NOTICE OF PRIVACY PRACTICES
Revised Date: August 21, 2013

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.

We at The MS Center of Saint Louis (referred to herein as “The Center”) are required by law to maintain the privacy of individually identifiable patient health information (this information is “protected health information” and is referred to herein as (“PHI”). We are also required to provide patients with a Notice of Privacy Practices regarding PHI. We are required to post this Notice in a prominent place within our facility. We will only use or disclose your PHI as permitted or required by applicable state law. This Notice applies to your PHI in our possession including the medical records generated by us. The Center understands that your health information is highly personal, and we are committed to safeguarding your privacy. Please read this Notice of Privacy Practices thoroughly. It describes how The Center will use and disclose your PHI. This Notice applies to the delivery of health care by The Center and its medical staff. This Notice also applies to the utilization review and quality assessment activities of Mercy Clinic Neurology.

I. Permitted Use or Disclosure

A. Treatment: The Center will use and disclose your PHI in the provision and coordination of health care to carry out treatment functions.

  • The Center will disclose all or any portion of your patient medical record information to consulting physician(s), resident physicians, nurses, technicians, medical students, other health care providers, staff and hospital staff/associates who have a legitimate need for such information in your care and continued treatment.
  • Medical information about you will be shared in order to coordinate specific services, such as lab work, diagnostic images and prescriptions.
  • The Center also will disclose your medical information to people or entities outside The Center who will be involved in your medical care such as family members and others who will provide services that are part of your care.
  • The Center will share certain information such as your name, address, employment, insurance carrier, emergency contact information and appointment scheduling information in an effort to coordinate your treatment with us and with other health care providers.
  • The Center will use and disclose your PHI to inform you of, or recommend possible treatment options or alternatives that will be of interest to you.
  • The Center will use and disclose PHI to contact you as a reminder that you have an appointment for treatment or medical care. If you are an inmate of a correctional institution or under the custody of a law enforcement officer, The Center will disclose your PHI to the correctional institution or law enforcement official.

B. Payment: The Center will disclose PHI about you for the purposes of determining coverage, eligibility, funding, billing, claims management, medical data processing, stop loss / reinsurance and reimbursement.

  • The medical information will be disclosed to an insurance company, third party payer, third party administrator, health plan or other health care provider (or their duly authorized representatives) involved in the payment of your medical bill and will include copies or excerpts of your medical records which are necessary for payment of your account. It will also include sharing the necessary information to obtain pre-approval for payment for treatment from your health plan.
  • The Center will disclose PHI to collection agencies and other subcontractors engaged in obtaining payment for care.

C. Health Care Operations: The Center will use and disclose your PHI during routine health care operations including quality assurance, utilization review, medical review, internal auditing, case management and care coordination, and contacting health care providers and patients with information about treatment alternatives, in order for us to operate our business in an efficient, safe and legal manner.

D. Other Uses and Disclosures: As part of treatment, payment and health care operations, we may also use your PHI for the following purposes:

  • Medical Research: The Center may disclose your PHI without your Authorization to medical researchers who request it for approved medical research projects; however, with very limited exceptions such disclosures must be cleared through a special approval process before any PHI is disclosed to the researchers. Researchers will be required to safeguard the PHI they receive.
  • Information and Health Promotion Activities: The Center will use and disclose some of your PHI for certain health promotion activities. For example, your name and address will be used to send you newsletters or general communications. The Center will also send you information based on your own health concerns. The Center may send you this information if it has determined that a product or service may help you. The communication will explain how the product or service relates to your well-being and can improve your health.

E. More Stringent State and Federal Laws: The State law of Michigan is more stringent than HIPAA in several areas. State law is more stringent when the individual is entitled to greater access to records than under HIPAA and when under state law the records are more protected from disclosure than under HIPAA. Certain federal laws also are more stringent than HIPAA. The Center will continue to abide by these more stringent state and federal laws. The federal laws include applicable Internet privacy laws, such as the Children’s Online Privacy Protection Act and the federal laws and regulations governing the confidentiality of health information regarding substance abuse treatment. An example of more stringent State law is that patients in Michigan have more rights of access to behavioral health information under Michigan law than under HIPAA and the state law defines a minimum necessary standard for release of mental health information. Disclosure is permitted with consent and for treatment without consent but only in an emergency. Minors in Michigan have more rights to confidentiality and protection of certain information (reproductive health, behavioral health and substance abuse) than under HIPAA. State law requires facilities to adopt policies regarding release of information outside the facility. If the facility policy requires consent for release, then consent will be required. State law genetic and HIV testing and disclosure consents remain in place.

