St. Anthony Medical Centers

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I. We have a legal duty to safeguard your protected health information (SAMC). We at St. Anthony Medical Centers (SAMC), are legally required to protect the privacy of your health information. We call this information protected health information, or a for short, and it includes information that can be used to identify you that we've created or received about your past, present, or future health or condition, the provision of health care to you, or the payment of this health care. We must provide you with this notice of our privacy practices that explains how, when and why we use and disclose your PHI. With some exceptions, we many not use or disclose any more of your PHI than is necessary to accomplish the purpose of the use or disclosure. We are legally required to follow the privacy practices that are described in this notice. However, we reserve the right to change the terms of this notice and our privacy policies at any time . Any changes will apply to the PHI guidelines we already have. Before we make an important change to our policies, we will promptly change this notice and post a new notice in the Clinics reception area and on our corporate website: 1.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. 2.This notice went into effect June 30, 2006. www.stanthonymedical.org. You can also request a copy of the notice from the contact person listed in Section V below at any time. II. How we may use and disclose your protected PHI We use and disclose health information for any different reasons. For some of these uses or disclosures, we need your specific written authorization. Below, we describe the different categories of our uses and disclosures and give you some examples of each category. A. Uses and Disclosures Relating to Treatment, Payment or Health Care Operations. We may use and disclose your PHI without your consent or authorization for the following reasons: 1. For treatment. We may disclose your PHI to physicians, nurses, medical students, and other health care personnel who provide you with health care services or are involved in your care. For example, if you're being treated for a knee injury, we may disclose your PHI to the physical rehabilitation department in order to coordinate your care. In addition, we may disclose your PHI to discuss various treatment alternatives and health related benefits and services. 2. To obtain payment for treatment. We may use and disclose your PHI in order to bill and collect payment for the treatment and services provided to you. For example, we may provide portions of your PHI to our billing department and your health plan to get paid for the health care services we provided to you. We may also provide your PHI to our business associates, such as billing companies, claims processing companies, our information technology (SAMC) providers, and others that assist in the processing of our health care claims. 3. For health care operations. We may use and disclose your PHI in order to operate this clinic and any other community clinics operated by SAMC. For example, we may use your PHI in order to evaluate the quality of health care services that you received or to evaluate the performance of the health care professionals who provided health care services to you. We may also provide your PHI to our accountants, attorneys, consultants, and others in order to make sure we're complying with the laws that affect us. B. Certain Other Uses and Disclosures Which Do Not Require Your Authorization. We may use and disclose your PHI without your consent or authorization for the following additional reasons: 1. When a disclosure is required by federal, state or local law, judicial or administrative proceedings, or law enforcement. For example, we make disclosures when a law requires that we report information to government agencies and law enforcement personnel about victims of abuse, neglect, or domestic violence; when dealing with gunshot and other wounds; or when ordered in a judicial or administrative proceeding. 2. For public health activities. For example, we report information about births, deaths, and various diseases, to government officials in charge of collecting that information, and we provide coroners, medical examiners, and funeral directors necessary information relating to an individual's death. 3. For health oversight activities. For example, we will provide information to assist the government when it conducts an investigation or inspection of a health care provider or organization. 4. For purposes of organ donation. We may notify organ procurement organizations to assist them in organ, eye, or tissue donation and transplants. 5. For research purposes. In certain circumstances, we may provide PHI in order to conduct medical research. 6. To avoid harm. In order to avoid a serious threat to the health and safety of a person or the public, we may provide PHI to law enforcement personnel or persons able to prevent or lessen such harm. 7. For specific government functions. We may disclose PHI of military personnel and veterans in certain situations. We may also disclose PHI for national security purposes, such as protecting requests from U.S. intelligence operations. 8. For workers' compensation purposes. We may provide PHI in order to comply with workers compensation laws. 9. Appointment reminders and health-related benefits or services. We may use PHI to provide appointment reminders or give you information about treatment alternatives, or other health care services or benefits we offer. C. Two Uses and Disclosures Require You to Have the Opportunity to Agree or to Object. 