Genesee Health Plan 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.

This notice describes how we protect the personal health information we have about you (“Health Information”), and how we may use and disclose this information. We get Health Information about you when you enroll in Genesee Health Plan. It includes your date of birth, sex, ID number, and other personal information. This notice also describes your rights with respect to the Health Information and how you can exercise those rights.

We are required by law to (1) maintain the privacy of your Health Information, (2) provide you this notice of our legal duties and privacy practices with respect to your Health Information and (3) follow the terms of this notice. We protect your Health Information from inappropriate use or disclosure. Our employees, and those companies that help us service your Health Plan Benefits, are required to protect the confidentiality of your Health Information.

How We May Use and Disclose Your Privacy Information

In some circumstances, your Health Information may be disclosed without asking for your authorization in advance or giving you an opportunity to object. These circumstances include:

  • For Treatment: We may use and disclose your Health Information to facilitate medical treatment or services by providers. This includes use of your personal information under the Disease Case Management Program by case managers. For example, we may contact your doctor about care you get from other doctors.
  • For Payment: We may use and disclose your Health Information to pay for benefits under your Health Plan Benefits. For example, we may review Health Information contained on claims to reimburse providers for services rendered.
  • For Health Care Operations: We may also use and disclose Health Information for our Health Plan Benefits operations. For example, we may use Health Information to determine your eligibility for the program or review the quality of the care you receive.
  • As Required by Law: We will disclose your Health Information when required to do so by federal, state or local law. These include (1) for judicial and administrative proceedings pursuant to legal authority; (2) to report information related to victims of abuse, neglect or domestic violence; and (3) to assist law enforcement officials in their law enforcement duties.
  • Public Health Risks: We may disclose your Health Information for public health activities such as assisting public health authorities to prevent or control disease, injury or disability.
  • Health Oversight Activities: We may disclose Health Information to a health oversight agency for activities authorized by law, such as audits and licensure.
  • To Prevent a Serious Threat to Health or Safety: We may disclose Health Information to prevent a serious threat to your health and safety or the health and safety of the public or another person as required by law.
  • For Health-Related Benefits or Services: We may use Health Information to provide you with information about benefits available to you under your current Health Plan Benefits and about
    health-related products or services that may be of interest to you.
  • Specific Government Functions: We may use and disclose Health Information for specialized government functions such as protection of public officials, reporting to various branches of the armed services. We may disclose your Health Information to federal officials for intelligence, counterintelligence, and other national security activities authorized by law.
  • Individuals Involved in Your Care or Payment for Your Care: We will disclose relevant Health Information to family members and close personal friends who are involved in your care or the payment of your care, if you have agreed or haven’t objected to the disclosure or if we determine in the exercise of professional judgment that the disclosure is in your best interests.
  • Workers’ Compensation: We may release your Health Information about you in order to comply with laws and regulations related to Workers’ Compensation.
  • Inmates: We may disclose your Health Information about you to the correctional institution or law enforcement official if you are an inmate of a correctional institution or under the custody of a law
    enforcement official.
  • To the Federal Department of Health and Human Services (“DHHS”): Under the privacy standards, we must disclose your Health Information to the Secretary of DHHS as necessary for them to determine our compliance with those standards. Our use and disclosure of your Health Information must follow not only federal privacy regulations, but also applicable Michigan law.
    Michigan law provides different protections to your health information. For example, Michigan provides extra protection for sensitive information, like HIV/AIDS information and mental
    health information.

Other Uses and Disclosures of Your Health Information

Other uses and disclosures of your Health Information not covered by this notice will be made only with your written authorization. If you authorize us to use or disclose Health Information about you, you may revoke that authorization, in writing, at any time, except to the extent that we have taken action relying on the authorization. You should understand that we will not be able to take back any disclosures we have already made with the authorization. To revoke your authorization, you must send a written revocation to the Privacy Officer at the address listed below.

Your Rights Regarding Health Information We Have About You

You have the following rights regarding the Health Information that we have about you. To exercise these rights you must make your request in writing to the Privacy Officer at the address listed below.

  • Right to Inspect and Copy Your Health Information: In most cases, you have the right to look at or get a copy of your Health Information that we have about you. We reserve the right to charge a reasonable, cost-based fee for making copies.
  • Right to Amend/Correct Your Health Information: You may ask us to change your Health Information if you feel there is a mistake. We cam deny your request for certain reasons, but we must give you a written reason for our denial.
  • Right to an Accounting of Disclosures: You have the right to ask for a list of the disclosures we have made of your Health Information after April 14, 2003. This list will only include certain disclosures. For example it will not include, disclosures made for payment, health care operations or pursuant to an authorization from you.
  • Right to Request Restrictions: You have the right to ask for limits on how your information is used or disclosed. While we will consider your request, we are not required to agree to it.
  • Right to Request Confidential Communications: You have the right to ask that we share information with you in a certain way or in a certain place, if you tell us that the disclosure of all or part of that information could endanger you. We will accommodate reasonable requests that you make.
  • Right to Receive a Paper Copy of this Notice upon Request: You have the right to obtain an additional paper copy of this notice.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the DHHS: Office of Civil Rights, Department of Health and Human Services, 233 N. Michigan Ave. Suite 240, Chicago, IL 60601 (1-800-368-1019). To file a complaint with us, please contact the Privacy Officer at the address provided below. All complaints must be submitted in writing. We will not retaliate against you for filing a complaint with the federal government or with Genesee Health Plan.

Right to Change Our Privacy Practices

We reserve the right to change the terms of this notice at any time. We reserve the right to make the revised or changed notice effective for Health Information we already have about you as well as any Health Information we receive in the future. You can locate the effective date of this and any revised notice on the first page in the top right hand corner. If we make a material change to this notice you will receive a copy of the revised notice from us within 60 days of the revision.

Contacting Us About Disclosure of Your Health Information

If you wish to exercise your rights, file a complaint or have any questions regarding the contents of this notice please contact the Privacy Officer listed below.

Jim Milanowski
(810) 232-7740
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