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New Hanover Regional Medical Center Employee Health Plan (the "NHRMC Plan")
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.
Under the federal privacy regulations enacted pursuant to the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the Plan is required to protect the confidentiality of your Protected Health Information. We also are required to provide you with notice of the Plan's legal duties and privacy practices with respect to Protected Health Information. In addition the Plan is required to abide by the terms of the privacy notice currently in effect. Protected Health Information (PHI) is individually identifiable health information related to your health conditions, health care provided to you, or payments made for that care, which is created or received by a health plan, a health care clearinghouse, or a health care provider that electronically transmits such information.
How We Use and Disclose Protected Health Information
The Plan and New Hanover Regional Medical Center may use and disclose your Protected Health Information as permitted by law. This notice describes how we are most likely to use and disclose Protected Health Information. We will use and disclose Protected Health Information for treatment, payment, and health care operations. The following are examples of these permitted uses and disclosures of PHI:
- 'Payment' includes activities undertaken by the Plan to obtain premiums or determine or fulfill its responsibility for coverage and provision of plan benefits, such as determination of eligibility, coverage and cost sharing amounts;
- 'Health care operations' include rating provider and plan performance, quality assessment and improvement, business management and general administrative activities; and
- 'Treatment' includes provision, coordination, or management of health care and related services among health care providers or by a health care provider with a third party, consultation between health care providers regarding a patient, or the referral of a patient from one health care provider to another.
We also may use or disclose PHI in the following circumstances:
- When we are required to do so by law, such as if a government agency is determining our compliance with law;
- For public health activities, such as preventing or controlling the spread of communicable diseases;
- In order to report suspected abuse, neglect, or domestic violence;
- In cooperation with agencies that carry out health oversight activities, such as audits, investigations, inspections, licensure, and other criminal or civil proceedings;
- In connection with legal proceedings, such as in response to a court order, administrative order, or subpoena;
- In cooperation with law enforcement, such as in connection with a subpoena or court order; the locations of suspects, fugitives, witnesses and missing persons; investigations of crimes on the premises; and where the PHI relates to the victim of a crime;
- When reasonably necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public;
- In connection with activities related to worker's compensation, such as the provision of benefits for work-related injuries or illnesses and compliance with worker's compensation laws; and
- For the purpose of modifying, amending, or terminating the Plan; obtaining premium bids from health plans for providing health insurance coverage; and to perform plan administrative functions (such as claims processing, quality assurance, auditing and monitoring).
The Plan also may disclose PHI to New Hanover Regional Medical Center, the plan sponsor, for purposes such as coordinating your Plan coverage; modifying, amending, or terminating the Plan; obtaining premium bids; and performing plan administrative functions such as those described above.
Other uses and disclosures will be made only with your written authorization, which you may choose to give us in order to use or disclose your PHI for purposes not described in this notice. If you have provided an authorization, you may revoke it at any time by giving us written notice of your revocation. Your revocation will not affect uses and disclosures undertaken while your authorization was in effect.
You have rights with respect to your PHI. You have the right to:
- Request restrictions on certain uses and disclosures of PHI as provided by HIPAA, but the Plan may not be required to agree to a requested restriction.DIX C
- Receive confidential communications of PHI at reasonable alternative locations and by reasonable alternative means if you believe that our disclosure of PHI could endanger you (please contact your human resources representative to request confidential communications);
- Access, inspect and copy certain PHI, for which we may require a reasonable fee;
- Request that we amend or update PHI, but the Plan may not be required to agree to the request, in which case we will inform you of our decision in writing and you will have the right to submit a written statement of disagreement;
- Receive an accounting of certain types of disclosures of PHI made by the Plan in the six years prior to the date on which the accounting is requested, as provided by HIPAA (we may charge you a reasonable fee for this accounting if you have made a request more than once in a twelve month period); and
- Obtain a paper copy of this notice from the Plan upon request. You should contact the Plan Administrator if you have questions about exercising your rights with respect to your PHI.
If you believe your rights under HIPAA have been violated, you have the right to file a complaint with the Plan by contacting New Hanover Regional Medical Center's Compliance/Privacy Officer at 910.815.5331 or the Compliance Hotline at 800.348.9847. You also may file a complaint with the U.S. Department of Health and Human Services. For more information on how to file a complaint and other rights under HIPAA, contact your human resources representative. We will not take any adverse action against you for filing a complaint.
The Plan reserves the right to change the terms of this notice and to make the new notice provisions effective for all protected health information that it maintains. If the notice is revised in a manner that materially changes its terms, the Plan will provide individuals then covered by the Plan with a copy of the revised notice within 60 days of the revision. All revised notices will be distributed in the same manner as this notice or as otherwise permitted or required by HIPAA. You may also request a copy of the current privacy notice at any time by contacting your human resources representative. All other terms, provisions and conditions shown in this summary of benefits will continue to apply.
For more information about NHRMC privacy practices pertaining to PHI, contact:
Vera Newkirk, Compliance/Privacy Officer- 910.815.5331
Effective: August 2015