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Notice of Privacy Practices
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KAISER PERMANENTE - COLORADO REGION
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.
In
this notice, we use the terms "we," "us" and "our" to describe Kaiser
Permanente - Colorado Region. For more details, please refer to section
IV. of this notice.
I. WHAT IS
"PROTECTED HEALTH INFORMATION?"
Your
protected health information ("PHI") is health information that
contains identifiers, such as your name, social security number, or
other information that reveals who you are. For example, your medical
record is PHI because it includes your name and other identifiers.
If you
are a Kaiser Foundation Health Plan member and also an employee of any
Kaiser Permanente company, PHI does not include the health information
in your employment records.
II. ABOUT OUR
RESPONSIBILITY TO PROTECT YOUR PHI
By law, we must
- protect the privacy of your PHI;
- tell you about your rights and our legal duties
with respect to your PHI; and
- tell you about our privacy practices and follow our
notice currently in effect.
We take
these responsibilities seriously and, as in the past, we will continue
to take appropriate steps to safeguard the privacy of your PHI.
III. YOUR
RIGHTS REGARDING YOUR PHI
This
section tells you about your rights regarding your PHI, for example,
your medical and billing records. It also describes how you can
exercise these rights.
Your
right to see and receive copies of your PHI
In general, you have a right to see and receive copies of your PHI in
designated record sets, such as your medical record or billing record.
If you would like to see or receive a copy of such a record, please
write to us at Kaiser Foundation Health Plan of Colorado,
Release of Information Department, 14701 E. Exposition Avenue, Aurora,
CO 80012. After we receive your written request, we will let
you know when and how you can see or obtain a copy of your record. In
certain circumstances, if you agree, we will give you a summary or
explanation of your PHI instead of providing copies. We are permitted
to charge you a fee for the copies, summary, or explanation. If we
don't have the record you asked for but we know who does, we will tell
you who to contact to request it.
In
limited situations, we may deny some or all of your request to see or
receive copies of your records, but if we do, we will tell you why in
writing and explain your right, if any, to have our denial reviewed.
Your
right to choose how we send PHI to you
You may ask us to send your PHI to you at a different address (for
example, your work address) or by different means (for example, fax
instead of regular mail). When we can reasonably and lawfully agree to
your request, we will. However, we are permitted to charge you for any
additional cost of sending your PHI to different addresses or by
different means.
Your
right to correct or update your PHI
If you believe there is a mistake in your PHI or that important
information is missing, you may request that we correct or add to the
record. Please write to us and tell us what you are asking for and why
we should make the correction or addition. Send your requests to Kaiser
Foundation Health Plan of Colorado, Medical Record Department, 16601
East Centretech Pkwy, Aurora, CO 80011. We will respond in
writing after receiving your request. If we approve your request, we
will make the correction or addition to your PHI. If we deny your
request, we will tell you why and explain your right to file a written
statement of disagreement.
Your
right to an accounting of disclosures of PHI
You may ask us for a list of our disclosures of your PHI. Write to us
at Kaiser Foundation Health Plan of Colorado, Release of
Information Department, 14701 E. Exposition Avenue, Aurora, CO 80012.
The list we give you will include disclosures made in the last six
years, unless you request a shorter time or if less than six years have
passed since April 14, 2003. For example, if you requested a list of
disclosures on April 14, 2005, the list would cover only two years.
You
are entitled to one disclosure accounting in any 12-month period at no
charge. If you request any additional accountings less than 12 months
later, we may charge a fee.
An
accounting does not include certain disclosures, for example,
disclosures to carry out treatment, payment and health care operations;
disclosures that occurred prior to April 14, 2003; disclosures for
which KP had a signed authorization; disclosures of your PHI to you;
disclosures from a KP facility directory; disclosures for notifications
for disaster relief purposes; or disclosures to persons involved in
your care and persons acting on your behalf.
Your
right to request limits on uses and disclosures of your PHI
You may request that we limit our uses and disclosures of your PHI for
treatment, payment, and health care operations purposes. However, by
law, we do not have to agree to your request. Because we strongly
believe that this information is needed to appropriately manage the
care of our members/patients, it is our policy not to agree to requests
for restrictions.
