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.

USE AND DISCLOSURE OF HEALTH INFORMATION

Bluegrass Care Navigators℠ may use your health information, information that constitutes protected health information (hereafter referred to as PHI) as defined in the Privacy Rule of the Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996, for purposes of providing you treatment, obtaining payment for your care and conducting health care operations. Bluegrass Care Navigators℠ has established policies to guard against unnecessary disclosure of your health information.

THE FOLLOWING IS A SUMMARY OF THE CIRCUMSTANCES UNDER WHICH AND PURPOSES FOR WHICH YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED:

To Provide Treatment. Bluegrass Care Navigators℠ may use your health information to coordinate care within Bluegrass Care Navigators℠ and with others involved in your care, such as your attending physician, members of a Bluegrass Care Navigators℠ interdisciplinary team and other health care professionals who have agreed to assist Bluegrass Care Navigators℠ in coordinating care. For example, physicians involved in your care will need information about your symptoms in order to prescribe appropriate medications. Bluegrass Care Navigators℠ also may disclose your health care information to individuals outside of Bluegrass Care Navigators℠ involved in your care including family members, clergy you have designated, pharmacists, suppliers of medical equipment or other health care professionals.

These agencies are considered Business Associates and must abide by the following:

The business associate must implement safeguards for electronic PHI in accordance with the HIPAA Security Rule. The business associate must notify the covered entity of a security breach. The business associate must enter into a similarly restrictive business associate agreement with any subcontractor to which the business associate discloses PHI. If the agreement delegates any of the covered entity’s HIPAA compliance obligations to the business associate, the business associate must fulfill those obligations to the same extent as the covered entity.

To Obtain Payment. Bluegrass Care Navigators℠ may include your health information in invoices to collect payment from third parties for the care you receive from Bluegrass Care Navigators℠. For example, Bluegrass Care Navigators℠ may be required by your health insurer to provide information regarding your health care status so that the insurer will reimburse you or Bluegrass Care Navigators℠. Bluegrass Care Navigators℠ also may need to obtain prior approval from your insurer and may need to explain to the insurer your need for hospice care and the services that will be provided to you.

To Conduct Health Care Operations. Bluegrass Care Navigators℠ may use and disclose health information for its own operations in order to facilitate the function of Bluegrass Care Navigators℠ and, as necessary, to provide quality care to all of Bluegrass Care Navigators℠ patients. Health care operations include such activities as:

  • Quality assessment and improvement activities
  • Activities designed to improve quality of life or reduce health care costs
  • Protocol development, case management and care coordination
  • Contacting health care providers and patients with information about treatment alternatives and other related functions that do not include treatment
  • Professional review and performance evaluation
  • Training programs including those in which students, trainees or practitioners in health care learn under supervision
  • Training of non-health care professionals
  • Accreditation, certification, licensing or credentialing activities
  • Review and auditing, including compliance reviews, medical reviews, legal services and compliance programs
  • Business planning and development including cost management and planning related analyses and formulary development
  • Business management and general administrative activities of Bluegrass Care Navigators℠
  • Fundraising for the benefit of Bluegrass Care Navigators℠

 

For example Bluegrass Care Navigators℠ may use your health information to evaluate its staff performance, combine your health information with other Bluegrass Care Navigators℠ patients in evaluating how to more effectively serve all Bluegrass Care Navigators℠ patients, disclose your health information to Bluegrass Care Navigators℠ staff and contracted personnel for training purposes, use your health information to contact you as a reminder regarding a visit to you, or contact you as part of general fundraising and community information mailings (unless you tell us you do not want to be contacted).

Bluegrass Care Navigators℠ may disclose certain information about you including your name, your general health status, your religious affiliation and where you are in the Hospice Care Center in a Saint Joseph Hospital list while you are in the Hospice Care Center. Bluegrass Care Navigators℠ may disclose this information to people who ask for you by name. Please inform us if you do not want your information to be included in the list.

For Fundraising Activities. Bluegrass Care Navigators℠ may use certain information (name, address, telephone number, dates of service, age, and gender) to contact you (or your family members involved in your care) in the future for fundraising activities. We may also provide this name to our related foundation – Bluegrass Care Navigators Foundation, Inc., for the same purpose. The money raised will be used to expand and improve the services and programs we provide the community. If you do not want the hospice or the foundation to contact you, please notify the VP of Development at (859) 276-5344 to let us know you do not wish to be contacted.

For Appointment Reminders. Bluegrass Care Navigators℠ may use and disclose your health information to contact you as a reminder that you have an appointment for a home visit.

For Treatment Alternatives. Bluegrass Care Navigators℠ may use and disclose your health information to tell you about or recommend possible treatment options or alternatives that may be of interest to you.

THE FOLLOWING IS A SUMMARY OF THE CIRCUMSTANCES UNDER WHICH AND PURPOSES FOR WHICH YOUR HEALTH INFORMATION MAY ALSO BE USED AND DISCLOSED.

When Legally Required. Bluegrass Care Navigators℠ will disclose your health information when it is required to do so by any Federal, State or Local law.