III. Use or Disclosure Requiring Your Authorization

A. Marketing: The Center is not permitted to provide your PHI to any other person or company for marketing to you of any products or services other than The Center products or services unless you have signed an authorization.

B. Research: The Center will use or disclose your PHI as part of research that includes providing you with treatment. For example, if you are part of a research study that includes treatment, The Center may require that you sign an authorization to allow the researchers to use or disclose your PHI for this research.

C. Other Uses: Any uses or disclosures that are not for treatment, payment or operations and that are not permitted or required for public policy purposes or by law will be made only with your written authorization. Written authorizations will let you know why we are using your PHI. You have the right to revoke an authorization at any time.

IV. Use or Disclosure Permitted by Public Policy or Law without your Authorization

A. Law Enforcement Purposes: The Center will disclose your PHI for law enforcement purposes as required by law, such as responding to a court order or subpoena, identifying a criminal suspect or a missing person, or providing information about a crime victim or criminal conduct.

Required by Law: The Center will disclose PHI about you when required by federal, state or local law to make reports or other disclosures. The Center also will make disclosures for judicial and administrative proceedings such as lawsuits or other disputes in response to a court order or subpoena. The Center will disclose your medical information to government agencies concerning victims of abuse, neglect or domestic violence. The Center will report drug diversion and information related to fraudulent prescription activity to law enforcement and regulatory agencies. Specialized government functions will warrant the use and disclosure of PHI. These government functions will include military and veteran’s activities, national security and intelligence activities, and protective services for the President and others. The Center will make certain disclosures that are required in order to comply with State Social Services/Disability or similar programs.

B. Coroners, Medical Examiners, and Funeral Directors: The Center will disclose your PHI to a coroner or medical examiner. For example, this will be necessary to identify a deceased person or to determine a cause of death. The Center will also disclose your medical information to funeral directors as necessary to carry out their duties.

C. Organ Procurement: The Center will disclose PHI to an organ procurement organization or entity for organ, eye or tissue donation purposes.

D. Health or Safety: The Center will use and disclose PHI to avert a serious threat to health and safety of a person or the public. The Center will use and disclose PHI to Public Health Agencies for immunizations, communicable diseases, etc. The Center will use and disclose PHI for activities related to the quality, safety or effectiveness of FDA-regulated products or activities, including collecting and reporting adverse events, tracking and facilitating product recalls, etc. and post marketing surveillance. Any patient receiving a medical device subject to FDA tracking requirements may refuse to disclose, or refuse permission to disclose, their name, address, telephone number and social security number, or other identifying information for the purpose of tracking.

V. Your Health Information Rights
Although we at The Center must maintain all records concerning your care and treatment by The Center, you have the following rights concerning your PHI:

A. Right to Access, Inspect and Copy: You have the right to access your PHI and to inspect and copy your PHI as long as we maintain it except for: psychotherapy notes, information that will be used in a civil, criminal or administrative action or proceeding, and where prohibited or protected by law. The Center will deny your request for access to your PHI without giving you an opportunity to review that decision if:

  • You don’t have the right to inspect the information; or it is otherwise prohibited or protected by law;
  • You are an inmate at a correctional institution and obtaining a copy of the information would risk the health, safety, security, custody or rehabilitation of you or other inmates;
  • The disclosure of the information would threaten the safety of any officer, employee or other person at the correctional institution or who is responsible for transporting you;
  • You are involved in an approved clinical research project and The Center created or obtained the PHI during that research. Your access to the information will be temporarily suspended for as long as the research is in progress;
  • The Center obtained the information that you seek access to from someone other than the health care provider under a promise of confidentiality and your access request is likely to reveal the source of the information; or
  • Under other limited circumstances. In these instances, however, The Center will allow the review of its decision by a health care professional that The Center has chosen. This person will not have been involved in the original decision to deny your request.

You may be required to pay a reasonable copying charge. You must make your requests to access and copy your PHI in writing to The Center. The Center will respond to your request within 30 days of its receipt. If The Center cannot respond to your request within 30 days, The Center will notify you in writing to explain the delay and the date by which we will act on your request. In any event, The Center will act on your request within 60 days of its receipt.

B. Right to Amend: You have the right to amend your PHI for as long as The Center maintains it. However, The Center will deny your request for amendment if:

  • The Center did not create the information;
  • The information is not part of the designated record set;
  • The information would not be available for your inspection (due to its condition or nature); or
  • The information is accurate and complete.

