Urology Cancer Center, PC
EFFECTIVE JULY 1, 2017
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.
Urology Cancer Center and GU Research Network (UCC) understands that your medical information is private and confidential. This notice provides you with information about your rights and our duties with respect to the privacy of your health information. This notice also discusses the uses and disclosures we will make of your health information. We will comply with the provisions of this notice as currently in effect, although we reserve the right to change the terms of this notice from time to time and to make the revised notice effective for all your health information we maintain.
All of our independent physician consultants follow the terms of this Notice. UCC and its independent physician consultants may share your health information with each other for reasons of treatment, payment, and health care operations as discussed below.
PERMITTED USES AND DISCLOSURES
The following categories describe some of the ways that we will use and disclose your health information:
Treatment, Payment and Health Care Operations
We can use or disclose your health information for purposes of treatment, payment and health care operations.
- Treatment means the provision, coordination or management of your health care, including consultations.
- Payment means the activities we undertake to obtain reimbursement for the health care provided to you, including billing, collections, claims management, determinations of eligibility and coverage and other utilization review activities. For example, we may need to provide information to a third party for collection purposes.
- Health care operations means the support functions of UCC, related to treatment and payment, such as quality assurance activities, case management, receiving and responding to patient comments and complaints, physician reviews, compliance programs, audits, business planning, development, management and administrative activities. For example, we may use your health information to evaluate the performance of our services.
OTHER USES AND DISCLOSURES OF YOUR HEALTH INFORMATION
In addition to using and disclosing your information for treatment, payment and health care operations, we may use your health information in the following ways:
- We may contact you to provide reminders or updates on treatment options.
- We may disclose your health information to your family or friends or any other individual identified by you, if such information is directly related to such person’s involvement in your care.
- When permitted by law, we may use or disclose your health information in coordination with private entities authorized by law or by charter to assist in disaster relief efforts.
- Subject to applicable law, we may make incidental uses and disclosures of your health information. Incidental uses and disclosures are by-products of otherwise permitted uses or disclosures which are limited in nature and cannot be reasonably prevented.
- We may use or disclose your health information for research purposes, subject to the requirements of applicable law. For example, a research project may involve comparisons of the health and recovery of all patients who received a particular treatment. All research projects are subject to a special approval process, which balances research needs with a patient’s need for privacy. When required, we will obtain a written authorization from you prior to using your health information for research.
- We will use or disclose your health information when required to do so by applicable law.
Subject to the requirements of applicable law, we will make the following uses and disclosures of your health information:
- Military and Veterans. If you are a member of the Armed Forces, we may release your health information as required by military command authorities. We may also release health information about foreign military personnel to the appropriate foreign military authority.
- Worker’s Compensation. We may release your health information for programs that provide benefits for work-related injuries or illnesses.
- Public Health Activities. We may disclose your health information for public health activities, including disclosures:
- to prevent or control disease, injury or disability;
- to report child abuse or neglect;
- to persons subject to the jurisdiction of the Food and Drug Administration (FDA) for activities related to the quality, safety, or effectiveness of FDA-regulated products or services and to report reactions to medications or problems with products;
- to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition;
- to notify the appropriate government authority if we believe that an adult patient has been the victim of abuse, neglect, or domestic violence. We will only make this disclosure if the patient agrees or when required or authorized by law.
- Health Oversight Activities. We may disclose your health information to Federal or State agencies that oversee our activities. These activities are necessary for the government to monitor the health care system, government benefit programs, and compliance with civil rights laws or regulatory program standards.
- Lawsuits and Disputes. If you are involved in a lawsuit or dispute, we may disclose your health information in response to a court or administrative order. We may also disclose your health information in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if UCC is given assurances that efforts have been made by the person making the request to tell you about the request or to obtain an order protecting the information requested.
- Law Enforcement. We may release your 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 under certain limited circumstances;
- About a death we believe may be the result of criminal conduct;
- About criminal conduct on our premises; and
- In emergency circumstances, to report a crime, the location of the crime or the victims, or the identity, description or location of the person who committed the crime.
- Coroners, Medical Examiners and Funeral Directors. We may release your health information to a coroner or medical examiner. Such disclosures may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release your health information to funeral directors as necessary to carry out their duties.
- National Security and Intelligence Activities. We may release your health information to authorized Federal officials for intelligence, counterintelligence, or other national security activities.
- Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release your health information to the correctional institution or law enforcement official. This release would be necessary (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) for the safety and security of the correctional institution.
