HealthNet, Inc.
HIPAA Notice of Privacy Practices
Effective Date: 4/14/2003
Revision Date: 7/1/2017
Reviewed: 2/2020

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.

This notice covers services and medical information for all HealthNet services.  If you have any questions about this notice, please contact HealthNet Administration at:  957-2000 and ask for the Privacy Officer.

Our pledge about health information:
We are required by law to maintain the privacy of your health information.  We will provide you with a notice of our legal duties and privacy practices.  

“Protected health information” is your health information or other individually identifiable information, such as demographic data, that may identify you.  Protected health information relates to your past, present or future physical or mental health or condition related to healthcare services.

This Notice of Privacy Practices describes how HealthNet may use and disclose your protected information to carry out treatment, for payment, to healthcare operations and for purposes permitted or required by law. This notice also describes certain rights that you may have to access your protected health information. HealthNet is required to abide by the terms of this Notice of Privacy Practices.

The terms of this Notice may change at any time.  The new Notice will apply  to all protected health information acquired after it goes into effect.  Upon your request, HealthNet will provide you with any historical Notice of Privacy Practices or you may obtain the most current copy by visiting HealthNet website at www.indyhealthnet.org.

Uses and disclosures of health information that do not require your authorization:
Your protected health information may be used and disclosed by HealthNet, its staff and others outside of its offices who are involved in your care and treatment for the purposes of providing healthcare services to you.

The categories below describe ways that we use and disclose your health information.  For each category we will explain what we mean and give an example.  Not every use or disclosure in a category will be listed.  All of the ways we are allowed to use and disclose information will fall within one of the categories. Information may be disclosed in writing, orally, or by computer.

TREATMENT
We will use your medical information to treat you, provide you with services, or organize the things you need.  

We may give your medical information to doctors, nurses, technicians, medical students, or others involved in your care. They may work at our offices or other places like another doctor’s office, lab, x-ray, or pharmacy that we refer you to.

For example, a doctor treating you for a broken leg may need to know if you have diabetes. This may affect the healing process.

HealthNet participates in certain Health Information Exchanges or Organizations (HIEs or HIOs).  For example, HealthNet participates in the Indiana Health Exchange (IHIE) and the Indiana Network for Patient Care (INPC), which helps to make information available to other providers who may need access it in order to provide care or treatment to you.

PAYMENT
We may use and disclose your medical information to get paid for the treatment and services you receive.  This may include providing it to your health insurance plan before it approves or pays for recommended healthcare services so that it may make a decision of eligibility or coverage for insurance benefits. It may also include supplying the information to review services provided to you for medical necessity.

For example, we may give information about your health and the treatment you receive to your insurance company so they will pay us or repay you.  We may also tell your insurance company about treatment you are going to receive to find out if they will pay for it.

HEALTH CARE OPERATIONS
We may use and disclose your health information to run our business.  We need this information to make sure that all of our patients get quality care.

For example, we may use health information to review our treatment and services to check how we are doing.

We may combine health information about many patients to decide what services we should offer, what services are not needed, and what new treatments would be useful.

We may combine this health information with medical information from other healthcare places. This helps us to see how we are doing compared to others and where we can improve. We may remove information that tells who you are.  Others may use it to study health care and health care delivery without learning who you are.

Business Associates
We hire outside organizations, called business associates, who perform some services for us. HealthNet has written contracts with its business associates to protect the privacy of your protected health information, and business associates are also required by law to comply with the same privacy and security requirements that apply to HealthNet.

For example, we may contract with a lab. When these services are done, we give the needed health information to these companies so that they can bill you or your insurance for the services.

Appointment Reminders  
We may use and disclose your medical information to remind you of health care visits, yearly exams, or prescription refills.  HealthNet may contact you by mail or telephone.  HealthNet may leave messages at the telephone number you provide.

Treatment Options
We may use and disclose medical information to tell you about treatment options. For example, a program for low-cost medicine.  

Health Benefits and Services  
We may use and disclose medical information to tell you about health benefits or services.  For example, a new diabetes program that we offer.

FUNDRAISING ACTIVITIES
HealthNet may use your medical information’s to contact you in an effort to raise money for its operations.  It may give medical information to a foundation related to HealthNet so that it may raise money to support HealthNet.  You may contact HealthNet’s Privacy Officer and request, in writing or by phone, not be contacted for this purpose.  

INDIVIDUALS INVOLVED IN YOUR CARE OR PAYMENT FOR YOUR CARE
If it is ok with you, we will share your health information with a family member or close friend that is involved in your care.  If you are unable to agree or to object to sharing this information, we may use our judgment to disclose this information if it is in your best interest. HealthNet may disclose medical information to notify or assist in notifying a family member or personal representative (or any other person who is responsible for our care) of your location, general condition, or death.  We may use or disclose your health information to help in disaster relief efforts.

