Notice of Privacy Practices
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THIS
NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY
BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO
THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
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The
University of Pittsburgh is required by law to maintain the
privacy of your medical records and to give you this Notice
that describes our privacy practices. This Notice describes
how we may use and disclose your protected health information
to carry out treatment, payment and health care operations
and for other purposes permitted or required by law. It also
describes your rights to access and control your protected
health information, which is information about you, including
demographics that may identify you and that relates to your
past, present or future physical or mental health and related
health care services. This Notice takes effect April 14, 2003,
and will remain in effect until we replace it.
We
are required to abide by the terms of this Notice of Privacy
Practices. We reserve the right to change our privacy practices
at any time. We reserve the right to make the changes to our
privacy practices and this Notice effective for all health
information that we maintain, including health information
we created or received before we made the changes. Before
we make a significant change to our privacy practices, we
will change this Notice and make the new Notice available
upon request. You may access the Notice on the University's
website at http://www.pitt.edu/hipaa,
or by contacting the University's Privacy Officer at 809 Cathedral
of Learning, University of Pittsburgh, Pittsburgh, PA 15260,
or you may request one at the time of your appointments.
USES
AND DISCLOSURES OF PROTECTED HEALTH INFORMATION. We
may use or disclosure your health information as follows:
Treatment.
To a physician, dentist or other healthcare provider providing
treatment to you. For example, your protected health information
may be provided to a physician to whom you have been referred
to ensure that the physician has the necessary information
to diagnose or treat you.
Payment.
To obtain payment for services we provide to you. This may
include activities your health insurance plan may undertake
if it approves or pays for the health care service we recommend
for you, or to determine eligibility for plan benefits, or
to coordinate benefits.
Health Care Operations. In connection with our healthcare
operations, including insurance related activities, quality
assessment, reviewing the competence or qualifications of
health care professionals, conducting medical review, legal
services, audit services, accreditation, certification, licensing
or credentialing activities and for business planning, management
and general administration.
Authorization.
In addition to our use of your health information for treatment,
payment or healthcare operations, you may give us written
authorization to use your health information or to disclose
it to anyone for any purpose. You may revoke your authorization
at any time, in writing, except to the extent an action already
has been taken in reliance on your authorization while it
was in effect. Unless you give us a written authorization,
we cannot use or disclose your health information for any
purpose except those described in this Notice.
OTHER
PERMITTED AND REQUIRED USES AND DISCLOSURES THAT MAY BE MADE
WITH YOUR CONSENT, AUTHORIZATION OR OPPORTUNITY TO OBJECT.
We may use and disclose your health information in the following
ways. You have the opportunity to object to these uses.
- Others
Involved in Your Healthcare. Unless you object, we may
disclose to a family member, other relative, close personal
friend or any other person you identify, health care information
relevant to that person's involvement in your care or payment
related to your care, if we determine it is in your best
interests based on our professional judgment.
- Emergencies.
We may use or disclose your health information in an emergency
situation. If this happens, your physician or other health
care provider shall try to obtain your consent as soon as
reasonably practical after the delivery of treatment.
- Communication
Barriers. We may use and disclose your health information
if your physician, dentist or other health care provider
attempts to obtain consent from you but is unable to do
so due to substantial communication barriers and the physician
determines, using professional judgment, that you intend
to consent under the circumstances.
OTHER
PERMITTED AND REQUIRED USES AND DISCLOSURES THAT MAY BE MADE
WITHOUT YOUR CONSENT, AUTHORIZATION OR OPPORTUNITY TO OBJECT.
We may use or disclose your health information in the following
situations without your consent or authorization.
- As
Required by Law. We may use or disclose your health
information to the extent disclosure is required by law.
You will be notified, as required by law, of a use or disclosure.
- Public
Health. We may use or disclose your health information
to public health authorities for purposes related to preventing
or controlling disease, injury or disability; reporting
child abuse or neglect; reporting domestic violence; reporting
to the Food and Drug Administration problems with products
and reactions to medications; and reporting disease or infection
exposure.
- Health
Oversight Activities. We may disclose your health information
to a health oversight agency for activities authorized by
law, such as audits, investigations, inspections, licensure
and other activities related to oversight of the health
care system.
- Legal
Proceedings. We may disclose your health information
in the course of any administrative or judicial proceeding.
- Coroners,
Medical Examiners and Funeral Directors. We may disclose
your health information to coroners, medical examiners and
funeral directors for purposes of identification, determining
cause of death and to enable them to perform their duties
as authorized by law. Health information may be used and
disclosed for cadaveric organ, eye or tissue donation purposes.
