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Policies on Individual Rights
Access to PHI and Requests for Amendment
HIPAA gives participants the right to access and obtain copies of their
PHI that the Plan and its Business Associates maintain in designated record
sets. HIPAA also provides that participants may request to have their
PHI in designated record sets amended. In accordance with the College's
privacy procedures, the Plan will provide access to PHI and it will consider
reasonable requests for amendment that are submitted in writing by participants.
The "designated record set" is a group of records maintained
by or for the Plan that includes:
the enrollment, payment, and claims adjudication record of an individual
maintained by or for the Plan; or
other PHI used, in whole or in part, by or for the Plan to make coverage
decisions about an individual.
Accounting
An individual has the right to obtain an accounting of certain disclosures
of his or her own PHI. This right to an accounting extends to disclosures
made in the last six years (but not prior to April 14, 2003), other than
the following kinds of disclosures:
to carry out treatment, payment or health care operations;
to individuals about their own PHI;
incidental to an otherwise permitted use or disclosure;
pursuant to an authorization;
to persons involved in the patient's care or other notification purposes;
as part of a limited data set; or
for national security or law enforcement purposes.
The Plan or the Business Associate will respond to an accounting request
within 60 days. If the Plan or Business Associate as applicable is unable
to provide the accounting within 60 days, it may extend the period by
30 days, provided that it gives the participant written notice within
the original 60?day period that states the reason for the delay and the
date the information will be provided.
The accounting will include the date of the disclosure, the name and address
of the receiving party, a brief description of the information disclosed,
and a brief statement of the purpose of the disclosure.
The first accounting in any 12 month period will be provided free of charge.
The Privacy Officer may impose a reasonable cost?based fee for subsequent
accountings.
Requests for Alternative Communication Means or Locations
The Plan will receive in writing a participant's reasonable request to
have PHI sent to an alternative address or other location. This request
should be submitted to the Privacy Officer who will respond in writing
within ten business days. The Plan will accommodate such a request if
the participant clearly provides information that the disclosure of all
or part of that information could endanger the participant.
Requests for Restrictions on Uses and Disclosures of PHI
If the participant wants to further restrict the use and disclosure of
PHI, the participant must so request in writing. This request must be
submitted to the Privacy Officer and state in detail what restrictions
are being requested, to whom they apply, and a beginning and ending date.
The Privacy Officer will determine whether or not to approve such a request
and will respond in writing within ten business days.
Procedures for Fully Insured Plan
In the event the Plan is fully insured, a privacy notice is provided to
participants by the insurance company which insures the Plan. Individual
rights described above shall, notwithstanding the foregoing provisions,
be exercised in accordance with procedures established by the insurance
company and set forth in that privacy notice.
Revised 4/13/06
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