RESEARCH
HealthNet performs medical research.  HealthNet may disclose your medical information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure, among other things, the privacy of your medical information.  HealthNet may release information about you to researchers who need to know how many patients have a specific health issue in preparation for proposed research.  If a doctor caring for you believes you may be interested in, or may benefit from, a research study, your doctor and the research review committee will designate someone to contact you.  This individual will see if you are interested in the study, provide you with more information and give you the opportunity to participate or to decline further contact. 

THE FOLLOWING AREAS ARE REQUIRED OR ALLOWED BY LAW

To Avert a Serious Threat to Health or Safety
We may use and disclose your health information when needed to prevent a serious threat to your health and safety.  This includes the health and safety of the public or another person.  We would only give this information to someone that can help stop the threat.  

Organ and Tissue Donation
HealthNet may release medical information to organizations that handle organ procurement or organ, eye or tissue transplantation, or to an organ-donation bank as necessary to facilitate organ or tissue donation and transplantation. 

Workers’ Compensation
We may release your health information for workers’ compensation or such programs.  These programs provide benefits for work-related injuries or illness. 

Public Health Risks and Patient Safety Issues
We may disclose your health information to public health programs or to keep you safe.  For example: purposes of preventing  or controlling disease, disability or injury; to report births and  deaths; to report reactions to medications or problems with products; and to notify people of recalls of products that they maybe be using. 

Health Oversight Activities
We may disclose your health information to a health group that oversees activities allowed by law.  This might include having someone check to see how we are doing or a licensure to make sure that we can treat patients.  The government needs to do this to check the health care system, government benefit programs and compliance with civil rights laws. Examples of health oversight activities are:  audits, investigations and inspections.

Communicable diseases
HealthNet may disclose medical information to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition, and to comply with stat-mandatory disease reporting, such as cancer registries. 

Abuse and Neglect
HealthNet may disclose your medical information to a public health authority authorized by law to receive reports of child abuse or neglect, and to notify the appropriate government authority if HealthNet believes a patient has been the victim of abuse, neglect or domestic violence. HealthNet will only make this disclosure when required or authorized by law. 

Food and Drug Administration (FDA)
HealthNet may disclose your medical information to a person or company required by the Food and Drug Administration for the purpose of quality, safety, or effectiveness of FDA-regulated products or activities, which include; to report adverse events, product defects or problems; biologic product deviations; to track products; to enable product recalls; to make repairs or replacements; or to conduct post-marketing surveillance, as required. 

Grants
Places that give us money can review health information.  They review the information to make sure we are giving quality care and doing what the grant expects us to do.

Legal Proceedings
HealthNet may disclose medical information in the course of any judicial or administrative proceeding, in response to an order of a court or administrative tribunal (to the extent such disclosure is expressly authorized) or, in certain conditions, in response to a subpoena, discovery request or other lawful process.

Law Enforcement
HealthNet may disclose medical information for certain law-enforcement purposes, such as: in response to a court order, subpoena, warrant, summons or similar process; to identify or locate a suspect, fugitive, material witness or missing person; about the victim of a crime, if under certain limited circumstances, it is unable  to obtain the person’s agreement; about a death it believes may be the result of criminal conduct; about criminal conduct at the facility; and, in emergency circumstances, to report a crime, the location of the crime or victims, or the identity, description or location of the person who committed the crime. 

Coroners, Medical Examiners and Funeral Directors
We may release health information to a coroner or medical examiner.  This may be needed to identify a deceased person or find the cause of death.  We may also release health information to funeral directors when asked to do so.  

Military Activity and National Security 
We may use or disclose medical information of individuals who are armed forces personnel for activities deemed necessary by appropriate military-command authorities, for the purpose of a determination by the Department of Veterans Affairs of your eligibility for benefits or to a foreign military authority if you are member of that foreign military service.  It may also disclose your medical information to authorized federal officials for conducting national security and intelligence activities, including for the provision of protective services to the president or others legally authorized. 

Inmates
If you are in custody, we may release your health information to law enforcement.  The release would be for them to treat you, protect your health and safety, or the health and safety of others.

USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION THAT DO REQUIRE YOUR AUTHORIZATION
As described above, HealthNet may use or disclose your protected health information to third parties for treatment, payment, healthcare operations and when permitted or required by law.  HeathNet will not disclose your protected health information for marketing purposes or the sale of protected health information.  In addition, certain disclosures of your psychotherapy notes, mental health records and drug and alcohol abuse treatment records may require your prior written authorization.

