Effective Date:
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.
WHO WILL FOLLOW THIS NOTICE.
This notice describes
the health information practices of certain members of the UAB Health System,
including University of Alabama Hospital, The Kirklin Clinic, UAB Health
Centers, and the University of Alabama Health Services Foundation (referred to
as “UAB Health System”). All these entities,
sites and locations follow the terms of this notice. In addition, these entities, sites and locations may share
medical information with each other for treatment, payment or hospital
operations purposes described in this notice.
OUR PLEDGE REGARDING MEDICAL INFORMATION:
Ø For
Treatment and Treatment Alternatives. We may use medical information about you to
provide you with medical treatment or services. We may disclose medical information about you to doctors, nurses,
technicians, medical residents or students, or other UAB Health System
personnel or people outside our facility who are involved in taking care of
you. For example, a doctor treating you
for a broken leg may need to know if you have diabetes because diabetes may
slow the healing process. In addition,
the doctor may need to tell the dietitian if you have diabetes so that we can
arrange for appropriate meals. Different departments of UAB Health System
entities and different entities within UAB Health System also may share medical
information about you in order to coordinate the different things you need,
such as prescriptions, lab work and x-rays.
We also may disclose medical information about you to people outside UAB
Health System who may be involved in your medical care after you leave, such as
your local physician, family members, clergy or others we use to provide
services that are part of your care. We
may use and disclose your medical information to tell you about or recommend
possible treatment options or alternatives that may be of interest to you.
Ø For
Payment. We may use and disclose medical information
about you so that the treatment and services you receive through UAB Health
System may be billed to and payment may be collected from you, an insurance
company or a third party. For example,
we may need to give your health plan information about surgery you received at
UAB Health System so your health plan will pay us or reimburse you for the
surgery. We may also tell your health
plan about a treatment you are going to receive to obtain prior approval or to
determine whether your plan will cover the treatment.
Ø For
Routine Health Care Operations. We may use and disclose medical information
about you for UAB Health System routine operations. These uses and disclosures are necessary to run UAB Health System
and make sure that all of our patients receive quality care. For example, we may use medical information
to review our treatment and services and to evaluate the performance of our
staff in caring for you. We may also
combine medical information about many UAB Health System patients to decide
what additional services UAB Health System should offer, what services are not
needed, and whether certain new treatments are effective. We may also disclose information to doctors,
nurses, technicians, medical residents and students, and UAB Health System
personnel for review and learning purposes.
We may also combine the medical information we have with medical information
from other entities to compare how we are doing and see where we can make
improvements in the care and services we offer. We may remove information that identifies you from this set of
medical information so others may use it to study health care and health care
delivery without learning who the specific patients are.
Ø Individuals
Involved in Your Care or Payment for Your Care. We may release
medical information about you to a friend or family member who is involved in
your medical care. We may also give
information to someone who helps pay for your care. We may also tell your family or friends your condition and that
you are in the hospital. In addition,
we may disclose medical information about you to an entity assisting in a
disaster relief effort so that your family can be notified about your
condition, status and location.
Ø Appointment
Reminders and Health-Related Benefits and Services We may use and
disclose medical information to contact you as a reminder that you have an
appointment for treatment or medical care at UAB Health System. We may use and disclose medical information
to tell you about health-related benefits or services that may be of interest
to you.
Ø Research. Under certain
circumstances, we may use and disclose medical information about you to
researchers when their clinical research study has been approved by UAB’s
Institutional Review Board. While most
clinical research studies require specific patient consent, there are some
instances where patient authorization is not required. For example, a research project may involve
comparing the health and recovery of all patients who received one medication
to those who received another, for the same condition. This would be done through a retrospective
record review with no patient contact.
The Institutional Review Board reviews the research proposal to make
certain that the proposal has established protocols to protect the privacy of
your health information.
Ø Fundraising
Activities. We may use medical information about you to
contact you in an effort to raise money for UAB Health System. We may disclose medical information to a
foundation related to UAB Health System so that the foundation may contact you
in raising money for UAB Health System.
We only would release contact information, such as your name, address
and phone number and the dates you received treatment or services at UAB Health
System. If you do not want UAB Health
System to contact you for fundraising efforts, you must notify the UAB Health
System Privacy Officer [address] in writing.
Ø Certain
Marketing Activities. UABHS may use medical information about you
to forward promotional gifts of nominal value, to communicate with you about
services offered by UABHS, to communicate with you about case management and
care coordination and to communicate with you about treatment alternatives.