- Serious Threats. As permitted by applicable law and standards of ethical conduct. we may use and disclose your health information if we, in good faith, believe that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public or is necessary for law enforcement authorities to identify or apprehend an individual.
Note: HIV-related information, genetic information, alcohol and/or substance abuse records, mental health records and other special health information may enjoy certain special confidentiality protections under applicable State and Federal law.
OTHER USES OF YOUR HEALTH INFORMATION
Other uses and disclosures of your health information not covered by this notice or the laws that apply to us will be made only with your permission in a written authorization. You have the right to revoke that authorization at any time, except to the extent that we already have taken action in reliance on your authorization. Any such revocation must be in writing.
- You have the right to request restrictions on our uses and disclosures of your health information for treatment, payment, and health care operations. However, we are not required to agree to your request unless the request is to restrict disclosure to a health plan for payment or health care operations purposes and the your health information portions to an item or service for which you have paid us in full out of pocket. To request a restriction, you must make your request in writing to UCC.
- You have the right to reasonably request to receive confidential communications of your health information by alternative means or at alternative locations. To make such a request, you must submit your request in writing at the time of registration.
- You have the right to inspect and copy the your health information contained in your medical and billing records and in any other records used by us to make decisions about you except:
- for information compiled in reasonable anticipation of, or for use in, a civil, criminal, or administrative action or proceeding;
- for health information involving laboratory tests when your access is restricted by law;
- if you are a prison inmate, obtaining a copy of your information may be restricted if it would jeopardize your health, safety, security, custody, or rehabilitation or that of other inmates, or the safety of any officer, employee, or other person at the correctional institution or person responsible for transporting you;
- if we obtained or created your health information as part of a research study, your access to your health information may be restricted for as long as the research is in progress, provided that you agreed to the temporary denial of access when consenting to participate in the research;
- for your health information contained in records kept by a Federal agency or contractor when your access is restricted by law; and
- for your health information obtained from someone other than us under a promise of confidentiality when the access requested would be reasonably likely to reveal the source of the information.
In order to inspect and copy your health information, you must submit your request in writing to UCC. If you request a copy of your health information, we may charge you a fee for the costs of copying and mailing your records, as well as other costs associated with your request. We may also deny a request for access to your health information if:
- UCC has determined, in the exercise of professional judgment, that the access requested is reasonably likely to endanger your life or physical safety or that of another person;
- the health information makes reference to another person (unless such other person is a health care provider) and UCC has determined, in the exercise of professional judgment, that the access requested is reasonably likely to cause substantial harm to such other person; or
- the request for access is made by your personal representative and UCC has determined, in the exercise of professional judgment, that the provision of access to such personal representative is reasonably likely to cause substantial harm to you or another person.
If we deny a request for access for any of the three reasons described above, you have the right to have our denial reviewed in accordance with the requirements of applicable law.
- You have the right to request an amendment to your health information, but we may deny your request for amendment, if we determine that the your health information or record that is the subject of the request:
- was not created by us, unless you provide a reasonable basis to believe that the originator of your health information is no longer available to act on the requested amendment;
- is not part of your medical or billing records or other records used to make decisions about you;
- is not available for inspection as set forth above; or
- is accurate and complete.
In any event, any agreed upon amendment will be included as an addition to, and not a replacement of, already existing records. In order to request an amendment to your health information, you must submit your request in writing to UCC.
- You have the right to receive an accounting of disclosures of certain of your health information made by us to individuals or entities other than to you for the six years prior to your request, except for disclosures:
- to carry out treatment, payment and health care operations as provided above, unless such disclosure is made through an electronic health record, in which case, the law may allow an accounting of disclosures made for a period of three (3) years prior to the request for an accounting;
- incident to a use or disclosure otherwise permitted or required by applicable law;
- pursuant to a written authorization obtained from you;
- persons involved in your care or for other notification purposes as provided by law;
- for national security or intelligence purposes as provided by law;
- to correctional institutions or law enforcement officials as provided by law;
- as part of a limited data set as provided by law; or
- that occurred prior to July 1, 2017.
To request an accounting of disclosures of your health information, you must submit your request in writing to UCC. Your request must state a specific time period for the accounting (e.g., the past three months). The first accounting you request within a twelve (12) month period will be free. For additional accountings, we may charge you for the costs 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.
If you believe that your privacy rights have been violated, you should immediately contact us at UCC. We will not take action against you for filing a complaint. You also may file a complaint directly with the Secretary of Health and Human Services.
If you have any questions or would like further information about this notice, please contact our Privacy Officer at (402) 991-8468.