This notice contains important information about NewYork-Presbyterian/Hudson Valley Hospital’s privacy practices which were revised pursuant to the Health Insurance Portability and Accountability Act of 1996 and related regulations. This notice describes how medical information about you may be used and disclosed, and indicates how you can get access to this information. Please review it carefully.
If you have any questions about this notice, please contact our Privacy Officer or Hospital Administration at (914) 734-3200.
Our hospital is dedicated to maintaining the privacy of your medical information. In conducting our business, we will create records regarding the treatment and services we provide to you.
These records are our property. However, we are required by law:
This notice provides you with the following important information:
Changes To This Notice
The terms of this notice apply to all records containing your medical information that are created or retained by us. We reserve the right to revise, change, or amend our notice of privacy practices. Any revision or amendment to this notice will be effective for all of the information that we already have about you, as well as any of your medical information that we may receive, create, or maintain in the future. Our organization will make a "good faith" effort to document that we provided our patients with a copy of this organization’s NPP, and you may request a copy of our most current notice during any visit to our organization.
You have the following rights regarding the medical information that we maintain about you:
When requested in writing, you have the right to request a restriction in our use or disclosure of your medical information for treatment, payment or health care operations. Additionally, you have the right to request that we limit our disclosure of your medical information to individuals involved in your care or the payment for your care, such as family members and friends.
We are not required to agree to your request; however, if we do agree, we are bound by our agreement except when otherwise required by law, in emergencies, or when the information is necessary to treat you. In order to request a restriction in our use or disclosure of your medical information, you must make your request in writing to the Assistant to the President, at (914) 734-3929. Your request must describe in a clear and concise fashion: (i) the information you wish restricted; (ii) whether you are requesting to limit our use, disclosure or both; and (iii) to whom you want the limits to apply.
You have the right to request that our organization communicate with you about your health and related issues in a particular manner, or at a certain location. For instance, you may ask that we contact you by mail, rather than by telephone, or at home, rather than work.
In order to request a type of confidential communication, you must make a written request to the Assistant to the President specifying the requested method of contact, or the location where you wish to be contacted. Our organization will accommodate reasonable requests. You do not need to give a reason for your request.
Inspection and Copies
You have the right to inspect and obtain a copy of the medical information that may be used to make decisions about you, including patient medical records and billing records, but not including psychotherapy notes. You must submit your request in writing to the Assistant to the President, in order to inspect and/or obtain a copy of your medical information. Our organization may charge a fee for the costs of copying, mailing, labor and supplies associated with your request. In accordance with law and in our best judgment, we may deny your request to inspect and/or copy your medical information in certain limited circumstances; however, you may request a review of our denial. Reviews will be conducted not by the person that denied your request, but by another licensed health care professional chosen by us.
You may ask us to amend your medical information if you believe it is incorrect or incomplete, and you may request an amendment for as long as the information is kept by or for our organization. To request an amendment, your request must be made in writing and submitted to Assistant to the President. You must provide us with a reason that supports your request for amendment.
Our organization may deny your request if you fail to submit your request and the reason supporting your request in writing. Also, we may deny your request if the amendment would violate any law or statute or if you ask us to amend information that is:
Accurate and complete
Not part of the medical information kept by or for the organization
Not part of the medical information which you would be permitted to inspect and copy
Not created by our organization unless the individual or entity that created the information is not available to amend the information.
Accounting of Disclosures
An accounting of disclosures is a list of certain disclosures our organization has made of your medical information that you did not specifically authorize. You have the right to request a copy of our accounting of disclosures for your medical information; in order to obtain an accounting of disclosures, you must submit your request in writing to the Director of Health Information Systems Department (Medical Records). All requests for an accounting of disclosures must state a time period that may not be longer than six years and may not include dates before April 14, 2003. The first list you request within a 12-month period is free of charge. Our organization may charge you for additional lists within the same 12-month period. Our organization will notify you of the costs involved with additional requests, and you may withdraw your request before you incur any costs. No accounting of disclosures is made when you request release of PHI.
Right to a Paper Copy of This Notice
Upon request you are entitled to receive a paper copy of our Notice of Privacy Practices. You may ask us to give you a copy of this notice at any time. To obtain a paper copy of this notice, contact the Manager of Admitting/Registration, Assistant to the President or any member of our admitting department.
