FREDERICK MEMORIAL HOSPITAL NOTICE OF PRIVACY PRACTICES
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
WE WILL FOLLOW THIS NOTICE
This notice describes our hospital's practices and those of:
- All employees, staff, volunteers and any other hospital personnel and physicians employed by us;
- All departments and units of the hospital, including Home Health, Durable Medical Equipment, Hospice; and
- All Outpatient Facilities
When this Notice refers to "we" or "us" it is referring to the Hospital and each of the entities or persons listed above.
OUR PLEDGE REGARDING YOUR MEDICAL INFORMATION
We understand that medical information about you and your health is personal. We are committed to protecting medical information about you. We create a record of the care and services you receive at Frederick Memorial Hospital. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated or received by the hospital, whether made by hospital personnel or made regarding the doctor's use and disclosure of your medical information created in the doctor's office or clinic. Your doctor may have different policies or notices regarding the doctor's use and disclosure of your medical information created in the doctor's office.
This Notice will tell you about the ways in which we may use and disclose medical information about you. We also describe your rights and certain obligations we have regarding the use and disclosure of medical information.
We are required by law to:
- Make sure that medical information that identifies you is kept private, and will be used or disclosed only as described by this Notice or applicable law;
- Give you this Notice of our legal duties and privacy practices with respect to medical information about you; and
- Follow the terms of the Notice that is currently in effect.
HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU
The following categories describe different ways that we use and disclose your medical information. For each category of uses or disclosures we will explain what we mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of these categories.
We will use medical information about you to provide you with medical treatment or services. We may disclose medical information about you to doctors, nurses, technicians, or other hospital or other personnel who are involved in taking care of you at the hospital. For example, a doctor treating you for a broken hip 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. We also may disclose medical information about you to people outside the hospital who may be involved in your medical care after you leave the hospital, such as family members, clergy, or others we use to provide services that are part of your care, such as therapist or physicians.
We will use and disclose medical information about you so that the treatment and services you receive at the hospital may be billed to and payment may be collected from you, an insurance company, a governmental entity such as Medicare or Medicaid, or a third party. For example, we may need to give your health plan information about treatment you received at the hospital so your health plan will pay us or reimburse you for the treatment. 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. We may also have to send your information to more than one health plan in circumstances where it is not clear which of two or more health plans has the responsibility to make payment for your care.
For Healthcare Operations
We will use and disclose medical information about you for hospital Operations. These uses and disclosures are necessary to run the hospital 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 hospital patients to decide what additional services the hospital should offer, what services are not needed, and whether certain new treatments are effective. We may also disclose information to doctors, nurses, technicians, and other hospital personnel for review and learning purposes.
Maryland Health Information Exchange / CRISP
We have chosen to participate in the Chesapeake Regional Information System (CRISP) a statewide internet-based health information exchange approved but not operated by a State of Maryland agency. As permitted by law, your health information will be shared with this exchange in order to facilitate the secure exchange of your electronic health information between health care providers and other health care entities for your treatment, payment, or other health care operation purposes. You may "opt-out" and prevent searching of your health information available through CRISP by calling 1-877-952-7477 or completing and submitting an OPT-OUT form to CRISP by mail, fax or through their website at www.crisphealth.org. We are not CRISP and cannot submit your opt-out should you decide to opt-out.
Health-Related Benefits and Services
We may contact you to provide information about our services and health improvement education. We may send newsletters, or contact you by other means regarding treatment options, disease management programs, wellness programs, or other community based activities.
We may use limited medical information about you, to contact you, or may disclose limited medical information about you to a foundation related to the hospital to permit the foundation to contact you in an effort to raise money for the hospital and its operations. Fundraising communications will include information about how you may choose not to receive any future fundraising communication.
We may use and disclose medical information about you to contact you in an effort to provide appointment reminders for medical care, or to tell you about or recommend possible treatment options or alternatives that may be of interest to you.
Under certain circumstances, we will use and disclose medical information about you for research purposes. 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. All research projects, however, are subject to a special approval process that takes into account patients' need for privacy.
We contract with business associates to provide some services. Examples include reference labs, physician services in the emergency department or laboratory, and the copy service used to make copies of your health record. When these services are contracted we may/will disclose your health information to our business associate so that they may perform the job we have asked them to do. To protect your health information, we require the business associates to appropriately safeguard your information.
As Required By Law
We will disclose medical information about you when required to do so by federal, state, or local law.
To Avert a Serious Threat to Health or Safety
We will 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.
We may also use or disclose your medical information in the following circumstances. However, except in emergency situations, you have the opportunity to object to the uses and disclosures described below, either in general or to any specific person or persons to whom your medical information might otherwise be disclosed:
We will include certain limited information about you in the hospital directory while you are a patient at the hospital. This information may include your name, location in the hospital, 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. Your religious affiliation may be given too 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 in the hospital and generally know how you are doing. If you do not want anyone to know this information about you, you must notify the hospital at the time of registration.
