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Notice of Privacy Practices

Revised: 03/21/2011, 09/23/2013 

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. If you have any questions about this notice, please contact the Privacy Officer.
Effective Date: April 14, 2003 

We Are Required by Law To

  • make sure that medical information that identifies you is kept private;
  • 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.

Because of the requirements of the Privacy Rule regarding the receipt of this notice, you may receive multiple copies. 

Who Will Follow This Notice

This notice applies to MyMichigan Health and its wholly owned members and their respective health care facilities, sites, services, programs and personnel (collectively, “MyMichigan”), including, but not limited to, the following:

  • medical centers, doctor/provider offices, rehabilitation services, nursing homes, urgent care facilities and home care, hospice and dialysis services;
  • any health care professional authorized to enter information into your medical chart;
  • all departments and units of MyMichigan;
  • any member of a volunteer group authorized to help you while you are at MyMichigan;
  • all employees, staff, trainees and other MyMichigan personnel, as well as our business associates; and
  • MyMichigan Health, as an organized health care arrangement, consists of multiple health care providers. 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

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. 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 at MyMichigan, whether made by or received by MyMichigan personnel or your personal doctor. Your personal doctor may have different policies or notices regarding the doctor’s use and disclosure of your medical information created in the doctor’s office or clinic.

This notice will tell you about the ways MyMichigan may use and disclose medical information about you. This notice also describes your rights and certain obligations we have regarding the use and disclosure of medical information.

How We May Use and Disclose Medical Information about You

The following categories describe different ways that we may use and disclose 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 the categories. 

For Treatment. 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 students, or other MyMichigan personnel who are involved in taking care of you. Different departments of MyMichigan 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 the organization who may be involved in your medical care after you leave, such as family members, clergy or others who provide services that are part of your care. 

For Payment. We may use and disclose medical information about you so that the treatment and services you receive at our facility may be billed to and payment may be collected from you, an insurance company or a third party. 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. 

For Health Care Operations. We may use and disclose medical information about you for MyMichigan operations. These uses and disclosures are necessary to run our organization 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 patients to decide what additional services the organization should offer, what services are not needed, and whether certain new treatments are effective. We may also disclose information to doctors, nurses, technicians, medical students, and other organization personnel for review and learning purposes. We may also combine the medical information we have with medical information from other organizations 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. 

Appointment Reminders. We may use and disclose medical information to contact you as a reminder that you have an appointment for treatment or medical care at our organization. 

Treatment Alternatives. We may use and disclose medical information to tell you about or recommend possible treatment options or alternatives that may be of interest to you. 

Health-related Benefits and Services. We may use and disclose medical information to tell you about health-related benefits or services that may be of interest to you. 

Patient Satisfaction Surveys. We may disclose limited information about you to a third party who may contact you and ask questions to determine how satisfied you were with your health care. (If you do not want to be contacted for this, you must notify the Privacy Officer). 

Fundraising Activities. We may use limited information about you to contact you in an effort to raise money for MyMichigan and its operations. We only would release contact information, such as your name, address and phone number and the dates you received treatment or services at MyMichigan. (If you do not want us to contact you for fundraising efforts, you must notify the Privacy Officer). 

Hospital Directory. We may include certain limited information about you in the directory while you are a patient in the hospital. This information may include your name, location in the hospital, your general condition (e.g., fair, stable, etc.) and your religious affiliation. (If you do not want us to include you in the directory, you must notify the Privacy Officer). The directory information may be released only to people who ask for you by name; except for religious affiliation, which will be shared with members of the clergy. 

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. Unless you state otherwise, if family members or friends are present while care is being provided to you, we will assume they may hear the discussion. 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. 

Research. Under certain circumstances, we may 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. This process evaluates a proposed research project and its use of medical information, trying to balance the research needs with patients’ need for privacy of their medical information. Before we use or disclose medical information for research, the project will have been approved through this research approval process, but we may, however, disclose medical information about you to people preparing to conduct a research project, for example, to help them look for patients with specific medical needs, so long as the medical information they review does not leave the organization. We will almost always ask for your specific permission if the researcher will have access to your name, address or other information that reveals who you are, or will be involved in your care at our organization. 

Health Information Exchange. We may make your protected health information (PHI) available electronically through health information exchanges (HIEs) to other health care providers, health plans and health care clearinghouses. Participation in HIEs also lets us see their information about you which helps us provide care to you. You have the right to opt out of participating in such efforts by contacting the Privacy Officer. 

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 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. 

Special Situations

Organ and Tissue Donation. We may release medical information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation. 

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. 

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. 

Public Health Risks. We may disclose medical information about you for public health activities. These activities generally include the following:

  • to prevent or control disease, injury or disability;
  • to report births and deaths;
  • to report child abuse or neglect;
  • to report reactions to medications or problems with products;
  • to notify people of recalls of products they may be using;
  • 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 a patient has been the victim of abuse, neglect or domestic violence. We will only make this disclosure when required or authorized by law. We will only make this disclosure when required or authorized by law.

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. 

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. 

Law Enforcement. We may release medical 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 if, under certain limited circumstances, we are unable to obtain the person’s agreement;
  • about a death we believe may be the result of criminal conduct;
  • about criminal conduct at the hospital; and
  • in emergency circumstances to report a crime; the location of the crime or victims; or the identity, description or location of the person who committed the crime. 

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. 

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. 

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. 

Inmates. 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. 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; and/or (3) for the safety and security of the correctional institution. 

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 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, submit your request in writing. If you request a copy of the information, we may charge a fee for the cost of copying, mailing and/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 licensed health care professional chosen by MyMichigan 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 believe that information in your record is incorrect, or that information is missing, you have the right to ask us, in writing, to amend the record by including your position. We may deny your request if it is not in writing or if it does not include a reason to support the request. In addition, we may deny the request if our information is complete and accurate, was not created by us, if the person or entity that created the information is no longer available to make the amendment, is not part of the health information kept by or for the hospital/member or is not part of the information that you would be permitted to inspect and copy under certain circumstances. 

Right to an Accounting of Disclosures. You have the right to request an “accounting of disclosures.” This is a list of the disclosures we made of medical information about you without your authorization.

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. 

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. 

MyMichigan will carefully consider all requests. However, because of the integrated nature of MyMichigan’s medical record, we are not able to honor all requests, nor are we legally required to do so. 

The request should be in writing and must identify: (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 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. 

While this request should be in writing, 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. 

Right to Restrict Disclosures to Your Health Plan. You have the right to restrict disclosure of information to your health plan and to pay out of pocket in full for the item or service provided. 

Right to Authorize the Sale of Protected Health Information. You have the right to authorize any sale or use of your PHI for paid marketing. 

Right to Breach Notification. You have the right to be notified of any breach of your unsecured PHI. 

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, mymichigan.org. You may request a paper copy of this notice at the registration desk. 

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 organization. The notice will contain on the first page, in the top right-hand corner, the effective date. In addition, each time you register at a MyMichigan Health wholly owned member we will offer you a copy of the current notice in effect. 

Complaints

If you believe your privacy rights have been violated, you may file a complaint with the Privacy Officer at (989) 839-3255 or with the Secretary of the Department of Health and Human Services. If you have questions or would like to file a complaint with the Privacy Officer, please submit a written complaint to:

MyMichigan Health Patient Relations
4000 Wellness Drive
Midland, MI 48670
(989) 839-3255
privacy@mymichigan.org

You will not be penalized for filing a complaint. 

Other Uses of Medical Information

Other uses and disclosures of medical information not covered by this notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose medical information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you.