Right to File a Complaint
If you believe your privacy rights have been violated, you may file a complaint with our organization. To file a complaint with our organization, contact the Privacy Officer at NewYork-Presbyterian/Hudson Valley Hospital, 1980 Crompond Road, Cortlandt Manor, NY 10567. All complaints must be submitted in writing, provide the name the organization that is the subject of the complaint, and describe the acts or omissions believed to violate applicable law. The complaint must be filed within 180 days of the referenced violation in general. You will not be penalized for filing a complaint.
Right to Provide an Authorization for Other Uses and Disclosures
Our organization shall make a good faith effort to obtain your written authorization for uses and disclosures that are not identified by this notice or are not permitted by applicable law. Any authorization you provide to us regarding the use and disclosure of your medical information may be revoked at any time in writing by sending a written, signed and dated request to Director of Health Information Services. After you revoke your authorization, we will no longer use or disclose your medical information for the reasons described in the authorization. Of course, we are unable to take back any disclosures that we have already made with your permission. Please note that we are required to retain records of your care.
As required of us by law, please sign the attached form acknowledging simply that you have received a copy of the Notice of Privacy Provisions.
The following categories describe the different ways in which we may use and disclose your medical information or Protected Health Information (PHI). Please note that each particular use or disclosure is not necessarily listed below. However, the different ways we are permitted to use and disclose your medical information do fall within one of the listed categories.
Our organization may use and disclose your medical information to treat you. Many of the people who work for our organization may use or disclose your medical information in order to treat you or to assist others in your treatment. Additionally, we may disclose your medical information to others who may assist in your care, such as your physician and other health care professionals, your spouse, children or parents. For example, a lab tech may need your health information in analyzing a blood test for you.
Our organization may use and disclose your medical information in order to bill and collect payment for the services and items you may receive from us. For example, we may contact your health insurer to certify that you are eligible for benefits (and for what range of benefits), and we may provide your insurer with details regarding your treatment to determine if your insurer will cover, or pay for, your treatment. We also may use and disclose your medical information to obtain payment from other third parties who may be responsible for such costs, such as family members. Also, we may use your medical information to bill you directly for services and items under applicable law.
Health Care Operations
Our organization may use and disclose your medical information to operate our business. These uses and disclosures are important to provide that you receive quality care and that our organization is well run. As examples of the ways in which we may use and disclose your information for our operations, our organization may use your medical information to evaluate the quality of care you received from us or to conduct cost-management and business planning activities for our organization. Further, we may disclose your information to doctors, nurses, medical students, student interns, and other personnel for review and learning purposes. We will make every reasonable effort to restrict access to PHI to those health care providers who need it to provide products or services to you. We maintain physical, electronic, and procedural safeguards to protect PHI against unauthorized access and use.
We have appointed a Privacy Officer, the Assistant to the President, and we have training programs for our medical staff and employees regarding our policies and procedures to implement and enforce the safeguarding of PHI.
Our organization may use and disclose your medical information to remind you that you have an appointment.
We shall only disclose PHI as permitted by law or with your consent. In addition, we shall make every effort to prevent unintentional disclosure although the regulations consider such disclosure legal. When necessary for your care or treatment, our operations and related activities, we use PHI internally and may disclose such information to other healthcare providers such as doctors, dentists, other hospitals, nursing homes or other covered healthcare providers, insurers, third party administrators, payors and others who may be financially responsible for payment for the services and benefits you receive, vendors, consultants, government authorities, other surveying entities and their respective agents. These parties are required to keep PHI confidential, as provided by law. Here are some examples of what we do with the information we collect and the reasons:
In addition, we may disclose PHI to affiliated entities or nonaffiliated third parties as otherwise permitted by law. For other purposes, we seek special consents before disclosing the information. In the event that a special consent is required but the member in question is unable to give the consent (for example, if the member is medically unable to give consent), we accept consent from any person legally authorized to give consent on behalf of the member.
Patients may request in writing that their PHI be disclosed to a third party. For example, you may wish to have your records available for a friend, neighbor, or family member to help resolve a question about a claim or other concern you have. Please sign the authorization form available in the Admitting or Emergency Departments.
Treatment Alternatives/Health-Related Benefits and Services
Our organization may use and disclose your medical information to inform you of treatment alternatives and/or health-related benefits and services that may be of interest to you.
In the course of fundraising activities, we shall use or disclose only (i) demographic information relating to you (such as your name, address, and phone number). No other physical health information shall be released.