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, has power of attorney or a similar document provided to us. We may also give information to someone who helps pay for your care. 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.
SPECIAL SITUATIONS: We may also release your medical information in any of the following circumstances:
- For specialized governmental functions, including the military and veterans, national security, criminal corrections and public benefit purposes.
- For Workers' Compensation or similar programs, as permitted by law.
- For public health activities.
- To notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect, or domestic violence.
For Health Oversight Activities
For example, audits, investigations, inspections, and licensure.
Lawsuits and Disputes
If you are involved in a lawsuit or a dispute, we will disclose medical information about you in response to a valid court or administrative order, or in the course of defending ourselves.
- For Law Enforcement Purposes When asked to do so by a law enforcement official when required,
- To Coroner, Medical Examiners, and Funeral Directors As necessary to assist them to carry out their duties.
Except as described above, we will disclose your medical information only with your prior written authorization. You may revoke that authorization, in writing, at any time, unless we have taken action relying on your prior authorization, or if you signed the authorization as a condition of obtaining insurance coverage.
YOUR RIGHTS REGARDING MEDICAL INFORMATION ABOUT YOU
You have the following rights regarding medical information we maintain about you:
Right to Inspect and Copy
You have the right to inspect and obtain a copy of 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 and other mental health records under certain circumstances or information compiled in anticipation of or for use in court or administrative proceedings.
To inspect and copy medical information that may be used to make decisions about you, you must submit your request in writing to the Medical Records Department. If you request a copy of the information, we may charge a fee for the cost of copying, mailing, or other supplies associated with your request.
We may deny your request to inspect and copy medical information in certain very limited circumstances, including requests by an inmate at a correctional institution, requests for information we obtained from someone else subject to certain confidentiality agreements, and some requests concerning ongoing research projects.
If you are denied access to medical information for any other reason, you may request that the denial be reviewed. Another licensed healthcare professional chosen by the hospital 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.
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 the Medical Records Department. 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.
If we deny your request, you may submit a written statement disagreeing with the denial. We will keep your statement on file and distribute it with all future disclosures of the information to which it relates.
Right to an Accounting of Disclosures
You have the right to request an "accounting of disclosures."
This is a list of the disclosures of medical information about you, with exceptions. We do not need to account for disclosures made: (i) to you; (ii) pursuant to your written authorization; (iii) for the purpose of carrying out treatment, payment or operations; (iv) of information contained in our patient directory; (v) that are incidental to another permissible use or disclosure; (vi) for national security or intelligence purposes; (vii) to correctional institutions or law enforcement officers who had you in custody at the time of the disclosure; (viii) as part of a limited data set; (ix) to a health oversight agency or law enforcement official if they so request. The accounting will include the date of each disclosure, the name of the entity or person to whom the disclosure was made and that person's address (if known), and a brief description of the information disclosed together with the purpose of the disclosure.
To request this list of accounting of disclosures, you must submit your request in writing to the Hospital's Privacy Officer. Your request must state a time period that 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 the time before any costs are incurred.
Right to Request Restrictions
You also have the right to request a limit on the medical information we disclose about you for treatment, payment, or healthcare operations. You also have the right to request a limit of 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.
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, in which case we will request that the provider not further use or disclose the information.
To request restrictions, you must make your request in writing to the Hospital's Privacy Officer. 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.
Right to Confidential Communications
You have the right to request to receive communications from us on a confidential basis by using alternative means for receipt of information or by receiving the information at alternative locations. All reasonable requests will be granted. Contact the Privacy Officer if you require such confidential communications.
Right to a Paper Copy of This Notice
You have the right to a paper copy of this notice by requesting a paper copy the Hospital's Privacy Officer in writing.
CHANGES TO THIS NOTICE
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 the hospital and on our website. The notice will contain the effective date on the first page. In addition, each time you register at, or are admitted to, the hospital for treatment or healthcare services as an inpatient or outpatient, we will offer you a copy of the current notice in effect.
Complaints about this Notice of Privacy Practices or how we handle your health information should be directed to:
Ms. Cathleen Casagrande
Frederick Regional Health System
400 West Seventh Street
Frederick, Maryland 21701
If you are not satisfied with the manner in which this office handles a complaint, you may submit a formal complaint to: Department of Health and Human Services, Office of Civil Rights, Hubert H. Humphrey Building, 200 Independence Avenue, S.W., Room 509F HHH Building, Washington, DC 20201. Or, contact their website at www.hhs.gov/ocr/privacy/hipaa/complaints/hipcomplaintpackage.pdf
Updated August, 2011