NEBRASKA METHODIST HEALTH SYSTEM
NOTICE OF PRIVACY PRACTICES
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 applies to the following organizations, which form the Methodist Health System Affiliated Covered Entity, including hospitals, clinics and other health care providers the organization operates, as well as any health care facility or physician practice now or in the future controlled by or under common control by Methodist Health System (MHS). The following organizations are part of the Methodist Health System Affiliated Covered Entity (“Methodist Health System ACE”) and share similar information practices:
- Methodist Health System
- Nebraska Methodist Hospital and Methodist Women’s Hospital
- Jennie Edmundson Hospital
- Physicians Clinic, Inc. d/b/a Methodist Physicians Clinic
- Methodist Endoscopy Center, LLC
- West Dodge Imaging, LLC
- Methodist Healthwest
- Methodist Fremont Health
- Fremont Health Clinic
The contact information of the MHS Privacy Officer is found below:
MHS Privacy Officer – (402) 354-6863
The organizations listed above will share your health information with each other, as necessary, to carry out treatment, payment and health care operations.
Although your health record belongs to the health care provider or facility that compiled it, you do have certain rights with regard to your health information. To exercise any of the following rights, please contact the MHS Privacy Officer at the above number:
- You have a right to receive this privacy notice that explains how your health information may be used or disclosed.
- You have a right to know who has received your health information during the previous 6 years, and for what purpose. If you make additional requests for such an accounting during any 12-month period, we may charge you a reasonable, cost-based fee.
- You have a right to view, and receive a copy or summary of all of your health records in the format you request (electronic and/or paper), except for psychotherapy notes. Your request for a copy of your record must be in writing. We may charge a reasonable, cost-based copying or labor fee for such copy.
- You have a right to ask for correction or amendment of anything in your records that you feel is in error. If we are unable to comply with your request we will notify you why in writing within 60 days. You also have the right to request that a statement of disagreement be included in your record. Your request must be in writing and include supporting documentation.
- You have a right to request we not use or share certain health information for treatment, payment or our health care operations. You also have the right to request that we not share information with your health insurer if you pay for a service or item out-of-pocket in full. However, we are not required to accommodate your request except as provided below.
- You have the right to be notified of a breach of your unsecured protected health information.
- You have the right to request confidential communications by asking us to contact you in a specific way or to send mail to a different address. We will honor all reasonable requests.
- You have the right to choose someone to act for you. If you give someone medical power of attorney or if someone is your legal guardian, we will confirm the person has this authority and can act for you before we take any action.
You have the right and choice to tell us to:
- Share information with your family, friends or others involved in your care
- Share information in a disaster relief situation
- Include your information in a hospital directory
- Contact you for fundraising efforts.
In these cases we never share your information unless you give us written permission:
- Marketing purposes;
- Sale of your information;
- Psychotherapy notes
We must disclose your health information to you, as described in this Notice. You may also give us written authorization to use your health information or to disclose it for any purpose. You may revoke your authorization at any time by contacting the MHS Privacy Officer at the number listed above, but your revocation will not affect any use or disclosure made by us in reliance on your authorization. Without your written authorization, we may not use or disclose your medical information for any reason except those described in this Notice.
We also have certain responsibilities. These include:
- Maintaining the privacy and security of your health record;
- Providing you with a copy of this Notice;
- Abiding by the terms of this Notice;
- Notifying you if a breach occurs that may compromise your information; and
- Not using or sharing your information other than as described in this Notice unless you tell us we can in writing. If you tell us we can, you may change your mind at any time; let us know in writing if you change your mind.
We may revise this Notice as our information practices change. Any revision will be effective for all information in the record, regardless of whether it was gathered before or after the change took effect. However, before we change our practices, a copy of our new Notice will be posted at all Methodist Health System affiliates and on our Web site. The effective date of our Notice will always appear at the end of the Notice.
Our Uses & Disclosures for Treatment, Payment and Health Care Operations
When state law requires us to obtain your written permission to use or disclose your health information for treatment, payment or health care operations, we will do so. However, there are also situations where we may use or disclose your information for treatment, payment, and health care operations without your permission.
We may use or disclose your health information for treatment purposes.
For example: Information obtained by members of your health care team will be documented in your record and used to determine the course of your treatment. Health care team members may communicate with each other personally and through your health record to coordinate your care. We may provide your physician or other health care provider with copies of reports that may help determine
your future treatment. We may also disclose your information to another health care provider for its payment purposes or its health care operations. These exchanges may be done through electronic health information exchange networks.
We may use or disclose your health information for payment purposes.
For example: We may send your bill to you or your insurance company. Your bill may contain information that identifies you, as well as your diagnosis, procedures and supplies used. However, if you pay for a health care service or item out-of-pocket in full and request in writing that we not provide information to your health insurer, we will comply with your request unless a law requires us to share that information with them.
We may use or disclose your health information for health care operations purposes and internal business practices.
For example: Members of the medical staff, members of the quality improvement team, or the risk or quality improvement manager may use information in your health record to assess your care and outcomes. This information is used in our ongoing efforts to improve the quality and effectiveness of the health care and services we provide.
Other Disclosures That May be Made Without Your Authorization
Unless we are otherwise restricted from doing so, we may also use or disclose your information for the following purposes without your authorization:
Notification: We may use or disclose information to notify or assist in notifying a family member, personal representative, or another person responsible for your care about your location and general condition.