Your
right to receive a paper copy of this notice
You also have a right to receive a paper copy of this notice upon
request. Please refer to section VII of this notice on how to request a
copy.
IV. KAISER
PERMANENTE COMPANIES SUBJECT TO THIS NOTICE
This notice applies to the Kaiser Permanente Colorado Region, which
includes:
- The Colorado Permanente Medical Group (CPMG);
- Kaiser Foundation Health Plan of Colorado,
including its health plan and provider operations;
- Kaiser Foundation Hospitals (KFH), as discussed
below; and
- Kaiser Foundation Health Plan, Inc. (KFHP, Inc.),
as discussed below.
Our
health care delivery sites include the Kaiser Permanente medical
offices, the Kaiser Ambulatory Surgery Center, the member call center
and our member web site.
To
provide you with the health care you expect, to treat you, to pay for
your care and to conduct our operations, such as quality assurance,
accreditation, licensing and compliance, these Kaiser Permanente
companies share your PHI with each other.
Our
personnel may have access to your PHI either as employees, physicians,
volunteers or persons working with us in other capacities. Our region
may share your PHI with KFH and KFHP, Inc., in connection with shared
services and other national Kaiser Permanente activities for treatment,
payment, or health care operations purposes. For example, if you are
being considered for a transplant, we will share your PHI with our
Kaiser Permanente National Transplant Network.
This
Notice of Privacy Practices does not apply to our contracted providers
who are not part of Kaiser Permanente's workforce. Please contact those
providers directly for information about their privacy practices.
For
Colorado Springs members: Please note that this Notice of
Privacy Practices does not apply to our affiliated
providers in Colorado Springs. Please contact your provider for
information about your provider's privacy practices.
V. HOW WE MAY
USE AND DISCLOSE YOUR PHI
Your
confidentiality is important to us. Our physicians and employees are
required to maintain the confidentiality of the PHI of our
members/patients, and we have policies and procedures and other
safeguards to help protect your PHI from improper use and disclosure.
Sometimes, we are allowed by law to use and disclose certain PHI
without your written permission. We briefly describe these uses and
disclosures below and give you some examples.
How
much PHI is used or disclosed without your written permission will vary
depending, for example, on the intended purpose of the use or
disclosure. Sometimes we may only need to use or disclose a limited
amount of PHI, such as to send you an appointment reminder or to
confirm that you are a health plan member. At other times, we may need
to use or disclose more PHI such as when we are providing medical
treatment.
- Treatment: This is
the most important use and disclosure of your PHI. For example, our
physicians, nurses, and other health care personnel, including
trainees, involved in your care use and disclose your PHI to diagnose
your condition and evaluate your health care needs. Our personnel will
use and disclose your PHI in order to provide and coordinate the care
and services you need, for example: prescriptions; X-rays; and lab
work. If you need care from health care providers who are not part of
Kaiser Permanente, such as community resources to assist with your
health care needs at home, we may disclose your PHI to them.
- Treatment
alternatives and health-related benefits and services: In some
instances, the law permits us to contact you: 1) to describe our
network or describe the extent to which we offer and pay for various
products and services; 2) for your treatment; 3) for case management
and care coordination; or 4) to direct or recommend available treatment
options, therapies, health care providers, or care settings. For
example, we may tell you about a new drug or procedure or about
educational or health management activities.
-
Payment:
Your PHI may be needed to determine our responsibility to pay for, or
to permit us to bill and collect payment for, treatment and
health-related services that you receive. For example, we may have an
obligation to pay for health care you receive from an outside provider.
When you or the provider sends us the bill for health care services, we
use and disclose your PHI to determine how much, if any, of the bill we
are responsible for paying.
- Health
care operations: We may use and disclose your PHI for certain
health care operations, such as: quality assessment and improvement;
training and evaluation of health care professionals; licensing;
accreditation; activities relating to the creation, renewal or
replacement of health insurance or health benefits; conducting medical
review; legal services; auditing functions, including fraud and abuse
detection and compliance programs; customer services; and determining
premiums and other costs of providing health care. We may also disclose
your PHI for certain health care operations of other health plans and
health care providers.
- Business
associates: We may
contract with business associates to perform certain functions or
activities on our behalf, such as payment and health care operations.
These business associates must agree to safeguard your PHI.
