Your Information. Your Rights. Our Responsibilities.
This notice describes how health information about you may be used and disclosed and how you can get access to this information. Please review it carefully. Click here for a printable version of this document.
Your Rights
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
Get an electronic or paper copy of your medical record
- You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
- We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
Ask us to correct your medical record
- You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
- We may say “no” to your request, but we’ll tell you why in writing within 60 days.
Request confidential communications
- You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
- We will say “yes” to all reasonable requests.
Ask us to limit what we use or share
- You can ask us not to use or share certain health information for treatment, payment, or our operations.
- We are not required to agree to your request, and we may say “no” if it would affect your care.
- If you pay for a service or health care item out- of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer.
- We will say “yes” unless a law requires us to share that information.
Get a list of those with whom we’ve shared information
- You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
- We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
Get a copy of this privacy notice
- You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
Choose someone to act for you
- If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
- We will make sure the person has this authority and can act for you before we take any action.
File a complaint if you feel your rights are violated
- You can complain if you feel we have violated your rights by contacting us using the information on the back page.
- You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696- 6775, or visiting www.hhs.gov/ocr/privacy/hipaa/ complaints/.
- We will not retaliate against you for filing a complaint.
Your Choices
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to:
- Share information with your family, close friends, or others involved in your care
- Share information in a disaster relief situation
- Share your location information if requested
If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
In these cases, we never share your information unless you give us written permission:
- Marketing purposes
- Sale of your information
- Most sharing of psychotherapy notes
In the case of fundraising, we may contact you for fundraising efforts, but you can tell us not to contact you again.
Other Uses and Disclosures
How do we typically use or share your health information? We typically use or share your health information in the following ways.
Treat you
- We can use your health information and share it with other professionals who are treating you.
- Example: A doctor treating you for an injury asks another doctor about your overall health condition.
Run our organization
- We can use and share your health information to run our practice, improve your care, and contact you when necessary.
- Example: We use health information about you to manage your treatment and services.
Bill for your services
- We can use and share your health information to bill and get payment from health plans or other entities.
- Example: We give information about you to your health insurance plan so it will pay for your services.
How else can we use or share your health information?
We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
Help with public health and safety issues
- We can share health information about you for certain situations such as:
- Preventing disease
- Helping with product recalls
- Reporting adverse reactions to medications
- Reporting suspected abuse, neglect, or domestic violence
- Preventing or reducing a serious threat to anyone’s health or safety
Do research
- We can use or share your information for health research.
Comply with the law
- We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
Respond to organ and tissue donation requests
- We can share health information about you with organ procurement organizations.
Work with a medical examiner or funeral director
- We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
Address workers’ compensation, law enforcement, and other government requests
- We can use or share health information about you:
- For workers’ compensation claims
- For law enforcement purposes or with a law enforcement official
- With health oversight agencies for activities authorized by law
- For special government functions such as military, national security, and presidential protective services
Respond to lawsuits and legal actions
- We can share health information about you in response to a court or administrative order, or in response to a subpoena.
How do we protect your Reproductive Health Care medical records?
Access to Reproductive Health Care services is essential to individual health and well-being. The HIPAA Privacy Rule protects that health information and helps us keep your information private. For more information see: https://www.hhs.gov/hipaa/for-professionals/special-topics/reproductive-health/final-rule-fact-sheet/index.html
Reproductive Health Care can include many things
- Contraceptives/Emergency contraceptives
- Birth control education and counseling
- Pregnancy testing and options counseling
- Infertility counsel, education, & referral
- Breast and cervical cancer screening
- Testing and treatment for STIs
- HIV testing and counseling
- Treatment for miscarriage or other loss
We can release these records for these among other reasons
- For all the previously mentioned reasons (Treatment, Payment, and Operations).
- For defense purposes against misconduct or negligence charges
- To the Inspector General for an audit
We will not release these records if requested for
- To conduct a criminal, civil, or administrative investigation
- To impose criminal civil, or administrative liability
- To identify a person in order to conduct an investigation or impose such liability
We require an attestation that the request is not for the above reasons if it comes from one of these
- Health oversight activities
- Judicial and administrative proceedings
- Law enforcement purposes
- Disclosures to coroners and medical examiners
Releases to law enforcement allowed
- We may release records if a court order is produced, but only exactly what is requested
- To prevent or lessen a serious & imminent threat to the health/safety of a person/public
What can you expect regarding Substance Use Disorder records?
Substance Use Disorder (SUD) records contain sensitive information that can lead to personal loss or discrimination if it falls into the wrong hands. Your records are protected by Federal Regulations (“Part 2”) and we treat your privacy with respect. We are considered “lawful holders” because we may have your records or have you as a patient pre-, post-, or during treatment in a Part 2 program somewhere else. For more information see: https://www.hhs.gov/hipaa/for-professionals/regulatory-initiatives/fact-sheet-42-cfr-part-2-final-rule/index.html
What SUD records do we protect?
- Information in any form that would directly/ indirectly identify a person as having sought or received SUD treatment from a Part 2 program (Federally assisted Drug/Alcohol program).
- Name, date of birth, status as a patient in a Part 2 program, diagnosis, treatment or referral records, and prescription information
Unlike other records
- You must consent to use/disclosure for treatment, payment, and operations, but it can be for all future uses.
We can release without a written consent
- In a medical emergency
- When there is an immediate threat to the health/safety of an individual or the public
- Limited redisclosure for legal proceedings according to the Part 2 standards [See 42 CFR § 2.65(e)]
- To public health authorities once de-identified according to HIPAA regulations
Our Responsibilities
- We are required by law to maintain the privacy and security of your protected health information.
- We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
- We must follow the duties and privacy practices described in this notice and give you a copy of it.
- We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
For more information see: www.hhs.gov/ocr/privacy/hipaa/ understanding/consumers/noticepp.html.
Changes to the Terms of This Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.
This Notice of Privacy Practices applies to the following organizations:
This is a Joint NPP with independent contractors providing services at HMHD. Independent contractors providing services at HMHD and covered by this NPP include, but are not limited to, Integritas Providers (Emergency Department Physicians), SSM (hospitalist service), Cape Radiology Group (radiologists), Sarah Bush Lincoln (pathology), Integritas Providers (General Surgery), and Specialty in Anesthesia (anesthesia). These providers are independent contractors and are not agents, servants or employees of HMHD, unless otherwise identified; the providers exercise their own medical judgment in treatment and are solely responsible for their own compliance with state and federal privacy laws, and nothing in this privacy notice is meant to imply, infer or create any agency or employment relationship between the providers and HMHD, whether actual or implied.
Hamilton Memorial Hosp District Megan Hannel – Privacy Officer
611 S. Marshall Ave. email | mhannel@hmhospital.org
McLeansboro, IL 62859 phone | 618.643.2361 ext. 4501
www.hmhospital.org
Effective Date: 9.2024
