Notice of Privacy Practices

This notice describes how medical information about you may be used and disclosed and how you can get access to your information. Please review it carefully. If you have any questions about this notice, please contact the Health Center director.

The Health Center is committed to protecting the confidentiality of your medical information. In conducting our business, we create a record of the care and services you receive at the Health Center. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to information and records regarding your health care maintained at the Health Center.

This notice will tell you about the ways in which we may use and disclose your medical information. It also describes your rights and certain obligations we have regarding the use and disclosure of your medical information. We are required by law to:

• make sure that your medical information is protected.
• give you this notice describing our legal duties and privacy practices with respect to medical information about you.
• follow the terms of the privacy notice that is currently in effect.

How the Health Center May Use and Disclose Your Medical Information

The following describes the different ways that we may use and disclose your medical information. Not every possible use or disclosure is specifically mentioned. However, all of the ways we are permitted to use and disclose your medical information will fall within one of these general categories:

For Treatment
We will use medical information about you to provide you with medical treatment and services. We may disclose medical information about you to doctors, nurses, technicians and other medical personnel who are involved in providing you medical treatment.

For Payment
We may use and disclose medical information about you so that the treatment and services you receive at the Health Center may be billed to and payment may be collected from you, an insurance company or a third party. For example, we may need to give your health plan information about treatment you received here so your health plan will pay us or reimburse you for the treatment. We may also tell your health plan about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment.

For Health Care Operations
We may use and disclose medical information about you for Health Center operations. These uses and disclosures are necessary to run the Health Center and make sure that our patients receive quality care. For example, we may use medical information to review our treatment and service and to evaluate the performance of our staff in caring for you, or to conduct cost-management and business planning activities for the Health Center. We may also disclose information to doctors, nurses, technicians and other medical personnel for review and learning purposes.

Appointment Reminders
We may use and disclose medical information to contact you as a reminder that you have an appointment for treatment or medical care at the Health Center.

Treatment Alternatives
We may use and disclose medical information to tell you about or recommend possible treatment options or alternatives that may be of interest to you.

Health-Related Benefits and Services
We may use and disclose information to tell you about health-related benefits or services that may be of interest to you.

To Individuals Involved in Your Care or Payment for Your Care
We may disclose medical information to a friend or family member that is involved in your care or helps pay for your care if we obtain your verbal agreement to do so or if we give you an opportunity to object to such a disclosure and you do not raise an objection. We may also disclose health information to your friends or family if we can infer from the circumstances, based on our professional judgment, that you would not object. For example, we may assume you agree to our disclosure of information to your spouse when you bring your spouse into the exam room during treatment or while treatment is being discussed. In a medical emergency we may, using our professional judgment, determine that a disclosure to your family or friend is in your best interest. For example, we may inform the person who accompanied you to the emergency room that you suffered a heart attack. In these situations we will disclose only health information relevant to the person’s involvement in your care.

Research
We may use and disclose medical information about you for research purposes. Any research projects conducted by the Health Center must be approved through an institutional review process to protect patient safety, welfare and confidentiality.

As Required by Law
We will disclose medical information about you when required to do so by federal, state, or local law. For example, disclosure may be required by public health statutes in connection with required reporting of certain diseases, adverse drug reactions, domestic violence, and injuries associated with violent crimes.

To Avert a Serious Threat to Health or Safety
We may use and disclose medical information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent or lessen the threat.

Workers’ Compensation
We may use or disclose medical information about you for Workers’ Compensation or similar programs as permitted or required by law.

Public Health Risks
We may disclose medical information about you for public health purposes, including the following:

• preventing or controlling disease, injury or disability
• reporting child abuse or neglect
• reporting adverse events related to food, medications or defects or problems with products
• notifying persons of recalls or replacements of products they may be using
• notifying a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition

Health Oversight Activities
We may disclose medical information to a governmental or other oversight agency for activities authorized by law. For example, disclosures of you medical information may be made in connection with audits, investigations, inspections and licensure renewals.