When There Are Risks to Public Health. Bluegrass Care Navigators℠ may disclose your health information for public activities and purposes in order to:

  • Prevent or control disease, injury or disability, report disease, injury or vital events such as birth or death, and conduct public health surveillance, investigations and interventions
  • Report adverse events or product defects, track products or enable product recalls, repairs and replacements, and conduct post-marketing surveillance and compliance with requirements of the Food and Drug Administration
  • Notify a person who has been exposed to a communicable disease or who may be at risk of contracting or spreading a disease
  • Notify an employer about an individual who is a member of the workforce, as legally required

 

To Report Abuse, Neglect Or Domestic Violence. Bluegrass Care Navigators℠ is allowed to notify government authorities if Bluegrass Care Navigators℠ believes a patient is the victim of abuse, neglect or domestic violence. Bluegrass Care Navigators℠ will make this disclosure only when specifically required or authorized by law or when the patient agrees to the disclosure.

To Conduct Health Oversight Activities. Bluegrass Care Navigators℠ may disclose your health information to a health oversight agency for activities including audits, civil administrative or criminal investigations, inspections, licensure or disciplinary action.

Bluegrass Care Navigators℠, however, may not disclose your health information if you are the subject of an investigation and your health information is not directly related to your receipt of health care or public benefits.

In Connection With Judicial And Administrative Proceedings. Bluegrass Care Navigators℠ may disclose your health information in the course of any judicial or administrative proceeding in response to an order of a court or administrative tribunal as expressly authorized by such order or in response to a subpoena, discovery request or other lawful process, but only when Bluegrass Care Navigators℠ makes reasonable efforts to either notify you about the request or to obtain an order protecting your health information.

For Law Enforcement Purposes. As permitted or required by State law, Bluegrass Care Navigators℠ may disclose your health information to a law enforcement official for certain law enforcement purposes as follows:

  • As required by law for reporting certain types of wounds or other physical injuries pursuant to a court order, warrant, subpoena or summons or similar process
  • For the purpose of identifying or locating a suspect, fugitive, material witness or missing person
  • Under certain limited circumstances, when you are the victim of a crime
  • To a law enforcement official if Bluegrass Care Navigators℠ has a suspicion that your death was the result of criminal conduct including criminal conduct at Bluegrass Care Navigators
  • In an emergency in order to report a crime

 

To Coroners And Medical Examiners. Bluegrass Care Navigators℠ may disclose your health information to coroners and medical examiners for purposes of determining your cause of death or for other duties, as authorized by law.

To Funeral Directors. Bluegrass Care Navigators℠ may disclose your health information to funeral directors consistent with applicable law and, if necessary, to carry out their duties with respect to your funeral arrangements. If necessary to carry out their duties, Bluegrass Care Navigators℠ may disclose your health information prior to and in reasonable anticipation of your death.

For Organ, Eye Or Tissue Donation. Bluegrass Care Navigators℠ may use or disclose your health information to organ procurement organizations or other entities engaged in the procurement, banking or transplantation of organs, eyes or tissue for the purpose of facilitating the donation and transplantation.

For Research Purposes. Bluegrass Care Navigators℠ may, under very select circumstances, use your health information for research. Before Bluegrass Care Navigators℠ discloses any of your health information for such research purposes, the project will be subject to an extensive approval process. Bluegrass Care Navigators℠ will obtain your written permission if any researcher will be granted access to your identifiable health information.

In the Event of A Serious Threat To Health Or Safety. Bluegrass Care Navigators℠ may, consistent with applicable law and ethical standards of conduct, disclose your health information if Bluegrass Care Navigators℠, in good faith, believes that such disclosure is necessary to prevent or lessen a serious and imminent threat to your health or safety, or to the health and safety of the public.

For Specified Government Functions. In certain circumstances, Federal regulations authorize Bluegrass Care Navigators℠ to use or disclose your health information to facilitate specified government functions relating to the military and veterans, national security and intelligence activities, protective services for the President and others, medical suitability determinations, and inmates and law enforcement custody.

For Worker's Compensation. Bluegrass Care Navigators℠ may release your health information for worker's compensation or similar programs.

AUTHORIZATION TO USE OR DISCLOSE HEALTH INFORMATION

Other than is stated above, Bluegrass Care Navigators℠ will not disclose your health information other than with your written authorization. If you or your representative authorizes Bluegrass Care Navigators℠ to use or disclose your health information, you may revoke that authorization in writing at any time.

YOUR RIGHTS WITH RESPECT TO YOUR HEALTH INFORMATION

You have the following rights regarding your health information that Bluegrass Care Navigators℠ maintains:

Right to request restrictions. The Rules specifically require covered entities to comply with individuals’ requests to restrict the disclosure of their information, to the extent the disclosure satisfies three conditions:

  • The disclosure is for purposes of carrying out payment or health care operations;
  • The disclosure is not otherwise required by law or regulations (including Medicare, Medicaid and other requirements); and
  • The PHI subject to the request pertains solely to a health care item or service for which the individual (or family member, or anyone other than the health plan) paid in full.