If The Center denies your request to make changes in your PHI, The Center will notify you in writing with the reason for the denial. The Center will also inform you of your right to submit a written statement disagreeing with the denial. You may ask that The Center include your request for amendment and the denial any time that The Center discloses the information that you wanted changed. The Center may prepare a rebuttal to your statement of disagreement and will provide you with a copy of that rebuttal. You must make your request for amendment of your PHI in writing to The Center, including your reason to support the requested amendment. The Center will respond to your request within 60 days of its receipt. If The Center cannot, you will be notified in writing to explain the delay and the date by which The Center will act on your request. In any event, The Center will act on your request within 90 days of its receipt.

C. Right to an Accounting: You have a right to receive an accounting of the disclosures of your PHI that Mercy Health made, except for the following disclosures:

  • To carry out treatment, payment or health care operations;
  • To you;
  • To persons involved in your care;
  • For national security or intelligence purposes;
  • To correctional institutions or law enforcement officials; or
  • That occurred prior to April 14, 2003.

For each disclosure, you will receive: the date of the disclosure, the name of the receiving organization and address if known, a brief description of the PHI disclosed and a brief statement of the purpose of the disclosure or a copy of the written request for the information, if there was one. You must make your request for an accounting of disclosures of your PHI in writing to The Center. You must include the time period of the accounting, which may not be longer than 6 years. The Center will respond to your request within 60 days from its receipt. If The Center cannot respond to your request, you will be notified in writing to explain the delay and the date by which The Center will act on your request. In any event, The Center will act on your request within 90 days of its receipt. In any given 12-month period, The Center will provide you with an accounting of the disclosures of your PHI at no charge. Any additional requests for an accounting within that time period will be subject to a reasonable fee for preparing the accounting.

D. Right to Request Restrictions: You have the right to request restrictions on certain uses and disclosures of your PHI:

  • To carry out treatment, payment or health care operations functions;
  • Restricting specific information to only specified family members, relatives, close personal friends or other individuals involved in your care; or

For example, you may ask that your name not be used in the waiting room. The Center will consider your request but is not required to agree to the requested restrictions.

E. Right to Confidential Communications: You have the right to receive confidential communications of your PHI by alternative means or at alternative locations. For example, you may request that The Center only contact you at work or by mail.

F. Right to Receive a Copy of this Notice: You have the right to receive a paper copy of this Notice of Privacy Practices upon request. For more information regarding your rights to access, amend, receive an accounting or seek restrictions regarding the use of your PHI please feel free to contact your The Center’s office.

VI. Complaints
If you believe your privacy rights have been violated, you may file a complaint with The Center or with the Secretary of the Department of Health and Human Services. To file a complaint with The Center, please feel free to contact The Center office. You may also submit your privacy-related complaints in writing directly to The Center’s Privacy Officer. Complaints may also be submitted to the Health and Human Services Office for Civil Rights at: Office for Civil Rights U.S. Department of Health and Human Services 233 N. Michigan Ave., Suite 240 Chicago, IL 60601 Voice Phone (312) 886-2359 FAX (312) 886-1807 The Center assures you that there will be no retaliation for filing a complaint.

VII. Sharing and Joint use of your Health Information
In the course of providing care to you and in furtherance of The Center’s mission to improve the health of the community, The Center will share your PHI with other organizations as described below whom have agreed to abide by the terms described below:

VIII. The MS Center of Saint Louis and Mercy Health: The MS Center of Saint Louis and Mercy Health participate together in an organized health care arrangement to deliver health care to you at The MS Center of Saint Louis and Mercy Health locations. Both The MS Center of Saint Louis and Mercy Health and its Medical Staff have agreed to abide by the terms of this Notice with respect to PHI created or received as part of delivery of health care services to you. Physicians and allied health care providers are members of Mercy Health Medical Staff and will have access to and use your PHI for treatment, payment and health care operations purposes related to your care within. The Center will disclose your PHI to Mercy Health for payment, treatment and health care operations.

IX. Additional Information
For further information regarding the issues covered by this Notice of Privacy Practice, please contact:
Privacy Officer/Director of The MS Center Of Saint Louis
1176 Town and Country Commons Chesterfield, MO. 63017
P: 636-893-1256 F: 636-893-1261

X. Changes to this Notice

The Center will abide by the terms of the Notice currently in effect. The Center reserves the right to change the terms of its Notice and to make the new Notice provisions effective for all PHI that it maintains.