PATIENT PRIVACY, RIGHTS & RESPONSIBILITIES
The Health Insurance Portability and Accountability Act (HIPAA) of 1996 mandated changes in federal regulations governing the provision of health benefits, delivery and payment of healthcare services, and security and confidentiality of patient health information. The federal Department of Health and Human Services (DHHS) oversees the implementation of these regulations, including rules regarding patient privacy that were effective April 14, 2003.
Patient Rights and Responsibilities
Medical information about the patient may be used and disclosed by the Borrego Health and the Borrego Health Specialty Care Center. The patient will also have rights and responsibilities as to how to access this information.
Borrego Health Specialty Care Center protects medical information about the patient, creating a record of the care and services the patient receives.
Borrego Health Specialty Care Center is required by law to make sure medical information is protected. The clinic must also give notice describing legal duties and privacy practices with respect to medical information about the patient.
Borrego Health Specialty Care Center may use medical information about the patient to provide medical treatment or services, including the cases described below.
1. Disclosure of medical information about the patient may be given to doctors and other healthcare personnel who are involved in taking care of the patient. We may also share medical information about the patient with other Borrego Health personnel or non-Borrego Health Specialty Care Center providers, agencies or facilities in order to provide or coordinate the different types of care the patient may need.
2. Disclosure of medical information about the patient for treatment and services the patient receives at Borrego Health Specialty Care Center may be billed to and payment may be collected from the patient, an insurance company or a third party. Borrego Health Specialty Care Center may also disclose the patient’s health plan about a proposed treatment to secure approval for the plan.
3. Disclosure of medical information about the patient may occur for Borrego Health Specialty Care Center’s and Borrego Health’s operations. Medical information may also be used or disclosed to comply with law and regulation, for contractual obligations, patients' claims, grievances or lawsuits, health care contracting, legal services, business planning and development, business management and administration, performance improvement and educational purposes, underwriting and other insurance activities and to operate the health system.
4. Borrego Health Specialty Care Center may contact the patient to remind him or her of appointments at our facilities; recommend possible treatment options or alternatives that may be interesting to the patient; contact the patient about benefits or services that Borrego Health Specialty Care Center provides; provide information about Borrego Health Specialty Care Center sponsored activities, including fundraising programs and events; inquire if the patient wants to be part of a media or news story; or to release medical information to anyone involved in the patient’s medical care or medical payments.
5. Disclosure of medical information about the patient may be granted to an entity assisting in a disaster relief effort so that the patient’s family can be notified about their condition, status, and location.
6. Research projects conducted by Borrego Health Specialty Care Center must be approved by the Director of Research to protect patient safety, welfare and confidentiality. Borrego Health Specialty Care Center may use and disclose pertinent medical information for research purposes, subject to the confidentiality provisions of state and federal law. Enrollment in studies can only occur after the patient has been informed about the study, had an opportunity to ask questions, and indicated a willingness to participate by signing a consent form. The patient’s medical information will continue to be protected.
7. Borrego Health Specialty Care Center will disclose medical information about the patient when required to do so by federal or state law.
8. Borrego Health Specialty Care Center may use and disclose medical information about the patient when necessary to prevent or lessen a serious and imminent threat to the health and safety of the patient or the health and safety of the public or another person.
9. Borrego Health Specialty Care Center may use or disclose medical information about the patient for workers' compensation or similar programs as authorized or required by law.
10. Borrego Health Specialty Care Center may disclose medical information about the patient for public health purposes, such as (but not limited to) the following: prevention and/or disease control, injury or disability; report of vital events; report of child abuse or neglect; notification to a person who may have been exposed to a disease or may be at risk of contracting or spreading a disease or condition; or legally required notification to the appropriate government authority if believed that the patient has been the victim of abuse, neglect or domestic violence.
11. Disclosure of medical information may be given to governmental, licensing, auditing, and accrediting agencies as authorized or required by law; to courts, attorneys and court employees in the course of conservatorship and certain other judicial or administrative proceedings, when required by law; or in response to a court or administrative order, a subpoena, discovery request, warrant, summons or other lawful process, when required by law.
12. When legally necessary, Borrego Health Specialty Care Center may disclose medical information to law enforcement for these reasons: to identify or locate a suspect, fugitive, material witness, or missing person; to provide information about a suspected victim of a crime if, under certain limited circumstances, we are unable to obtain the person's agreement; about a death suspected to be the result of criminal conduct; about criminal conduct at Borrego Health Specialty Care Center; or in the case of a medical emergency to report a crime, the location of the crime or victims, or the identity, description or location of the person who committed the crime.
13. Borrego Health Specialty Care Center may disclose medical information to a coroner or medical examiner. The clinic may also disclose medical information about patients to funeral directors as necessary to carry out their duties.
14. As authorized or required by law, Borrego Health Specialty Care Center may disclose medical information about the patient to authorized federal officials for intelligence, counterintelligence, and other national security activities; so they may conduct special investigations or provide protection to the President, other authorized persons or foreign heads of state; or to a correctional institution or law enforcement officials, if the patient is an inmate.
15. Furthermore, Borrego Health Specialty Care Center and Borrego Health reserve the right to ask permission to disclose medical information in ways that have not been covered above, always preserving HIPAA abiding rules. Borrego Health Specialty Care Center obeys all applicable state and federal laws related to the protection of this information.
The patient has rights regarding medical information Borrego Health Specialty Care Center maintains under its ownership.
The patient has the right to do the following:
1. Inspect and/or receive copies of medical information, with certain limitations;
2. Amend the information or add an addendum, if he or she proves that the information is wrong or incomplete;
3. Request a restriction or limitation on the medical information Borrego Health Specialty Care Center uses or discloses about the patient for treatment, payment or health care operations.
4. Request a limit on the medical information Borrego Health Specialty Care Center discloses about the patient to a family member, spouse, partner, or friend, regardless of his or her connections to the patient;
5. Request confidential communications regarding the patient’s medical records in a certain way or at a certain location.