Right to receive confidential communications. You have the right to request that Bluegrass Care Navigators℠ communicate with you in a certain way. For example, you may ask that Bluegrass Care Navigators℠ only conduct communications pertaining to your health information with you privately, with no other family members present. If you wish to receive confidential communications, please contact a member of your Bluegrass Care Navigators℠ team. Bluegrass Care Navigators℠ will not request that you provide any reasons for your request and will attempt to honor your reasonable requests for confidential communications.

Right to inspect and copy your health information. You have the right to inspect and copy your health information, including billing records. A request to inspect and copy records containing your health information may be made to the Director of Information Systems/Privacy Officer at (859) 276-5344. If you request a copy of your health information, Bluegrass Care Navigators℠ may charge a reasonable fee for copying and assembling costs associated with your request.

Right to amend health care information. You or your representative have the right to request that Bluegrass Care Navigators℠ amend your records, if you believe that your health information is incorrect or incomplete. That request may be made as long as the information is maintained by Bluegrass Care Navigators℠. A request for an amendment of records must be made in writing to the Director of Information Systems/Privacy Officer at (859) 276-5344. Bluegrass Care Navigators℠ may deny the request if it is not in writing or does not include a reason for the amendment. The request also may be denied if your health information records were not created by Bluegrass Care Navigators℠, if the records you are requesting are not part of Bluegrass Care Navigators‘℠ records, if the health information you wish to amend is not part of the health information you or your representative are permitted to inspect and copy, or if, in the opinion of Bluegrass Care Navigators℠, the records containing your health information are accurate and complete.

Right to an accounting. You or your representative have the right to request an accounting of disclosures of your health information made by Bluegrass Care Navigators℠ for certain reasons, including reasons related to public purposes authorized by law and certain research. The request for an accounting must be made in writing to the Director of Information Systems/Privacy Officer at (859) 276-5344. The request should specify the time period for the accounting starting on or after April 14, 2003. Accounting requests may not be made for periods of time in excess of six (6) years. Bluegrass Care Navigators℠ would provide the first accounting you request during any 12-month period without charge. Subsequent accounting requests may be subject to a reasonable cost-based fee.

Right to a paper copy of this notice. You or your representative have a right to a separate paper copy of this Notice at any time, even if you or your representative have received this Notice previously. To obtain a separate paper copy, please contact the Director of Information Systems/Privacy Officer at (859) 276-5344. The patient or patient’s representative may also obtain a copy of the current version of this Notice of Privacy Practices at its website, www.bgcarenav.org.

DUTIES OF BLUEGRASS CARE NAVIGATORS

Bluegrass Care Navigators℠ is required by law to maintain the privacy of your health information and to provide to you and your representative this Notice of its duties and privacy practices. Bluegrass Care Navigators℠ is required to abide by the terms of this Notice but reserves the right to revise the Notice from time to time. Bluegrass Care Navigators℠ reserves the right to change the terms of its Notice and to make the new Notice provisions effective for all health information that it maintains. If Bluegrass Care Navigators℠ makes a policy altering changes to its Notice, Bluegrass Care Navigators℠ will provide a copy of the revised Notice to you or your appointed representative. You or your personal representative have the right to express complaints to Bluegrass Care Navigators℠ and to the Secretary of DHHS if you or your representative believe that your privacy rights have been violated. Any complaints to Bluegrass Care Navigators℠ should be made in writing to the Director of Information Systems/Privacy Officer at (859) 276-5344. Bluegrass Care Navigators℠ encourages you to express any concerns you may have regarding the privacy of your information. You will not be retaliated against in any way for filing a complaint.

CONTACT PERSON

Bluegrass Care Navigators℠ has designated the Director of Information Systems/Privacy Officer as its contact person for all issues regarding patient privacy and your rights under the Federal privacy standards. You may contact this person at 2312 Alexandria Dr., Lexington, KY 40504; (859) 276-5344.

EFFECTIVE DATE

This Notice is effective April 14, 2003.

IF YOU HAVE ANY QUESTIONS REGARDING THIS NOTICE, PLEASE CONTACT: Director of Information Systems/Privacy Officer; 2312 Alexandria Dr., Lexington, KY 40504; (859) 276-5344.

HOW DO I FILE A COMPLAINT?

If you think we have not protected your privacy and wish to complain to Bluegrass Care Navigators℠, send your complaint in writing to:

Director of Information Systems/Privacy Officer
2312 Alexandria Drive
Lexington, KY 40504

You may also complain to the Federal Government by writing to:

Office of Civil Rights
US Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, DC 20201

WHAT WILL HAPPEN TO ME IF I FILE A COMPLAINT?

Absolutely nothing. It is against the law for Bluegrass Care Navigators℠ to take any retaliatory or other negative action against you if you file a complaint.

Bluegrass Care Navigators℠ is required to abide by the terms of this notice; however, we reserve the right to change it. We reserve the right to make the revised notice effective for information we already have about you, as well as future information we receive. All notices will have the effective date on them. A current copy of this notice will be posted in all locations operated by Bluegrass Care Navigators℠, on the website, www.bgcarenav.org, and can be sent to you upon request. You will be offered a copy of this notice each time you initiate services.