YOUR RIGHTS REGARDING YOUR PROTECTED HEALTH INFORMATION
Although your health record belongs to HealthNet, the information belongs to you.  Unless you are an inmate, you have the:

Right to Look Over and Copy.
You have the right to request to look over and/or get an electronic or paper copy of your medical information. This includes medical and billing records but does not include psychotherapy notes. You can look over or copy this information as long as we keep it.  

Your request must be given in writing. If there is a fee for these services, you will be told in advance. In some cases, we may deny your request to look over and copy your records.  If this happens, you may ask that the denial be reviewed.  A manager chosen by HealthNet will review your request and the denial.  The person doing the review will not be the person who denied your request.  We will comply with the outcome of the review.  

Right to Amend.
If you feel that your health information is wrong, you may ask to change the information. You have the right to ask for a change for as long as we keep the information.  

Your request must be given in writing and include a reason. We may deny your request if:

  • It is not in writing or does not include a reason;
  • We did not create the information, unless the provider that created it is no longer available;
  • It is not part of the health information kept by HealthNet;
  • It is not part of the information which you would be allowed to look over and copy; or
  • It is accurate and complete.

Right to Receive Notification
Individuals will receive notifications of their unsecured protected health information that is breached.

Right to an Accounting of Disclosures.
You have the right to request a list of the disclosures we made that are not related to treat you, get paid for services, to run our business, or that you authorized.  To request an accounting of disclosures, submit your request in writing and include the specific time period to HealthNet’s Privacy Officer. 

Your request must be given in writing.  It must state a time period that may not be longer than seven years and may not include dates before April 14, 2003.  You may receive one free list each year.  For extra lists, we may charge you.  If there is a fee for this, we will tell you in advance. We will mail you a list of disclosures within 90 days.

Right to Request Restrictions
You have the right to ask us to give your health information only to the people that are helping with your care or in the payment for your care. For example, you could ask that we not use or give information about a surgery you had to a family member or friend. To request a restriction, submit your restriction in writing to HealthNet’s Privacy Officer.  The request should include what information you want to limit, whether you want to limit use or disclosure, or both, and to whom you want the limits to apply.  HealthNet is not required to agree to your request.  If it does agree, it will comply with your restrictions unless the information is needed to provide emergency medical treatment. 

HealthNet will agree to restrict disclosures of your health information to your health insurance plan for payment and healthcare operations (not for treatment) if the disclosure pertains solely to a healthcare item or service for which you paid in full.

Right to Request Confidential Communications
You have the right to request that we communicate with you about health matters in a certain way or at a certain location.  For example, you can ask that we only contact you at work or by mail.  Your request must be in writing. We will not ask you the reason for your request.  We will try to comply with your request. Your request must state how or where you wish to be contacted.

Right to a Paper Copy of This Notice
You have the right to a paper copy of this notice.  You may ask us to give you a copy of this notice at any time.  Even if you have agreed to receive this notice electronically – by computer, you can still get a paper copy of this notice.  A copy of this notice is on our website at www.indyhealthnet.org.

Other uses of Protected Health Information
Other uses and disclosures of health information not in this notice or allowed by law will be made only with your written consent.  If you give us consent, you may cancel it in writing at anytime.  If you cancel your consent, we will no longer use or disclose your health information for the reasons in your consent. This does not apply to any disclosures we have already made.  We are required to keep your original records.

Changes to this Privacy Notice
We have the right to change this notice.  We will post a copy of the current notice in all HealthNet locations. The notice will have the effective date.  Each time you receive services, you can get a copy of the notice.  You may also request that a revised copy be sent to you in the mail or obtain one at the time of an appointment. 

Questions or Complaints 
If you have a complaint about your privacy rights, fill out a Grievance Form located in the waiting room and put it in the suggestion box. You may also complain with HealthNet Privacy Officer or with the Secretary of the Department of Health and Human Services. You will not be penalized for filing a complaint.  To file a complaint with HealthNet, please submit a complaint in writing to the HealthNet Privacy Officer. 

Notice of Nondiscrimination
HealthNet complies  with applicable Federal civil rights law, laws and does not discriminate on the basis of race, color, age, disability  or sex.  HealthNet does not exclude people or treat them differently because of race, color, national origin, age, disability or sex.

If you have further questions about this Notice of Privacy Practices, please contact the HealthNet Privacy Officer at 317.957.2008.

CONTACT INFORMATION

HealthNet Privacy Officer
3403 E. Raymond St.
Indianapolis, IN 46203
317-957-2008

HealthNet Risk Officer
3403 E. Raymond Street
Indianapolis, IN  46203
317-957-2024

HealthNet Compliance Officer
3403 E. Raymond Street
Indianapolis, IN  46203
317-957-2042

Office of Civil Rights
U.S. Department of Health and Human Services
233 N. Michigan Avenue Suite 240
Chicago, IL 60601
(800) 368-1019
Hhs.gov/ocr

You will not be penalized for filing a complaint.