Gwinnett Hospital System Notice of Privacy Practices
This notice describes how medical information about you may be used and disclosed and how you can get access tot his information. Please review it carefully.
For the purposes of this Notice of Privacy Practices (“Notice”), Gwinnett Hospital System, Inc. (The “Hospital”) and the physicians and other health care providers who are members of the Hospital’s medical staff (the “Medical Staff”) work together in an organized health care arrangement to provide medical services to you when you are a patient in one of the Hospital’s inpatient facilities (including Gwinnett Medical Center, Gwinnett Medical Center – Duluth, and SummitRidge) or outpatient diagnostic and treatment facilities or clinics. However, physicians and other health care providers who are members of the Medical Staff are engaged in the independent practice of medicine and are not employees or agents of the Hospital. The Hospital and the Medical Staff are referred to collectively in this Notice as “GHS.” As health care providers, the GHS providers use confidential personal health information about patients, referred to below as protected health information (“PHI”). GHS protects the privacy of this information, and it is also protected from disclosure by state and federal law. In certain specific circumstances, pursuant to this Notice, patient authorization or applicable laws and regulations, PHI can be used by GHS or disclosed to other parties. Below are categories describing these uses and disclosures, along with some examples to help you better understand each category.
Uses and Disclosures for Treatment, Payment and Health Care Operations. GHS may use or disclose your PHI for the purposes of treatment, payment and health care operations, described in more detail below, without obtaining written authorization from you. In addition, the GHS providers may share your PHI as necessary to carry out its treatment, payment and health care operations related to the organized health care arrangement.
For Treatment. GHS may use and disclose PHI in the course of providing, coordinating, or managing your medical treatment, including the disclosure of PHI for treatment activities of another health care provider. These types of uses and disclosures may take place between physicians, nurses, technicians, students, and other health care professionals who provide you health care services or are otherwise involved in your care. For example, if you are being treated by a primary care physician, that physician may need to use/disclose PHI to a specialist physician whom he or she consults regarding your condition, or to a nurse who is assisting in your care.
For Payment. GHS may use and disclose PHI in order to bill and collect payment for the health care services provided to you. For example, GHS may need to give PHI to your health plan in order to be reimbursed for the services provided to you. GHS may also disclose PHI to its business associates, such as billing companies, claims processing companies, and others that assist in processing health claims. GHS may also disclose PHI to other health care providers and health plans for the payment activities of such providers or health plans.
For Health Care Operations. GHS may use and disclose PHI as part of its operations, including for quality assessment and improvement, such as evaluating the treatment and services you receive and the performance of its staff in caring for you, provider training, underwriting activities, compliance and risk management activities, planning and development, and management and administration. GHS may disclose PHI to doctors, nurses, technicians, students, attorneys, consultants, accountants, and others for review and learning purposes, to help make sure GHS is complying with all applicable laws, and to help GHS continue to provide health care to its patients at a high level of quality. GHS may also disclose PHI to other health care providers and health plans for such entity’s quality assessment and improvement activities, credentialing and peer review activities, and health care fraud and abuse detection or compliance, provided that such entity has, or has had in the past, a relationship with the patient who is the subject of the information.
Sharing of PHI Among the Hospital and the Medical Staff. As an organized health care arrangement, the Hospital and the members of the Medical Staff will share with each other PHI that they collect from you as necessary to carry out their treatment, payment and health care operations relating to the provision of care to patients by GHS.
Other Uses and Disclosures For Which Authorization is Not Required. In addition to using or disclosing PHI for treatment, payment and health care operations, GHS may use and disclose PHI without your written authorization under the following circumstances:
As Required by Law and Law Enforcement. GHS may use or disclose PHI when required to do so by applicable law. GHS also may disclose PHI when ordered to do so in a judicial or administrative proceeding, to identify or locate a suspect, fugitive, material witness, or missing person, when dealing with gunshot and other wounds, about criminal conduct, to report a crime, the location of the crime or victims, or the identity, description, or location of a person who committed a crime, to report a death or injury resulting from a boating accident, or for other law enforcement purposes.
