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.
Purdue University’s Health Plans are legally required to protect the privacy of your health information and to provide you with a notice of privacy practices. This Notice applies to the following Purdue University Health Plans including but not limited to: Medical Benefits, Pharmacy Benefits, Vision Benefits, Health Care Flexible Spending Accounts, Employee Assistance Programs, Employee Wellness and WorkLife. It also applies to the following portions of the University that provide business support to Purdue’s Health Plans: E-Commerce & Credit Card Operations, Accounts Receivable, Central Files, Internal Audit, Business Services Computing, IPFW Information Technology Services, Calumet Computing Technology and Information Services, North Central Information Services, North Central Accounting, Information Technology at Purdue (partial), Public Records Office, Printing Services, Purdue’s School of Nursing Nursing Centers, OnePurdue Initiative, Pharmacy, Nursing and Health Sciences Technical Services and RCHE-Health Outcomes and Policy Research Center. The full list of covered entities at Purdue University may be found in the Notice of Privacy Practices at the following Web site: www.purdue.edu/hipaa. For convenience, the Health Plans and the associated business support groups listed here will be referred to in this Notice as “the Purdue Health Plans.”
This Notice describes how the Purdue Health
Plans may use and disclose your health and medical information
to provide benefits to you. It also describes some rights
you have regarding your health information. Health information
is information about you that is received, used or disclosed
by the Purdue Health Plans concerning your physical or mental
health, health care services provided to you, or your health
insurance benefits and payments. Protected health information
may contain information that identifies you, including your
name, address, and other identifying information.
We use and disclose health information
for many different reasons. However, the privacy of your
health information and your family’s medical information
is important to us, and we take steps to ensure and protect
the privacy of that health information, including protections
in how we use and store it. Only employees of the Purdue
Health Plans who need your health information to provide
you services or assist you with problems, may see or access
your health information. For some uses or disclosures, we
need your specific authorization. Below, we describe the
different categories of our uses and disclosures and give
you some examples of each category.
Mental health information, including psychological
or psychiatric treatment records, and information relating
to communicable diseases, including HIV records, are subject
to special protections under Indiana law. We will generally
only release such records or information with your written
authorization or with an appropriate court order. Alcohol
and drug abuse treatment information is also subject to
special protections under federal law. We will usually need
to get your written authorization or an appropriate court
order before we release this information. Except where there
are special protections under Indiana law or other federal
laws, we may use and disclose your health information without
your authorization for the following purposes:
For treatment. The Purdue Health Plans
do not provide health treatment, but we may assist your
health care providers determine which treatments or alternative
treatments may be covered under your health plan. For example,
we may notify your doctor about alternative drug therapies
that may be covered under your plan so your doctor can decide
the best treatment available to you.
To obtain payment for health insurance premiums
or benefits. We may use and disclose your health
information in order to bill and collect payment for health
insurance premiums and for reimbursement of health care
insurance benefits provided to you. For example, we may
provide portions of your health information to other health
insurance providers to obtain reimbursement for health care
insurance benefits we provide to you. We may also provide
your health information to our business associates, such
as billing companies, claims processing companies, third
party administrators of Purdue’s Health Plans, and
others that process our health care claims.
For health care operations. Your health
information may be used or disclosed for health care operations.
For example, we may use your health information in order
to review coverage for referrals or health treatment requested
by your doctor. We may also use your health information
for quality assessment and improvement, for fraud and abuse
detection and prevention, to evaluate health care provider
performance, and to evaluate the cost and quality of the
benefits provided to you and other members of the Purdue
Health Plans. We may also provide your health information
to our auditors, attorneys, consultants, and others in order
to make sure we’re complying with the laws that affect
us.
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 state or federal law requires that we report information
to government agencies and law enforcement personnel or
when ordered in a judicial or administrative proceeding.
Health promotion and disease prevention. We may use your health information to tell you about disease
prevention and health care, or to notify you about benefits
available to you. For example, we may send health care ideas
to you for things like women’s health, diabetes, asthma,
etc. We may also work with other agencies, health care providers,
and pharmaceutical companies to provide good health and
disease prevention programs.
