HIPAA Privacy Notice

DELAWARE DIVISION OF MEDICAID & MEDICAL ASSISTANCE

HIPAA PRIVACY NOTICE

Effective Date: April 14, 2003

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.

PROMISES TO YOU

• The Delaware Division of Medicaid & Medical Assistance (DMMA) cares about your privacy. Information we collect about you is private. According to federal law, we must give you a notice of our privacy practices. Only people who have the need and legal right may see your information. We will only give your information for purposes of treatment, payment, business operations or when we must by law. We will only share your information with others if you give us written permission.

HEALTH INFORMATION RIGHTS

• Your Right to Inspect and Copy: In most cases, you have the right to look at and get copies of your records. You may be charged a fee for the cost of copying your records.
• Your Right to Amend: You may ask us to change your records if you feel that there is a mistake. We can deny your request for certain reasons. We must give you a written reason for our denial.
• Your Right to a List of Disclosures: You have the right to ask for a list of who has been given your records after April 14, 2003. This list will not include the times that information was shared for treatment, payment, or health care operations. The list will not include information provided directly to you or your family. The list will not include information that was sent with your consent.
• Your Right to Request Restrictions: You have the right to ask for limits on how your information is used or shared. We are not required to agree to such requests.
• Your Right to Request Confidential Communication: You have the right to ask that we share information with you in a certain way or in a certain place. For example, you can ask that we only contact you at work or by email.
• Your Right to a Paper Copy of this Notice: You have the right to ask for a paper copy of this notice. You may also get a copy of this notice at our website at www.delaware.gov/dhss/dmma/hipaanotice.html

YOU DO NOT HAVE TO DO ANYTHING. THIS NOTICE IS JUST FOR YOUR INFORMATION.

To use these rights, a request for inspecting, copying, amending, making restrictions, or obtaining an accounting of your health information must be made in writing to the: Division of Medicaid & Medical Assistance. For more information, please contact DMMA Customer Service. You may be asked to pay for copies.

Your health information may be used and given by DMMA for treatment, payment and operational needs. We have listed some allowed uses and releases.

• For Treatment: We may share information about you to help you get health care. For example, we may tell your doctor about care you get in an emergency room.
• For Payment: We may use and share information so the care you get can be billed and paid for. For example, we may ask an emergency room before we pay the bill for your care.
• For Business Operations: We may need to use and share information for our business operations. For example, we may use information to review the quality of the care you get.
• Exceptions. For certain kinds of records, your permission may be needed even for release for treatment, payment, or business operations.
• As Required By Law. We will share information when we are required by law to do so. Examples of such release would be law enforcement or in response to a court order or subpoena. We may also share information to prevent a serious threat to health, safety or other emergencies. We may also share information to allow government agencies to review our activities.
• With your Permission. If you give us permission in writing, we may use and share your information. If you give us permission, you have the right to change your mind and take it back. This must be in writing too. We can not take back any uses already made with your permission.

DMMA has the right to change this notice. A changed notice will be for information we already have as well as information we get in the future. We must follow whatever notice is currently in effect. We will send a new notice to you if the change we make is important. We will also post a copy of the current notice on our website at www.delaware.gov/dhss/dmma/hipaanotice.html

If you believe your privacy rights have been violated, you may file a complaint by writing to Region III, Office for Civil Rights, U.S. Department of Health and Human Services, 150 S. Independence Mall West, Suite 372, Public Ledger Building, Philadelphia, PA 19106-3499.
Main Line (215) 861-4441.
Hotline (800) 368-1019.
FAX (215) 861-4431.
TDD (215) 861-4440.

You will not be penalized for filing a complaint with the federal government.

Si necesita esta noticia en Espanol favor de llamar 1-800-372-2022.