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| April, 2003 |
HIPAA Privacy Notice |
Middletown Regional Organized Health Care
Arrangement (MROHCA)
Middletown Regional Health System;
Middletown Regional Hospital; McKnight Terrace; Partnership EAP; Mid-Miami
Healthcare Foundation; CareView Home Health; Southwest Ohio
Family Medicine; MiddCare Pharmacy; Middletown Regional Hospital’s Medical
Staff.
MROHCA
Notice of Privacy Practices for Protected Health Information.
This notice describes how
medical information about you may be used and disclosed and how you may get
access to this information. Please read
it carefully.
MROHCA
is dedicated to protecting your medical information. We are required by law to maintain the
privacy of protected health information and to provide you with this notice of
our legal duties and privacy practices with respect to protected health
information. MROHCA is required by law
to abide by the terms of this notice, and we reserve the right to change the
terms of this notice, making any revision applicable to all the protected
health information we maintain. If
MROHCA revises the terms of this notice, it will post a revised notice at all
locations and will make paper copies of this notice of Privacy Practices for
Protected Health Information available upon request.
How
Your Medical Information Will Be Used and Disclosed:
MROHCA
will use your medical information as part of rendering patient care. For example, your medical information may be
used by the health care professional treating you, by the business office to
process your payment for the services rendered and by administrative personnel
reviewing the quality and appropriateness of the care your receive.
MROHCA
may also use and / or disclose your information in accordance with federal and
state laws for the following purposes:
- MROHCA may contact you to provide appointment
reminders or information about treatment alternatives or other health-related
benefits and services that may be of interest to you.
-
One of the MROHCA organizations may contact you for fundraising purposes.
-
MROHCA may disclose medical information when
required by the United States Department of Health and Human Services as part
of an investigation or determination of the hospital’s compliance with relevant
laws.
- Unless you object, and with the exception of behavioral health patients, MROHCA will include general information, including your name, location in the hospital, your condition described in general terms and your religious affiliation in a directory of individuals admitted to
Middletown Regional Hospital. The directory information, except for your religious affiliation, will be released to people who ask for you by name. Your religious affiliation may be given to members of the clergy, even if they do not ask for you by name.
- Unless you object, and with the exception of
behavioral health patients, MROHCA may disclose to family members, other
relatives or close personal friends the medical information directly relevant
to such person’s involvement with your care.
-
Unless you object, and with the exception of
behavioral health patients, MROHCA may use or disclose your medical information
to notify a family member, a personal representative or another person
responsible for your care of your location, general condition or death.
-
MROHCA may disclose your medical information to a public or private entity for the purpose of coordinating with that entity to assist in disaster relief efforts.
-
MROHCA may use or disclose your medical
information for public health activities, including the reporting of disease,
injury, vital events and the conduct of public health surveillance,
investigation and / or intervention.
MROHCA may disclose your medical information to a health oversight
agency for oversight activities authorized by law, including audits, investigations,
inspections, licensure or disciplinary actions, administrative and / or legal
proceedings.
-
MROHCA may disclose your medical information
in the course of certain judicial or administrative proceedings.
- MROHCA may disclose your medical information
for law enforcement purposes or other specialized governmental functions.
- MROHCA may disclose your medical information
to a coroner, a medical examiner or a funeral director.
- If you are an organ donor, MROHCA may
disclose your medical information to an organ donation and procurement
organization.
-
MROHCA may use or disclose your medical
information for certain research purposes.
- MROHCA may use or disclose your medical
information to prevent or lessen a serious threat to the health or safety of
another person or the public.
- MROHCA may disclose your medical information
as authorized by laws relating to workers’ compensation or similar programs.
- Unless you object, MROHCA may disclose your
name, social security number, or other identifying information for tracking
medical devices under the Safe Medical Device Act.
Ohio law requires that we obtain a
consent from you in many instances, such as before disclosing the performance
or results of an HIV test or diagnoses of AIDS or an AIDS-related condition,
before disclosing information about drug or alcohol treatment you have received
in a drug or alcohol treatment program and before disclosing information about
mental health services you may have received. For full information on when such
consents may be necessary, you can contact Robyn Myers, privacy officer.
MROHCA will not
use or disclose your medical information for any other purpose without your
written authorization. Once given, you
may revoke your authorization in writing at any time.
Your
Rights Regarding Your Medical Information:
You
have the following rights with respect to your medical information:
-
The
right to request restrictions on certain uses and disclosures of your medical
information. MROHCA is not required to
agree to your requested restriction.
-
The
right to receive communications from MROHCA in a confidential manner.
-
The
right to inspect and copy your medical information. This right is subject to certain specific
exceptions, and you may be charged a reasonable fee for any copies of your records.
-
The
right to request an amendment of your medical information. MROHCA may deny your request for certain
specific reasons, and, if denied, you will be provided with a written
explanation for the denial and information regarding further rights you would
have at that point.
-
The
right to receive an accounting of the disclosures of your medical information
made by MROHCA in the six years prior to your request, except for disclosures
for treatment, payment or operational purposes, and for certain other specific
disclosure types.
-
The
right to request a paper copy of this Notice of Privacy Practices for Protected
Health Information.
-
The
right to complain to MROHCA and / or to the United States Department of Health
and Human Services if you believe that your privacy rights have been violated.
To complain to MROHCA, please contact the Hospital’s Privacy Officer.
If you would like further
information regarding your rights or regarding the uses and disclosures of your
medial information, you may contact Robyn Myers, privacy officer at
513/424-2111.
This Notice Is Effective as of April 14, 2003
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