Communication with Family: We may disclose to a family member, other relative, close personal friend or any other person you identify, health information relevant to that person’s involvement in your care or payment related to your care.
Hospital Directory: Unless state or federal law otherwise restricts us, or unless you instruct us not to, we may release your location within the hospital to people who ask for you by name. In addition, unless you instruct us not to, we may release your name, location, and religious affiliation to members of the clergy.
Business Associates: Some services of our organization are provided through contractual arrangements with business associates. These include radiology, certain laboratory services, supplemental staffing, transcription, and data management. When services are provided by a business associate, we may disclose your health information to our business associate so that they can perform the job we have asked
them to do and bill you or your insurance company for those services. In addition, we may disclose your health information to accrediting agencies and certain outside consultants. Our business associate must use appropriate safeguards to protect your health information.
Funeral Directors/Medical Examiners: We may disclose your health information to funeral directors, medical examiners and/or coroners consistent with applicable law so that they can carry out their duties.
Organ Procurement Organizations: Consistent with applicable law, we may disclose your health information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.
Research: We may disclose 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 the privacy of your health information. In addition, we may disclose information to researchers in preparation for research.
Appointment Reminders, Treatment Alternatives: We may use your information to provide you with information regarding a health-related product or service provided by MHS or an MHS affiliate or information regarding your treatment or care, such as appointment reminders, information about treatment alternatives, and/or in face-to face encounters.
Fundraising: We may use your name and limited demographic information to contact you as part of an MHS fundraising effort, but you can tell us not to contact you again.
Food and Drug Administration (FDA): We may disclose to the FDA, or an entity subject to FDA jurisdiction, your health information for public health purposes related to the quality, safety or effectiveness of an FDA-regulated product or activity for which that person has responsibility. For example, your information may be disclosed in connection with the reporting of an adverse event, product defect, product tracking or to provide post marketing surveillance information.
Workers’ Compensation: We may disclose your health information to the extent authorized by and to the extent necessary to comply with laws relating to workers’ compensation or other similar programs established by law.
Public Health: When required or permitted by law, we may disclose your health information to public health or legal authorities responsible for preventing or controlling disease, injury or disability or performing other public health functions. In addition, we may disclose your health information in order to avert a serious threat to health or safety.
Specialized Governmental Functions: We may disclose your health information for military and veterans activities, national security and intelligence activities and similar special governmental functions as required or permitted by law.
Correctional Institution: If you are an inmate of a correctional institution, we may disclose to the institution or agents thereof health information necessary for your health and the health and safety of other individuals.
Law Enforcement: We may disclose your health information for law enforcement purposes as required or permitted by law or in response to a valid subpoena, court order or other binding authority.
Disclosures Required by Law: We may use or disclose your health information as required by law provided such use or disclosure complies with and is limited to the relevant requirements of such law.
Health Oversight Agencies: We may disclose your health information to an appropriate health oversight agency, public health authority or attorney involved in health oversight activities.
Judicial and Administrative Proceedings: We may disclose your health information for judicial or administrative proceedings as required or permitted by law or in response to a valid subpoena, court order or other binding authority.
Organized Health Care Arrangement
The hospitals within MHS, including the outpatient surgical, rehabilitation and other ancillary service sites of the hospitals, are clinically integrated care settings in which patients receive care from both hospital staff and independent providers who belong to the Medical Staff. These Hospitals and their Medical Staff must be able to share protected health information freely for treatment, payment and health care operations. Therefore, each hospital and their respective Medical Staffs have entered into an “organized health care arrangement” or OHCA. Under the OHCA, each Hospital and the eligible providers on the Medical Staff (those providers who are themselves covered health care providers under HIPAA) will:
- Use a joint notice of privacy practices (this Notice) for all inpatient and outpatient visits;
- Obtain a single signed acknowledgment of receipt;
- Share protected health information from inpatient and outpatient hospital visits so that they can help the Hospital with its healthcare operations; and
- Follow the privacy and information practices described in this Notice. Each OHCA participant is individually responsible to follow the practices in this Notice. The OHCA does not cover the private offices of the providers or their information practices there or at other practice locations.
THIS NOTICE SERVES AS THE JOINT NOTICE OF PRIVACY PRACTICES OF THE ORGANIZED HEALTH CARE ARRANGEMENT FOR EACH OF THE MHS HOSPITALS.
Nebraska Health Information Initiative (NeHII)
NeHII is a state-wide, internet-based, health information exchange. NeHII is sponsored by Nebraska health care providers and health insurers who share and use your information for treatment, payment or health care operations purposes. Using NeHII, participating providers and health insurers can see certain health, demographic and payment information (your health information) in each other’s records. They can use this information for treatment, payment or health care operations purposes.
MHS is a participant in this initiative. Because of this, all MHS patients are included in the NeHII information exchange unless they specifically request to opt-out of NeHII.
For More Information or to Report a Problem
If you have questions or would like additional information, you may contact the MHS Privacy Officer at the phone number or email listed above. If you believe your privacy rights have been violated, you can file a complaint with the MHS Privacy Officer at the phone number or email listed at the beginning of this Notice, or with the Office of Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington,
If you would like a copy of this notice, please request one from the receptionist.
Effective Date: October 1,2019