Ø UAB
Health System Directory. We may include certain limited information
about you in the UAB Health System directories while you are a patient at UAB
Health System, unless you request otherwise.
This information may include your name, location in UAB Health System,
your general condition (e.g., fair, stable, etc.) and your religious
affiliation. The directory information,
except for your religious affiliation, may also be released to people who ask
for you by name. This information and
your religious affiliation may be given to a member of the clergy, such as a
priest or rabbi, even if they don’t ask for you by name. This is so your family, friends and clergy
can visit you and generally know how you are doing.
Ø Business
Associates. There are some services provided in UAB
Health System through contracts with business associates. Examples include a copy service we use when
making copies of your health record, consultants, accountants, lawyers, medical
transcriptionists and third-party billing companies. When these services are contracted, we may disclose your health
information to our business associate so that they can perform the job we’ve
asked them to do. To protect your
health information, however, we require the business associate to appropriately
safeguard your information.
Ø As
Required By Law. We will disclose medical information about
you when required to do so by federal, state or local law.
Ø Public
Health Activities. We may disclose medical information about
you to public health or legal authorities charged with preventing or
controlling disease, injury, or disability.
For example, we are required to report the existence of a communicable
disease, such as tuberculosis, to the Alabama Department of Public Health to
protect the health and well-being of the general public. We may disclose medical information about
you to individuals exposed to a communicable disease or otherwise at risk for
spreading the disease. We may disclose
medical information to an employer if the employer requires the healthcare
services to determine whether you suffered a work-related injury.
Ø Food
and Drug Administration (FDA). We may disclose to the FDA and to
manufacturers health information relative to adverse events with respect to
food, supplements, product and product defects, or post-marketing surveillance
information to enable product recalls, repairs, or replacement.
Ø Victims
of Abuse, Neglect or Domestic Violence. We are required to report child, elder and
domestic abuse or neglect to the State of Alabama.
Ø Health
Oversight Activities. We may disclose medical 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 for the
government to monitor the health care system, government programs, and
compliance with civil rights laws.
Ø Lawsuits
and Disputes. If you are involved in a lawsuit or a
dispute, we may disclose medical information about you in response to a court
or administrative order. We may also
disclose medical information about you in response to a subpoena, discovery
request, or other lawful process 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.
We may disclose medical information for judicial or administrative
proceedings, as required by law.
Ø Law
Enforcement. We may release medical information for law
enforcement purposes as required by law, in response to a valid subpoena, for
identification and location of fugitives, witnesses or missing persons, for
suspected victims of crime, for deaths that may have resulted from criminal
conduct and for suspected crimes on the premises.
Ø Coroners,
Medical Examiners and Funeral Directors. We may release medical 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 release medical
information about patients of the hospital to funeral directors as necessary to
carry out their duties.
Ø Organ
and Tissue Donation. If you are an organ donor, we may use or
release medical information to organizations that handle organ procurement or
other entities engaged in procurement, banking or transportation of organ, eye
or tissue to facilitate organ or tissue donation and transplantation.
Ø To
Avert a Serious Threat to Health or Safety. We may use and
disclose medical information about you when necessary to prevent a serious
threat to your health and safety or the health and safety of the public or
another person. Any disclosure,
however, would only be to someone able to help prevent the threat.
Ø Military
and Veterans. If you are a member of the armed forces, we
may release medical information about you as required by military command
authorities. We may also release
medical information about foreign military personnel to the appropriate foreign
military authority.
Ø National
Security and Intelligence Activities. We may release medical information about you
to authorized federal officials for intelligence, counterintelligence, and
other national security activities authorized by law.
Ø Protective
Services for the President and Others. We may disclose medical information about
you to authorized federal officials so they may provide protection to the
President, other authorized persons or foreign heads of state or conduct
special investigations.
Ø Workers'
Compensation. We may release medical information about you
for workers' compensation or similar programs.
These programs provide benefits for work-related injuries or illness.
Ø Inmates
or Individuals in Custody. If you are an inmate of a correctional
institution or under the custody of a law enforcement official, we may release
medical information about you to the correctional institution or law
enforcement official.
Ø Other
uses and disclosures. Any other uses and disclosures will be made
only with your written authorization.
YOUR RIGHTS REGARDING MEDICAL
INFORMATION ABOUT YOU.
