Privacy Notice
Maryland
Maryland Department of Health and Your Health Information
Notice of
Privacy Practices - General (MDH 4617)
THIS
NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED
AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW CAREFULLY.
Safeguarding
Your Protected Health Information
The
Maryland Maryland Department of Health (MDH) is committed to protecting your
health information. In order to provide treatment or to pay for your
healthcare, MDH will ask for certain health information and that health
information will be put into your record. The record usually contains
your symptoms, examination and test results, diagnoses, and treatment.
That information, referred to as your health or medical record, and legally
regulated as health information may be used for a variety of purposes. MDH is
required to follow the privacy practices described in this Notice, although MDH reserves
the right to change our privacy practices and the terms of this Notice at any
time. You may request a copy of the new notice from any MDH agency. It is also
posted on our website at http://www.MDH.maryland.gov.
How MDH May
Use and Disclose Your Protected Health Information
MDH
employees will only use your health information when doing their jobs.
For uses beyond what MDH normally does, MDH must have your written
authorization unless the law permits or requires it. The following are some
examples of our possible uses and disclosures of your health information.
Uses and
Disclosures Relating to Treatment, Payment, or Health Care Operations:
For
treatment:MDH may use or share your health information to approve, deny
treatment and to determine if your medical treatment is appropriate. For
example, MDH health care providers may need to review your treatment plan with
your healthcare provider for medical necessity or for coordination of care.
To obtain payment: MDH may use and share
your health information in order to bill and collect payment for your health
care services and to determine your eligibility to participate in our services.
For example, your health care provider may send claims for payment of medical
services provided to you.
For health care operations:MDH may use and share your health
information to evaluate the quality of services provided, or to our state or
federal auditors.
Other Uses and Disclosures of health information required or allowed by
law:
Information purposes: Unless you provide us with
alternative instructions, MDH may send appointment reminders and other
materials about the program to your home.
Required by law: MDH may disclose health information
when a law requires us to do so.
Public health activities: MDH may disclose health
information when MDH is required to collect or report information about disease
or injury, or to report vital statistics to other divisions in the department
and other public health authorities.
Health oversight activities: MDH may disclose your
health information to other divisions in the department and other agencies for
oversight activities required by law. Examples of these oversight
activities are audits, inspections, investigations, and licensure.
Coroners, Medical Examiners, Funeral Directors and Organ
Donations: MDH may disclose health information relating to a death to
coroners, medical examiners or funeral directors, and to authorized
organizations relating to organ, eye, or tissue donations or transplants.
Research purposes: In certain circumstances, and under
supervision of our Institutional Review Board or other designated privacy
board, MDH may disclose health information to assist medical research.
Avert threat to health or safety: In order to avoid a
serious threat to health or safety, MDH may disclose health information as
necessary to law enforcement or other persons who can reasonably prevent or
lessen the threat of harm.
Abuse and Neglect: MDH will disclose your health
information to appropriate authorities if we reasonably believe that you are a
possible victim of abuse, neglect, domestic violence, or some other
crime. MDH may disclose your health information to the extent necessary
to avert a serious threat to your health or safety or the health or safety of
others.
Specific government functions: MDH may disclose health
information of military personnel and veterans in certain situations, to
correctional facilities in certain situations, to government benefit programs
relating to eligibility and enrollment, and for national security reasons, such
as protection of the President.
Families, friends or others involved in your
care: MDH may share your health information with people as it is
directly related to their involvement in your care or payment of your care.
MDH may also share health information with people to notify them about your
location, general condition, or death.
Worker's Compensation: MDH may disclose health
information to worker's compensation programs that provide benefits for
work-related injuries or illnesses without regard to fault.
Patient Directories: The health plan under which you are
enrolled does not maintain a directory for disclosure to callers or visitors
who ask for you by name. You will not be identified to an unknown
caller or visitor without authorization.
Lawsuits, Disputes and Claims: If you are involved in a
lawsuit, a dispute, or a claim, MDH may disclose your health information in
response to a court or administrative order, subpoena, discovery request,
investigation of a claim filed on your behalf, or other lawful process.
Law Enforcement: MDH may disclose your health
information to a law enforcement official for purposes that are required by law
or in response to a subpoena.
You have a Right to:
Request restrictions: You have a right to request a
restriction or limitation on the health information MDH uses or discloses about
you. MDH will accommodate your request if possible, but is not legally
required to agree to the requested restriction. If MDH agrees to a restriction,
MDH will follow it except in emergency situations.
Request Confidential Communications: You have the right
to ask that MDH send you information at an alternative address or by
alternative means. MDH must agree to your request as long as it is reasonably
easy for us to do so.
Inspect and copy: You have a right to see your health
information upon your written request. If you want copies of your health
information, you may be charged a fee for copying, depending on your
circumstances. You have a right to choose what portions of your information you
want copied and to have prior information on the cost of copying.
Request amendment: You may request in writing that MDH correct
or add to your health record. MDH may deny the request if MDH determines that
the health information is: (1) correct and complete; (2) not created by us
and/or not part of our records; or (3) not permitted to be disclosed. If MDH
approves the request for amendment, MDH will change the health information and
inform you, and will tell others that need to know about the change in the
health information.
Accounting of disclosures: You have a right to request a
list of the disclosures made of your health information after April 14,
2003. Exceptions are health information that has been used for treatment,
payment, and operations. In addition, MDH does not have to list
disclosures made to you, based on your written authorization, provided for
national security, to law enforcement officials or correctional
facilities. There will be no charge for up to one such list each year.
Notice: You have the right to receive a paper copy of
this Notice and/or an electronic copy by email upon request.
For More Information
This document is available in other languages and alternate
formats that meet the guidelines for the Americans with Disabilities Act. If
you have questions and would like more information, you may contact the
facility, program, or local health department where you receive MDH services.
To Report a Problem about our Privacy Practices
If you are a resident of a MDH facility and believe your
privacy rights have been violated, you may file a complaint.
·
You can file a complaint
with the Maryland Department of Health, Resident Grievance System Central
Office at 1-800-RGS-7454.
·
You can file a complaint
with the Secretary of the U.S. Department of Health and Human Services, Office
ofa Civil Rights. You may call the Maryland Department of Health for the
contact information.
MDH will take no retaliatory action against you if you make
such complaints.
Effective Date: This
notice is effective on April 14, 2003.