Lawsuits and Disputes
We may disclose medical information about you in response to a court or administrative order, or in response to a subpoena, discovery request, warrant, summons or other lawful process.

Law Enforcement
We may release medical information about you if required by law when asked to do so by a law enforcement official.

Coroners and Medical Examiners
We may release medical information to a coroner or medical examiner to identify a deceased person or determine the cause of death.

Military and Veterans
If you are a member of the armed forces, we may disclose medical information about you as required by military authorities.

Your Rights Regarding Your Medical Information

Your medical information is the property of the Health Center. You have the following rights, however, regarding the medical information we maintain about you:

Right to Inspect and Copy
You have the right to inspect and copy your medical information. To inspect and/or to receive a copy of your medical information, you may use our form or submit your request in writing to the Health Center Medical Records Department at the above address. If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies associated with your request. We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to your medical information, you may request that the denial be reviewed. For information regarding such a review contact the Health Center director.

Right to Request an Amendment or Addendum
If you feel that the medical information we have about you is incorrect or incomplete, you may ask us to amend the information or add an addendum. You have the right to request an amendment or addendum as long as the information is kept by the Health Center. To request an amendment, you may use our form. Your request must be made in writing and submitted to the Health Center Medical Records Department at the address listed at the bottom of this page.

You must provide a reason that supports your request for the amendment or addendum. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:

• was not created by the Health Center
• is not part of the health information kept by the Health Center
• is not part of the information which you would be permitted to inspect and copy
• is accurate and complete in our opinion

Right to an Accounting of Disclosures
You have the right to request an “accounting of disclosures.” This is a list of the disclosures the Health Center has made of your medical information for purposes other than treatment, payment, health care operations and disclosures made to you or requested by you. To request this accounting of disclosures, you may use our form or submit your request in writing to the Health Center Medical Records Department at the above address. Your request must state a time period that may not be longer than six years from the date of disclosure and may not include dates before April 14, 2003.

Right to Request Restrictions
You have the right to request a restriction or limitation on the use or disclosure we make of your medical information. We are not required to agree to your request for a restriction. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment. To request restrictions, you may use our form or you must make your request in writing to the Health Center Medical Records Department at the address listed at the bottom of this page. In your request you must tell us:

• what information you want to limit
• whether you want to limit our use, disclosure or both
• to whom you want the limits to apply

Right to Request Confidential Communications
You have the right to request that we communicate with you about medical matters in a certain manner. For example, you can ask that we only contact you at work or by mail. The Health Center will accommodate reasonable requests. To request confidential communications, you may use our form or make your request in writing to the Health Center Medical Records Department at the address listed at the bottom of this page.

Right to a Paper Copy of This Notice
You have the right to a paper copy of this notice. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice. You may obtain a copy of this notice at our Web site, www.nmu.edu/healthcenter/. To obtain a paper copy of this notice, contact the Health Center Medical Records Department at the address listed at the bottom of this page.

Right to File a Complaint
If you believe your privacy rights have been violated, you may file a complaint with the Health Center or with the Secretary of the Department of Health and Human Services. To file a complaint with the Health Center, contact the Health Center Director at the above address. All complaints must be submitted in writing. You will not be penalized for filing a complaint.

Right to Provide an Authorization for Other Uses and Disclosures
Other uses and disclosures of your medical information not covered by this Notice of Privacy Practices will be made only with your written authorization. If you provide us such an authorization in writing to use or disclose medical information about you, you may revoke that authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose medical information about you for the reasons covered by your written authorization.

Revisions to the Health Center’s Privacy Practices and This Notice

We reserve the right to change the Health Center’s privacy practices and this notice. Any revised notice will be effective for medical information we already have about you as well as any information we receive in the future. We will post a copy of any revised notice in the Health Center. In addition, each time you visit the Health Center you may request a copy of the current notice in effect.