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 of Privacy Practices is a description of how MORC, Inc. may
use and disclose your protected health information to carry out treatment,
payment, or health care operations and for other purposes permitted or
required by law. This Notice also describes your rights to access and
control your protected health information. “Protected health information”
is information about you that may identify you and relates to your past,
present, or future physical or mental health or condition and related
care services.
MORC, Inc. is required to abide by the terms of the Notice of Privacy
Practices and may change the terms of this Notice at any time. The new
Notice would be effective for all protected health information maintained
by MORC, Inc. at that time.
I. USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION
A. USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION
Here are some examples of the types of uses and disclosures of your protected
health care information that MORC, Inc. is
permitted to make.
(1) Treatment: MORC, Inc. will use and disclose your protected health
information to provide, coordinate, or manage your
care and any related services including the coordination or management
of your care with a third party that has already
obtained your permission to have access to your protected health information.
For example, MORC, Inc. would disclose
your protected health information to a home health agency that provides
care to you.
(2) Payment: Your protected health information may be used to obtain payment
for your care services. This may include
making a determination of eligibility or coverage for insurance benefits,
reviewing medical services provided, or
undertaking utilization review activities.
(3) Health Care Operations: MORC, Inc. may use or disclose your protected
health information in order to support its
business activities, i.e., quality assessment, employee reviews, training,
etc.
B. USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION BASED UPON WRITTEN
AUTHORIZATION
Your protected health information may be released for other purposes
only with your written authorization. Please note that
this authorization can be revoked by you at any time by notifying MORC,
Inc.’s Privacy Officer in writing.
C. OTHER PERMITTED AND REQUIRED USES AND DISCLOSURES THAT MAY BE MADE
WITHOUT YOUR CONSENT,
AUTHORIZATION, OR OPPORTUNITY TO OBJECT
MORC, Inc. may use or disclose your protected health information without
your consent or authorization as required by law.
These situations could include the use or disclosure of your protected
health information for the following situations:
(1) Public health activities;
(2) Communicable diseases;
(3) Investigations by a health oversight agency;
(4) Abuse, neglect, or domestic violence;
(5) Food and Drug Administration product testing;
(6) Legal proceedings;
(7) Law enforcement purposes;
(8) Identification purposes for coroners, funeral directors, and organ
donations;
(9) Research;
(10) Requests from law enforcement authorities in attempts to prevent
criminal activity;
(11) Military activity and national security;
(12) Workers’ compensation and other legally established programs;
and
(13) Provision of care to inmates of correctional facilities.
MORC, Inc. must make disclosures to you under the law when required by
the Secretary of the Department of Health and
Human Services to investigate or determine MORC, Inc.’s compliance
with the requirements of Applicability (see Section
164.500 et.seq.)
II. YOUR RIGHTS
You have the right to inspect and copy your protected health information
contained in your MORC, Inc. record for as long as
MORC, Inc. maintains that protected health information.
For example, under federal law, you may not inspect or copy psychotherapy
notes, preparatory notes for court proceedings, etc. However, under certain
circumstances, the denial may be reviewed. Please contact MORC, Inc.’s
Privacy Officer should you have any questions regarding access to your
health record.
You have the right to request a restriction of your protected health
information. This request must state the specific restriction
requested and to whom you want the restriction to apply.
MORC, Inc. is not required to agree to a restriction that you may request
if MORC, Inc. believes that it is in your best interest
to permit the use and disclosure of your protected health information.
MORC, Inc. will accommodate all reasonable requests for the release of
your protected health information including all
reasonable requests for confidential communication. Such requests should
be made in writing to MORC, Inc.’s Privacy Officer.
You may have the right to have MORC, Inc. amend your protected health
information. However, MORC, Inc. may deny such a
request. Such requests should be made in writing to MORC, Inc.’s
Privacy Officer.
You have the right to receive an accounting of certain disclosures that
MORC, Inc. has made, if any, of your protected health
information. You have the right to receive specific information regarding
these disclosures that occur after April 14, 2003.
Please direct your questions to MORC, Inc.’s Privacy Officer.
Upon a request made to MORC, Inc.’s Privacy Officer, you may receive
a copy of this Notice electronically.
Should you believe your privacy rights have been violated by MORC, Inc.,
you may file a complaint in writing to:
MORC, Inc.
Attention: Privacy Officer
P. O. Box 380710
16200 Nineteen Mile Road
Clinton Township, Michigan 48038
PHONE (586) 263-8700 FAX (586) 412-7889 TTY/TTD
(586) 286-5036 E-MAIL privacy.officer@morcinc.org
U.S. Department of Health and Human Services
Region V, Office for Civil Rights
233 North Michigan Avenue, Suite 240
Chicago, Illinois 60601
PHONE (312) 886-2359 FAX (312) 886-1807 TTY/TDD
(312) 353-5693 E-MAIL OCRComplaint@hhs.gov
MORC, Inc. will not retaliate against you for filing a complaint.
This notice was published and becomes effective on April 14, 2003. |