Research purposes. In certain limited circumstances, we may provide health information in order to conduct research. Use of this information for research is subject to either a special approval process, or removal of information that may directly identify you. In most instances, we will require your written authorization prior to using or disclosing health information for research purposes.
Relatives and friends involved with your care or
with payment for your care. In limited cases, we
may provide health information to family members, or close
friends if the friend or family member is directly involved
with your care or with payment for your care, unless you
tell us not to. For example, we may provide information
to your spouse to assist with payment questions or the resolution
of claim related issues.
Member and Provider Claims Services. A
limited group of employees of Purdue are trained to answer
your calls and assist with your concerns or issues, and
this group of employees may need to review your health information
in order to assist you. The companies who help us administer
our health plans may also use your health information for
customer and member support and assistance. For example,
if you call us with a question about your health insurance
payments, we may review your health information in order
to answer your question.
Medical and Administrative Appeals. At
times, the Purdue Health Plans or its third party administrators
may make decisions about claims for services provided to
you. You or your provider may appeal these decisions. Your
health information may be used to make appeal decisions.
The information used could include parts of your health
record.
Appointment reminders and health-related benefits
or services. We may use health information to provide
appointment reminders or give you information about treatment
alternatives, or other health care services or benefits
we offer.
All other uses and disclosures require your prior
written authorization. In any other situation not
described above, we will ask for your written authorization
before using or disclosing any of your health information.
If you do sign an authorization to disclose your health
information, you can later revoke that authorization in
writing. This will stop any future uses and disclosures
to the extent that we have not taken any action relying
on the authorization.
RIGHTS YOU HAVE REGARDING YOUR
HEALTH INFORMATION
The Right to Request Limits on Uses and Disclosures
of Your Health Information. You have the right
to ask Purdue’s Health Plans to limit the use or disclosure
of your health information. We will consider your request
but we do not have to accept it. If we do, we will put any
limits in writing and abide by them except in emergency
situations where the information is needed. You may not
limit the uses and disclosures that we are legally required
to make.
The Right to Choose How We Send Health Information
to You. You have the right to ask that we send
your health information to you at an alternate address (for
example, sending information to your work address rather
than your home address) or by alternate means (for example,
by fax instead of regular mail). We must agree to your request
if we can easily provide it in the format you requested.
The Right to See and Get Copies of Your Health Information. In most cases, you have the right to look at or get copies
of your health information that we have, but you must make
the request in writing. If we do not have your health information
but we know who does, we will tell you how to get it. We
will respond to you within 30 days after receiving your
written request. 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. If you request copies of your health information,
we will charge you a reasonable fee as permitted by Indiana
law. Instead of providing the health information you requested,
we may provide you with a summary or explanation of the
health information. We will only do this if you agree to
receive information in that form and if you agree to pay
the cost in advance.
The Right to Get a List of Certain Disclosures We
Have Made. You have the right to request a list
of instances in which we have disclosed your health information.
The list will not include uses or disclosures made for treatment,
payment, and health care operation, or information given
to your family or friends with your permission or in your
presence without objection. It will also not include disclosures
made directly to you or when you have given us a written
authorization for the release of health information. The
list will also not include information released for national
security purposes or given to correctional institutions.
To obtain this list, you must make a request in writing
to the Privacy Officer identified above. The list we will
give you will include disclosures made in the last six years
unless you request a shorter time, but will not include
any disclosure which occurred before April 14, 2003. We
will provide the list to you at no charge, but if you make
more than one request in the same year, we will charge you
a reasonable fee for each additional request.
The Right to Amend or Update Your Health Information. If you believe that there is a mistake in your health information
or that a piece of important information is missing, you
have the right to request that we amend the existing information.
You must provide the request and your reason for the request
in writing to the Privacy Officer identified above. We may
deny your request in writing if the health information is:
1) correct and complete; 2) not created by us; 3) not allowed
to be disclosed, or 4) not part of our records. 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 do not file a statement of disagreement,
you have the right to ask that your request and our denial
be attached to all future disclosures of your health information.
If we approve your request, we will make the change to your
health information, tell you that we have done it, and tell
others that need to know about the change to your health
information.
The Right to Get This Notice by E-Mail. You have the right to get a copy of this Notice by e-mail.
Even if you have agreed to receive Notice via e-mail, you
also have the right to request a paper copy of this notice.