- Appointment
reminders: Your PHI
allows us to contact you about appointments for treatment or other
health care you may need.
- Specific
types of PHI: There are stricter requirements for use and
disclosure of some types of PHI, for example, information about drug
and alcohol abuse, AIDS and HIV, mental health, genetic testing, and
artificial insemination. However, there are still circumstances in
which these types of information may be used or disclosed without your
authorization. If you become a patient in our chemical dependency
program, we will give you a separate written notice, as required by
law, about your privacy rights for your chemical dependency program PHI.
-
Communications
with family and others when you are present: Sometimes a
family member or other person involved in your care will be present
when we are discussing your PHI with you. If you object, please tell us
and we won't discuss your PHI or we will ask the person to leave.
- Communications
with family and others when you are not present: There may be
times when it is necessary to disclose your PHI to a family member or
other person involved in your care because there is an emergency, you
are not present, or you lack the decision making capacity to agree or
object. In those instances, we will use our professional judgment to
determine if it's in your best interest to disclose your PHI. If so, we
will limit the disclosure to the PHI that is directly relevant to the
person's involvement with your health care. For example, we may allow
someone to pick up a prescription for you.
- Disclosure
in case of disaster relief: We may
disclose your name, city of residence, age, gender, and general
condition to a public or private disaster relief organization to assist
disaster relief efforts, unless you object at the time.
- Disclosures
to parents as personal representatives of minors: In most
cases, we may disclose your minor child's PHI to you. In some
situations, however, we are permitted or even required by law to deny
your access to your minor child's PHI - for example, information about
drug use or addiction, certain mental health services, and venereal
disease.
-
Facility
directories: When you are a patient in one of our facilities,
we may create a directory that includes your name, room location, and
your general condition. This information may be disclosed to a person
who asks for you by name. In addition, we may provide your religious
affiliation, if any, to clergy. You may object to the use or disclosure
of some or all of this information. If you do, we will not disclose it
to visitors or other members of the public.
- Research:
Kaiser Permanente engages in extensive and important health research.
Some of our research may involve medical procedures and some is limited
to collection and analysis of health data. Research of all kinds may
involve the use or disclosure of your PHI. Your PHI can generally be
used or disclosed without your permission if an Institutional Review
Board (IRB) approves such use or disclosure. An IRB is a committee that
is responsible, under federal law, for reviewing and approving human
subjects research to protect the safety of patients and confidentiality
of PHI.
- Organ
donation: We may
use or disclose PHI to organ procurement organizations to assist with
organ, eye or other tissue donations.
- Public
health activities: Public
health activities cover many functions performed or authorized by
government agencies to promote and protect the public's health and may
require us to disclose your PHI.
- For example, we may disclose your PHI as part of
our obligation to report to public health authorities certain diseases,
injuries, conditions, and vital events such as births or abortions.
Sometimes we may disclose your PHI to someone you may have exposed to a
communicable disease or who may otherwise be at risk of getting or
spreading the disease.
- The Food and Drug Administration (FDA) is
responsible for tracking and monitoring certain medical products, such
as pacemakers and hip replacements, to identify product problems and
failures and injuries they may have caused. If you have received one of
these products, we may use and disclose your PHI to the FDA or other
authorized persons or organizations, such as the maker of the product.
- We may use and disclose your PHI as necessary to
comply with federal and state laws that govern workplace safety.
- Health
oversight: As
health care providers and health plans, we are subject to oversight
conducted by federal and state agencies. These agencies may conduct
audits of our operations and activities and in that process, they may
review your PHI.
- Disclosures
to your employer or your employee organization: If you are
enrolled in Kaiser Foundation Health Plan of Colorado through your
employer or an employee organization, we may share certain PHI with
them without your authorization, but only when allowed by law. For
example, we may disclose your PHI for a workers' compensation claim or
to determine whether you are enrolled in the plan or whether premiums
have been paid on your behalf. For other purposes, such as for
inquiries by your employer or employee organization on your behalf, we
will obtain your authorization when necessary under applicable law.
- Workers'
compensation: In order to comply with workers' compensation
laws, we may use and disclose your PHI. For example, we may communicate
your medical information regarding a work-related injury or illness to
claims administrators, insurance carriers, and others responsible for
evaluating your claim for workers' compensation benefits.
