACTICES As required by the Health Insurance Portability and
Accountability Act (HIPAA) of 1996, this notice describes how health
information about you may be used and disclosed. This information is not applicable to
patient information covered under the Family Education Rights Act (FERPA) or
that is specifically exempted from FERPA.
Please read this carefully. WHO WILL
FOLLOW THIS NOTICE University Health Services (hereinafter referred to
as UHS) may use your health information for treatments, and/or payment as
described in this notice. All
employees of UHS follow these privacy policies. ABOUT THIS
NOTICE This notice will tell you about the ways we may use
and disclose health information about you.
We also describe your rights and certain obligations we have regarding
the use and disclosure of health information.
We are required by law to: · Make sure that health information that identifies you
is kept private. · Give you this notice of our legal duties and privacy
practices with respect to your health information and, · Follow the terms of the notice that is currently in
effect. HOW WE MAY
USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU The following categories describe different ways that
we use and disclose health information.
For each category or uses or disclosures we will explain what we mean
and give examples. Not every use or
disclosure in a category will be listed.
However, all of the ways we are permitted to use and disclose information
will fall within one or more of the categories. For
Treatment: We may use health information about you to
provide you with medical treatment or services. We may disclose health information about
you to doctors, nurses, counselors, technicians or other UHS personnel who
are involved in taking care of you. · If you are being seen in the UHS Counseling Center
and are receiving care by a medical provider here as well, health information
may need to be shared to ensure that you are receiving appropriate integrated
care. Departments within UHS may share
health information about you to coordinate your care. · We may need to provide information to your insurance
company to obtain prior approval to determine whether your plan will cover
your treatment. · We may disclose health information about you to
people outside of UHS involved in your health care with a signed
authorization form from you. Appointment
Reminders: We may use and disclose health information
about you to remind you that you have an appointment for treatment or
services in the UHS. Individuals Involved In Your Care: We may
release health information about you to you or any other person identified on
an authorization form completed by you. As Required by Law: We will disclose health
information about when required to do so by state or federal law. To Avert a Serious Threat to Health or Safety: We may use
and disclose your health information to prevent a serious threat to your
health or safety or the health and safety of the public or another person
when, in our judgment, such a threat exists.
Any disclosure would be only to someone able to help prevent the
threat or resolve the crisis that contributes to an unsafe situation. Military and
Veterans: If you are a member of the armed forces of
the United States or another country we may release health information about
you as required by military command authorities. YOUR RIGHTS
REGARDING MEDICAL INFORMATION ABOUT YOU You have the following rights regarding health
information we maintain about you: Right to
Inspect and Copy: You have the right to inspect and copy
health information that may be used to make decisions about your care. Usually, this includes medical and billing
records. This right does not include
psychotherapy notes; information compiled for use in a legal proceeding, or
certain information subject to the Clinical Laboratory Improvement Act (ACT)
Amendments of 1988. In order to inspect and copy health information that
may be used to make decisions about you, you must submit your request in
writing to the Privacy Officer at UHS, University of Massachusetts Boston,
100 Morrissey Blvd., Boston, MA 02125.
If you request a copy of the information, we may charge a fee for the
cost of copying, mailing or other supplies associated with your request. We may deny your request to inspect and copy in
certain limited circumstances. If you
are denied access to health information, you may be request in writing that
the denial be reviewed. A licensed
healthcare professional will review your request and the denial. The reviewer
will not be the person who denied your request. We will comply with the outcome of the
review. Right to
Amend: If you think your health information is incorrectly
recorded or incomplete, you may ask us to amend the information. The right to amend does not mean the right
to obliterate or totally remove documentation from the record. Rather it is an opportunity to “append” a
statement of correction or clarification to the record and to know that when
the original statement is used or disclosed, the new “corrective” or
“clarified” statement will accompany any released copies. You have the right to request an amendment
for as long as the information is maintained by UHS. To request an amendment,
your request must be made in writing and submitted to the Privacy Officer at
UHS. In addition, You must give a
reason that supports your 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 us to amend information that: ·
Was not created
by us, unless the person or entity that created the information is no longer
available to make the amendment. ·
Is not part of
the health information kept by or for UHS. ·
Is not part of
the information that you would be permitted to inspect and copy. ·
Is not accurate
and complete. We will provide you of
written notice of action we take in response to your request for an
amendment. Right to an Accounting of
Disclosure: You have the right to
request an “accounting of disclosure”.
This is a list of certain disclosures we made of your health
information. The accounting will
include: ·
The date of the
disclosure ·
The name of the
entity or person who received the health information and, if known, the address
of such entity or person. ·
A brief
description of the health information disclosed. ·
A brief
statement of the purpose of the disclosure or a copy of their authorization. We are not required to
account for any disclosures made to you or for disclosures related to
treatment, payment, healthcare operations, or made pursuant to an
authorization signed by you. |
Workers Compensation: We
may disclose health information about you for workers compensation or similar
programs. These programs provide
benefits for work-related injuries or illness. Public Health Risks: We may
disclose to authorized public health or government officials, health
information about you for public health activities. These activities generally include the
following: §
To the Food and
Drug Administration (FDA) for purposes related to the quality, safety or
effectiveness of an FDA-regulated product or service. §
To prevent or
control disease, injury or disability. §
To report
disease or injury; to report births or deaths §
To report child
abuse or neglect §
To report
reactions to medications and food
problems with products §
To notify people
of recalls or replacement of products they may be using §
To notify a
person who may have been exposed to a disease or may be at risk for contracting
or spreading disease or condition §
To notify the
appropriate government authority if we believe a patient has been the victim
of abuse, neglect or domestic violence.