- Public
Safety. We may disclose your health information to appropriate
persons to prevent or lessen a serious and imminent threat
to the health or safety of a particular person or the general
public.
- National
Security. We may disclose your health information for
military or national security purposes as necessary.
- Workers'
Compensation. We may disclose your health information
as necessary to comply with workers' compensation or similar
laws.
- Inmates.
We may use or disclose your health information if you are
an inmate of a facility and your physician, dentist or other
health care provider created or received your protected
health information in the course of providing care to you.
- Marketing.
We may contact you to give you information about health-related
benefits or services that may be of interest to you.
- Disclosure
to Plan Sponsors. We may disclose your health information
to the sponsor of your group health plan, for purposes of
administering benefits under the plan.
- Researchers.
We may disclose your health information to researchers when
their research has been approved by an Institutional Review
Board that has reviewed the research proposal and protocols
to ensure the privacy of your protected health information.
STATEMENT
OF YOUR HEALTH INFORMATION RIGHTS.
Right
to Inspect and Copy. You have the right to inspect and
copy your protected health information. This includes medical
and billing records and any other records that your physician,
dentist or other health care provider uses to make decisions
about you. To inspect and copy such information, you must
submit your request in writing. If you request a copy of the
information, we may charge you a reasonable fee to cover expenses
associated with your request. Under federal law, you may not
inspect or copy psychotherapy notes or information compiled
in reasonable anticipation of, or use in, a civil, criminal,
or administrative proceeding, and protected health information
that is subject to law that prohibits access to health information.
Right
to Request Restrictions. You have the right to request
restrictions on certain uses and disclosures of your health
information. You may ask us not to use or disclose any part
of your protected health information for the purpose of treatment,
payment or healthcare operations. You may also request that
any part of your protected health information not be disclosed
to family members or friends who may be involved in your care
for notification purposes as described in this Notice of Privacy
Practices. Your request must state the restriction requested
and to whom you want the restriction to apply. The University
is not required to agree to the restrictions you request.
You must submit your request in writing to the University's
Privacy Officer at 809 Cathedral of Learning, University of
Pittsburgh, Pittsburgh, PA 15260.
Right
to Request Confidential Communications. You have the right
to request to receive confidential communications by alternate
means or at an alternate location. You must submit this request
in writing to the University's Privacy Officer at 809 Cathedral
of Learning, University of Pittsburgh, Pittsburgh, PA 15260.
The University will try to accommodate reasonable requests;
however, we are not required to agree to your request.
Right
to Request Amendment. You have a right to request an amendment
to your health information that you believe is incorrect or
incomplete. We are not required to change your health information.
If your request is denied, we will provide you with information
about our denial and tell you how to file a statement of disagreement
with us. We may prepare a rebuttal to your statement, a copy
of which will be provided to you. To request an amendment,
you must submit the request in writing to the University's
Privacy Officer at 809 Cathedral of Learning, University of
Pittsburgh, Pittsburgh, PA 15260.
Right
to Accounting of Disclosures. This right applies to disclosures
for purposes other than treatment, payment or healthcare operations
as described in this Notice of Privacy Practices and disclosures
made to you. To request an accounting of disclosures, you
must submit your request in writing to the University's Privacy
Officer at 809 Cathedral of Learning, University of Pittsburgh,
Pittsburgh, PA 15260. Your request should specify a time period
of up to six years and may not include dates before April
14, 2003. The University will provide one list per 12 month
period free of charge. We may charge you for additional lists.
Right
to Paper Copy. You have the right to obtain a paper copy
of this Notice, even if you agreed to accept this Notice electronically.
To obtain a paper copy, submit a written request to the University's
Privacy Officer at 809 Cathedral of Learning, University of
Pittsburgh, Pittsburgh, PA 15260. You also may access this
Notice on the University website at http://www.pitt.edu/hipaa.
Complaints. You may complain to us or to the Secretary
of Health and Human Services about this Notice of Privacy
Practices or if you believe your rights under this Notice
have been violated. You may file a complaint with us by notifying
the University's Privacy Officer, Vice Provost Robert F. Pack,
at 809 Cathedral of Learning, University of Pittsburgh, Pittsburgh,
PA 15260, and completing the University of Pittsburgh Privacy
Practices Complaint form. We will not retaliate against you
for filing a complaint.
This
Notice was published and becomes effective on April 14, 2003.
Related
Forms (PDF format):
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