- Military
activity and national security: We may
sometimes use or disclose the PHI of armed forces personnel to the
applicable military authorities when they believe it is necessary to
properly carry out military missions. We may also disclose your PHI to
authorized federal officials as necessary for national security and
intelligence activities or for protection of the President and other
government officials and dignitaries.
- Marketing:
Kaiser Permanente may use and, in some instances, disclose your PHI to
contact you about benefits, services or supplies that we can offer you
in addition to your KP coverage.
- Fundraising: We may
use or disclose PHI to contact you to raise funds for our organization.
- Required
by law: In some
circumstances federal or state law requires that we disclose your PHI
to others. For example, the Secretary of the Department of Health and
Human Services may review our compliance efforts, which may include
seeing your PHI.
- Lawsuits
and other legal disputes: We may
use and disclose PHI in responding to a court or administrative order,
a subpoena, or a discovery request. We may also use and disclose PHI to
the extent permitted by law without your authorization, for example, to
defend a lawsuit or arbitration.
- Law
enforcement: We may
disclose PHI to authorized officials for law enforcement purposes, for
example, to respond to a search warrant, report a crime on our
premises, investigate fraud, or help identify or locate someone.
- Serious
threat to health or safety: We may use and disclose your PHI
if we believe it is necessary to avoid a serious threat to your health
or safety or to someone else's.
- Abuse or
neglect: By law,
we may disclose PHI to the appropriate authority to report suspected
child abuse or neglect or to identify suspected victims of abuse,
neglect, or domestic violence.
- Coroners
and funeral directors: We may disclose PHI to a coroner or
medical examiner to permit identification of a body, determine cause of
death, or for other official duties. We may also disclose PHI to
funeral directors.
- Inmates:
Under
the federal law that requires us to give you this notice, inmates do
not have the same rights to control their PHI as other individuals. If
you are an inmate of a correctional institution or in the custody of a
law enforcement official, we may disclose your PHI to the
correctional institution or the law enforcement official for certain
purposes, for example, to protect your health or safety or someone
else's.
VI. ALL OTHER USES AND DISCLOSURES OF YOUR PHI
REQUIRE YOUR PRIOR WRITTEN AUTHORIZATION
Except for those uses and disclosures described above, we will not use
or disclose your PHI without your written authorization. When your
authorization is required and you authorize us to use or disclose your
PHI for some purpose, you may revoke that authorization by notifying us
in writing at any time. Please note that the revocation will not apply
to any authorized use or disclosure of your PHI that took place before
we received your revocation. Also, if you gave your authorization to
secure a policy of insurance, including health care coverage from us,
you may not be permitted to revoke it until the insurer can no longer
contest the policy issued to you or a claim under the policy.
VII. HOW TO CONTACT US ABOUT THIS NOTICE OR TO
COMPLAIN ABOUT OUR PRIVACY PRACTICES
If you have any questions about this notice, want to request a copy of
the notice, or want to lodge a complaint about our privacy practices,
please let us know by calling the Customer Service Department at:
- Denver/Boulder area: 1-888-313-2329 or
(303) 338-3820 TTY/TDD
- Colorado Springs area: 1-888-313-2329 or
(719) 867-2132 TTY/TDD
You
may also e-mail the Customer Service Department at colorado.cs@kp.org,
or write to the Customer Service Department at: Kaiser Foundation
Health Plan of Colorado, Customer Service Department, 2500 South Havana
Street, Aurora, CO 80014-1622. You also may notify the Secretary of the
Department of Health and Human Services (HHS) to lodge a complaint
about our privacy practices.
We
will not take retaliatory action against you if you file a complaint
about our privacy practices.
VIII. CHANGES TO THIS NOTICE
We may change this notice and our privacy practices at any time, as
long as the change is consistent with state and federal law. Any
revised notice will apply both to the PHI we already have about you at
the time of the change, and any PHI created or received after the
change takes effect. If we make an important change to our privacy
practices, we will promptly change this notice and post a new notice at
the following Internet address: www.kp.org. Except
for changes required by law, we will not implement an important change
to our privacy practices before we revise this notice.
IX. EFFECTIVE DATE OF THIS NOTICE
This notice is effective on April 14, 2003.
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