Although all records concerning your hospitalization and
treatment obtained at UAB Health System are the property of UAB Health System,
you have the following rights regarding medical information we maintain about
you:
Ø Right
to Inspect and Copy. You have the right to inspect and copy
medical information that may be used to make decisions about your care. Usually, this includes medical and billing
records, but does not include psychotherapy notes.
To inspect and copy medical information that may be used to
make decisions about you, you must submit your request in writing to Privacy
Officer, UAB Health Center, HSV., 301 Governors Dr. SW., Huntsville, Al
35801. If you request a copy of the
information, we may charge a fee for the costs of copying, mailing or other
supplies associated with your request.
We may deny your
request to inspect and copy in certain very limited circumstances. If you are denied access to medical
information, you may request that the denial be reviewed. Another physician chosen by UAB Health
System will review your request and the denial. The person conducting the review will not be the person who
denied your request. We will comply
with the outcome of the review.
Ø Right
to Amend. If you feel that medical information we have
about you is incorrect or incomplete, you may ask us to amend the
information. You have the right to
request an amendment for as long as the information is kept by or for the
hospital.
To request an
amendment, your request must be made in writing and submitted to Privacy
Officer, UAB Health Center, HSV, 301 Governors Dr. SW., Huntsville, Al
35801. In addition, you must provide 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
medical information kept by or for the hospital;
·
Is not part of the
information which you would be permitted to inspect and copy; or
·
Is accurate and
complete.
Ø Right
to an Accounting of Disclosures.
You have the right to request an
"accounting of disclosures."
This is a list of certain disclosures we made of medical information
about you.
To request this list
or accounting of disclosures, you must submit your request in writing to
Privacy Officer, UAB Health Center, HSV, 301 Governors Dr. SW., Huntsville, Al
35801. Your request must state a time
period which may not be longer than six years and may not include dates before
April 14, 2003. Your request should
indicate in what form you want the list (for example, on paper,
electronically). The first list you
request within a 12 month period will be free.
For additional lists, we may charge you for the costs of providing the
list. We will notify you of the cost
involved and you may choose to withdraw or modify your request at that time
before any costs are incurred.
Ø Right
to Request Restrictions. You have the right to request a restriction
or limitation on the medical information we use or disclose about you for
treatment, payment or health care operations.
You also have the right to request a limit on the medical information we
disclose about you to someone who is involved in your care or the payment for
your care, like a family member or friend.
For example, you could ask that we not use or disclose information about
a surgery you had.
We
are not required to agree to your
request. If we do agree, we will comply with your
request unless the information is needed to provide you emergency treatment.
To request restrictions, you must make your request in
writing to Privacy Officer, UAB Health Center, HSV, 301 Governors Dr. SW.,
Huntsville, Al 35801. In your request,
you must tell us (1) what information you want to limit; (2) whether you want
to limit our use, disclosure or both; and (3) to whom you want the limits to
apply, for example, disclosures to your spouse.
Ø Right
to Request Confidential Communications. You have the right to request that we
communicate with you about medical 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 Privacy Officer, UAB Health Center, HSV, 301 Governors
Dr. SW., Huntsville, Al 35801. We will
not ask you the reason for your request.
We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.
Ø
Right to Revoke Authorization. You have the right
to revoke your authorization to use or disclose your medical information except
to the extent that action has already been taken in reliance on your
authorization.
Ø Right
to a Paper Copy of This Notice. You have the 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.
You may obtain a copy
of this notice at our website-http://www.health.uab.edu/show.asp?durki=56381
CHANGES TO THIS NOTICE
Ø We reserve the right to change this notice. We reserve the right to make the revised or
changed notice effective for medical information we already have about you as
well as any information we receive in the future. We will post a copy of the current notice in UAB Health System
facilities. The notice will contain on
the first page, in the top right-hand corner, the effective date. In addition, each time you visit UAB Health
System to receive services, we will offer you a copy of the current notice in
effect.
FOR MORE INFORMATION OR TO REPORT
A PROBLEM
If
you have questions and would like additional information, you may contact the
UAB Health System If you believe your privacy rights have been violated, you
may file a complaint with UAB Health System or with the Secretary of the
Department of Health and Human Services.
To file a complaint with UAB Health System, contact the Privacy
Officer-256-551-4520, UAB Health Center, HSV, 301 Governors Dr. SW.,
Huntsville, Al 35801. All complaints
must be submitted in writing.
You will not be penalized for filing a complaint.
NOTICE EFFECTIVE DATE: The effective date of the notice is April
14, 2003.