1. Patient directories. We may include your name, location in this facility, general condition, and religious affiliation, in our patient directory for use by clergy and visitors who ask for you by name, unless you object in whole or in part. The opportunity to consent may be obtained retroactively in emergency situations. 2. Disclosures to family, friends or others. We may provide your PHI to a family member, friend, or other person that you indicate is involved in your care or the payment for your health care, unless you object in whole or in part. The opportunity to consent may be obtained retroactively in emergency situations. B or C above, we will ask for your written authorization before using or disclosing any of your PHI. If you choose to sign an authorization to disclose your PHI, you can later revoke that authorization in writing to stop any future uses and disclosures (to the extent that we haven't taken any action relying on the authorization). However, if the authorization was necessary to obtain insurance coverage, the insurer has the right to contest the claim if the authorization is revoked. III. What rights you have regarding your PHI A. The Right to Request Limits on Uses and Disclosures of Your PHI. You have the right to ask that we limit how we use and disclose your PHI. We will consider your request but are not legally required to accept it. If we accept your request, we will put any limits in writing and abide by them except in emergency situations. You may not limit the uses and disclosures that we are legally required or allowed to make. B. The Right to See and Get Copies of Your PHI. In most cases, you have the right to look at or get copies of your PHI that we have, but you must make the request in writing. If we don't have your PHI, but we know who does, we will tell you how to get it. In certain situations, we may deny your request. If we do, we will tell you, in writing, our reasons for the denial and explain your right to have the denial reviewed. C. The Right to Choose How We Send PHI to You. You have the right to ask that we send information to you at an alternative address, (for example: sending information to your work address rather than your home address), or by alternative means (for example, e-mail instead of regular mail.) We must agree to your request, without requiring an explanation fro you, so long as we can easily provide it in the format you requested. As a reminder, as indicated in the section B above, your request must be in writing. D. The Right to Get a List of the Disclosures we have Made. You have the right to get a list of instances in which we have disclosed your PHI in the last six (6) years prior to the date of your request. The list will not include uses or disclosures for treatment, payment, health care operations, requests by you the patient, your family, or for listing in our clinic directory. The list also won't include uses and disclosures made for national security purposes, to corrections or law enforcement personnel on or before June 30, 2006. E. The Right To Correct or Update Your PHI. If you believe that there is a mistake in your PHI or that a piece of important information is missing, you have the request that we correct or add the existing or missing information. You must provide the request in writing. Your written request must state the reason for your request. We will respond within 10 days of receiving your request. We may deny your request in writing if the PHI is (i) correct and complete, (ii) not created by us, (iii) not allowed to be disclosed, or (iv) not part of our records. If we deny your request, our written denial will state the reasons for the denial and explain your right to file a written statement of disagreement with the denial. If you don't file one, you have the right to request that your request and our denial be attached to all future disclosures of your PHI. If we approve your request to change your PHI, we will make the change to your PHI, tell you that we have done it, and tell others that need to know about the change to your PHI. IV. How to complain about our privacy practices. If you think that we have violated your privacy rights or you disagree with a decision we made about access to your PHI, you may file a complaint with the person listed in Section V below or to the Secretary of Health and Human Services. The complaint to the Secretary should be made within 180 days of when you knew or should have known that the act or omission complained of ocurred, unless this time limit is waived by the Secretary for the good cuase shown. Either complaint should name us and describe the acts or omissions belived to be in violation of the applicable requirements. We will take no retaliatory action against you if you file a complaint about our privacy practices. V. Person to contact for information about this notice or to complain about our privacy practices. If you have any questions about this notice or any complaints about our privacy practices, or would like to know how to file a complaint with the Secretary of the Department of Health and Human Services, please contact: Chief Executive Officer St. Anthony Medical Centers - Corporate Office 6368 Hollywood Blvd. Los Angeles, Calif. 90028-6320 PHONE:. 323.469.5555
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