We will only make the disclosure if you agree or when required by
authorized law. Health Oversight Activities: We
may disclose health information to a health oversight agency for activities
authorized by law. These oversight
activities include, for example, audits, investigations, inspections, and
licensure. These activities are necessary
to monitor health care systems, government programs and compliance with civil
right laws. Lawsuits and Disputes: If you are
involved in a lawsuit or a dispute, we may disclose health information about
you in response to a court or administrative order. We may also disclose health information
about you in response to a subpoena, discovery request, or other legal demand
by someone else involved in the dispute, but only if efforts have been made
to tell you about the request or to obtain an order protecting the
information requested. Law Enforcement: We may disclose health
information if asked to do so by a law enforcement official: ·
In response to a
court order, subpoena, warrant, summons or similar process. ·
To identify or
locate a suspect, fugitive, material witness, or missing person ·
About the victim
of a crime, if under certain circumstances, the person is unable to give
consent. ·
About a death we
believe may be the result of criminal conduct. ·
About criminal
conduct relative to UHS operations. ·
In emergency
circumstances to report a crime, location of a crime or victims, or the
identity, description or location of the person who committed the crime. ·
To authorized
federal officials so they may provide protection for the President and other
authorized persons or to conduct special investigations. Coroners,
Medical Examiners and Funeral Directors: We may disclose health
information to a coroner or medical examiner.
This may be necessary, for example, to identify a deceased person or determine
the cause of death. We may also obtain
disclose health information to funeral directors as they carry out their
duties. National
Security and Intelligence Activities: We may disclose health information about
you to authorized federal officials for intelligence, counterintelligence,
and other national security activities authorized by law. In Legal
Custody: If you are an inmate of a correctional institution or
under custody of law enforcement officials, we may disclose health
information about you to the correction institution or law enforcement
official. Other Uses
of Health Information: Other uses and disclosures of health
information not covered by this Notice or the laws that apply to us will be
made with your written authorization.
You revoke such an authorization by writing to the Privacy Officer,
and such revocation will be effective to the extent that we have not already
released the information pursuant to the authorization or otherwise taken
action based on the authorization. To request an accounting of
disclosures, you must submit your request in writing to the Privacy
Officer. Your request must state a
time period, which may not be longer than six years and may not include dates
before April 10, 2006 (the effective date of this Privacy Notice). Your request should indicate on what form
you want the list (for example, on paper or electronically). The first list
you request within a 12-month period will be free. For additional lists, we may charge you the
cost of providing the list. We will
notify you of the costs 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 health information
we use to disclose about you for treatment, payment, etc. You also have the right to request a limit
on the health information we disclose about you to someone who is involved in
your care or the payment of your care, such as a family member or friend. To
request restrictions, you must make your request in writing to the Privacy
Officer. In your request, you must
tell us: ·
What information
you want to limit ·
Whether you want
to limit our use, disclosure or both ·
To whom you want
limits to apply, i.e., disclosure to parents. We are not required to agree
to your request. If we agree, we will
comply with your request unless the information is needed to provide you
emergency treatment. Right to Request Confidential Communications: You have the
right to request that we communicate with you about health matters in a
certain way or at a certain location.
For example, you can ask that we only contact you at work or by
mail. To request confidential
communications, you must make your request in writing to the UHS Privacy
Officer. Your request must specify how
or where you wish to be contacted. We
will not ask you for the reason for your request. We will attempt to accommodate reasonable
requests. Right to a Paper Copy of This Notice: You have a right
to a paper copy of this notice. You
may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this
notice electronically, you are still entitled to a paper copy of this notice. To obtain a paper copy of
this notice you must contact the UHS Privacy Officer. CHANGES TO THIS NOTICE We reserve the right to
change this Notice. We reserve the
right to make the revised or changed Notice effective for health information
about you we already have as well as any information we receive in the
future. The current Notice in effect
at any time will be posted on our website at http://www.healthservices.umb.edu/
and will also be available at UHS. COMPLAINTS If you believe your privacy
rights have been violated, you may file a complaint with UHS’ Privacy Officer
or with the Asst. to the Executive Director, UHS. To file a complaint with UHS, please call
or write to the Privacy Officer at the address listed at the end of this
Notice. You will not be penalized for
filing a complaint. QUESTIONS If you have a question about
the Privacy Notice, please contact: Privacy Officer University Health Services University of Massachusetts Boston 100 Morrissey Blvd. Boston, MA 02125-3393 (617) 287-5679 EFFECTIVE DATE;
April 10, 2006 |