For Public Health Activities and Public Health Risks. GHS may disclose PHI to government officials in charge of collecting information about births and deaths, preventing and controlling disease, reports of child abuse or neglect and of other victims of abuse, neglect, or domestic violence, reactions to medications or product defects or problems, or to notify a person who may have been exposed to a communicable disease or may be at risk of contracting or spreading a disease or condition.
For Health Oversight Activities. GHS may disclose PHI to the government for oversight activities authorized by law, such as audits, investigations, inspections, licensure or disciplinary actions, and other proceedings, actions or activities necessary for monitoring the health care system, government programs, and compliance with civil rights laws.
Coroners, Medical Examiners, and Funeral Directors. GHS may disclose PHI to coroners, medical examiners, and funeral directors for the purpose of identifying a decedent, determining a cause of death, or otherwise as necessary to enable these parties to carry out their duties consistent with applicable law.
Organ, Eye, and Tissue Donation. GHS may release PHI to organ procurement organizations to
facilitate organ, eye, and tissue donation and transplantation.
Research. Under certain circumstances, GHS may use and disclose PHI for medical research purposes.
To Avoid a Serious Threat to Health or Safety. GHS may use and disclose PHI, to law enforcement personnel or other appropriate persons, to prevent or lessen a serious threat to the health or safety of a person or the public.
Specialized Government Functions. GHS may use and disclose PHI of military personnel and veterans under certain circumstances. GHS may also disclose PHI to authorized federal officials for intelligence, counterintelligence, and other national security activities, and for the provision of protective services to the President or other authorized persons or foreign heads of state or to conduct special investigations.
Workers’ Compensation. GHS may disclose PHI to comply with workers’ compensation or other similar laws. These programs provide benefits for work-related injuries or illnesses.
Fundraising Activities. Your PHI may be used to contact you in an effort to raise money for the Hospital. Your PHI may be disclosed to a foundation related to the Hospital. Such disclosure would be limited to contact information, such as your name, address and phone number and the dates you required treatment or services at the Hospital. The money raised in connection with these activities would be used to expand and support the Hospital’s provision of health care and related services to the community. If you do not want to be contacted as part of these fundraising activities, please notify the Gwinnett Hospital System Foundation in writing.
Appointment Reminders; Health-related Benefits and Services; Marketing. GHS may use and disclose your PHI to contact you and remind you of an appointment at GHS, or to inform you of treatment alternatives or other health-related benefits and services that may be of interest to you, such as disease management programs. GHS may use and disclose your PHI to encourage you to purchase or use a product or service through a face-to-face communication or by giving you a promotional gift of nominal value.
Disclosures to You or for HIPAA Compliance Investigations. GHS may disclose your PHI to you or to your personal representative, and is required to do so in certain circumstances described below in connection with your rights of access to your PHI and to an accounting of certain disclosures of your PHI. GHS must disclose your PHI to the Secretary of the United States Department of Health and Human Services (the “Secretary”) when requested by the Secretary in order to investigate GHS’ compliance with privacy regulations issued under the federal Health Insurance Portability and Accountability Act of 1996 (“HIPAA”).
Uses and Disclosures To Which You Have an Opportunity to Object. You will have the opportunity to object to these categories of uses and disclosures of PHI that GHS may make:
Patient Directories. Unless you object, GHS may use some of your PHI to maintain a directory of individuals in its facility. This information may include your name, your location in the facility, your general condition (e.g. fair, stable, etc.), and your religious affiliation, and the information may be disclosed to members of the clergy. Except for your religious affiliation, the information may be disclosed to other persons who ask for you by name.
Disclosures to Individuals Involved in Your Health Care or Payment for Your Health Care. Unless you object, GHS may disclose your PHI to a family member, other relative, friend, or other person you identify as involved in your health care or payment for your health care. GHS may also notify those people about your location or condition.
Other Uses and Disclosures of PHI For Which Authorization is Required. Other types of uses and disclosures of your PHI not described above will be made only with your written authorization, which with some limitations you have the right to revoke in writing.
Regulatory Requirements. GHS is required by law to maintain the privacy of your PHI, to provide individuals with notice of its legal duties and privacy practices with respect to PHI, and to abide by the terms described in this Notice. GHS reserves the right to change the terms of this Notice and of its privacy policies, and to make the new terms applicable to all of the PHI it maintains. Before GHS makes an important change to its privacy policies, it will promptly revise this Notice and post a new Notice in all patient entry locations. You have the following rights regarding your PHI:
You may request that GHS restrict the use and disclosure of your PHI. GHS is not required to agree to any restrictions you request, but if GHS does so it will be bound by the restrictions to which it agrees except in emergency situations.