Should you not wish to be contacted regarding fundraising activities, please contact the Eecutive Director of the Foundation at (914) 734-3755.
With the exception of your treatment, case management, or disease management activities, we will obtain your individual authorization to use your medical information to make a marketing communication to you that (i) occurs in a face-to-face encounter with you; (ii) concerns products or services of nominal value; or (iii) concerns our health-related products or services, or those of another party, provided that we tell you that we are the party communicating with you, and provided that we tell you if we have received, or will receive, directly or indirectly, any money or other remuneration for making the communication to you. We will not sell listings of patients to third parties or disclose PHI to a third party for marketing activities of third party without your authorization If you do not want to receive marketing communications (other than those that are in a newsletter or other general communication device), please contact VP of Marketing at (914) 734-3576.
In addition, if we ever use or disclose your medical information to communicate with you based on your particular health status or condition, we will explain to you why you received the communication, and how the product or service relates to your health.
We may include certain limited information about you in our facility directory while you are a patient. This information may include your name, hospital location, your general condition and your religious affiliation. The directory information, except for your religious affiliation, may also be released to people who ask for you by name including the press. Your religious affiliation may be given to a member of the clergy even if they do not ask for you by name. If you do not want your information included in our directory, upon your admission you should inform the registrar or the Manager of Admitting at 734-3643.
The Following Categories Describe Additional Conditions in Which We May Use or Disclose Your Medical Information:
We will use or disclose medical information about you when required by applicable law.
Public Health Activities
Our organization may disclose your medical information for public health activities, including generally:
We may disclose your medical information to a government authority if we believe you are a victim of abuse, neglect, or domestic violence. If we make such a disclosure, we will inform you of it, unless we think that informing you places you at risk of serious harm or, if we were to inform your personal representative, is otherwise not in your best interest.
Health Oversight Activities
Our organization may disclose your medical information to a health oversight agency for activities authorized by law. Oversight activities can include, for example, investigations, inspections, audits, surveys, licensure and disciplinary actions; civil, administrative, and criminal procedures or actions; or other activities necessary for the government to monitor government programs, compliance with civil rights laws, and the health care system in general.
Lawsuits and Similar Proceedings
Our organization may use and disclose your medical information in response to a court or administrative order, if you are involved in a lawsuit or similar proceeding. We also may disclose your medical information in response to a discovery request, subpoena, or other lawful process by another party involved in the dispute, but only if we have made an effort to inform you of the request or to obtain an order protecting the information the party has requested.
We may release medical information if asked to do so by law enforcement officials:
Coroners, Medical Examiners, and Funeral Directors
Our organization may release medical information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or to determine the cause of death. We may also release medical information about our patients to funeral directors as necessary to carry out their duties.
Organ and Tissue Donation
We may use or disclose your medical information to organizations that handle organ and tissue procurement, banking, or transplantation.
We will obtain your authorization to use or disclose PHI for research purposes. You shall have the right, with certain exceptions, to revoke your authorization and prevent further use and disclosure of your health information. An example of an exception would be reporting adverse effects of a product. A written request should be sent to the Privacy Officer at NewYork-Presbyterian/Hudson Valley Hospital, 1980 Crompond Road, Cortlandt Manor, NY 10567 should you wish to revoke your authorization to allow the use or disclosure of PHI for research purposes.
Serious Threats to Health or Safety
Our organization may use and disclose your medical information when necessary to reduce or prevent a serious threat to your health and safety or the health and safety of another individual or the public. Under these circumstances, we will only make disclosures to a person or organization able to help prevent the threat.
Specialized Government Functions
Our organization may disclose your medical information if you are a member of U.S. or foreign military forces (including veterans) and if required by the appropriate military command authorities. In addition, our organization may disclose your medical information to federal and/or state and/or local officials for intelligence and national security activities authorized by law. We also may disclose your medical information to federal officials in order to protect the President, other officials or foreign heads of state, or to conduct investigations.
Furthermore, our organization may disclose your medical information to correctional institutions or law enforcement officials if you are an inmate or under the custody of a law enforcement official. Disclosure for these purposes would be necessary: (i) for the institution to provide health care services to you, (ii) for the safety and security of the institution, and/or (iii) to protect your health and safety or the health and safety of other individuals.
Workers’ Compensation or Disability Claims
Our organization may release your medical information for workers’ compensation and disability claims and similar programs to appropriate agencies.
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Effective April 14, 2003 - 1
Revised December 5, 2006