You have the right to request that communications of PHI to you from GHS be made by particular means or at particular locations. For instance, you might request that communications be made at your work address, or by e-mail rather than regular mail. Your requests must be made in writing and sent to the Privacy Officer. GHS will accommodate your reasonable requests without requiring you to provide a reason for your request.
Generally, you have the right to inspect and copy your PHI that GHS maintains, provided that you make your request in writing to the Hospital’s Department of Medical Records. Within thirty (30) days of receiving your request (unless extended by an additional thirty (30) days), GHS will inform you of the extent to which your request has or has not been granted. In some cases, GHS may provide you a summary of the PHI you request if you agree in advance to such a summary and any associated fees. If you request copies of your PHI or agree to a summary of your PHI, GHS may impose a reasonable fee to cover copying, postage, and related costs. If GHS denies access to your PHI, it will explain the basis for denial and your opportunity to have your request and the denial reviewed by a licensed health care professional (who was not involved in the initial denial decision) designated as a reviewing official. If GHS does not maintain the PHI you request, if it knows where that PHI is located it will tell you how to redirect your request.
If you believe that your PHI maintained by GHS contains an error or needs to be updated, you have the right to request that GHS correct or supplement your PHI. Your request must be made in writing to the Hospital’s Department of Medical Records, and it must explain why you are requesting an amendment to your PHI. Within sixty (60) days of receiving your request (unless extended by an additional thirty (30) days), GHS will inform you of the extent to which your request has or has not been granted. GHS generally can deny your request if your request relates to PHI: (i) not created by GHS; (ii) that is not part of the records GHS maintains; (iii) that is not subject to being inspected by you; or (iv) that is accurate and complete. If your request is denied, GHS will provide you a written denial that explains the reason for the denial and your rights to: (i) file a statement disagreeing with the denial; (ii) if you do not file a statement of disagreement, submit a request that any future disclosures of the relevant PHI be made with a copy of your request and GHS’s denial attached; and (iii) complain about the denial. You generally have the right to request and receive a list of the disclosures of your PHI that GHS has made at any time during the six (6) years prior to the date of your request (provided that such a list would not include disclosures made prior to April 14, 2003). The list will not include disclosure for which you have provided a written authorization, and does not include certain uses and disclosures to which this Notice already applies, such as those: (i) for treatment, payment, and health care operations; (ii) made to you; (iii) for the Hospital’s patient directory or to persons involved in your health care; (iv) for national security or intelligence purposes; or (v) to correctional institutions or law enforcement officials. You should submit any such request to the Hospital’s Department of Medical Records, and within sixty (60) days of receiving your request (unless extended by an additional thirty (30) days), GHS will respond to you regarding the status of your request. GHS will provide the list to you at no charge, but if you make more than one request in a year you may be charged a fee for each additional request. You have the right to receive a paper copy of this Notice upon request, even if you have agreed to receive this Notice electronically. You can receive a copy of this Notice at our Web site, http://www.gwinnetthealth.org. To obtain a paper copy of this Notice, please contact the GHS Privacy Officer.
You may complain to GHS if you believe your privacy rights with respect to your PHI have been violated by contacting a Hospital Patient Representative or the GHS Privacy Officer and submitting a written complaint. GHS will in no manner penalize you or retaliate against you for filing a complaint regarding GHS’ privacy practices. You also have the right to file a complaint with the Secretary of the Department of Health and Human Services.
If you have any questions about this Notice, please contact the GHS Privacy Officer by mail at 1000 Medical Center Boulevard, Lawrenceville, Georgia 30045, by telephone at (678) 312-3900 or by email at ghsprivacyofficer@gwinnettmedicalcenter.org.
If you have any questions about your medical records, please contact the Medical Records Department by mail at 1000 Medical Center Boulevard, attn Medical Records, Lawrenceville, GA 30045, or by telephone at (678)-312-4490.
Effective Date: April 14, 2003.
*2-18967*FORM 2-18967 REV. 06/2007