Privacy Practices

How is my privacy protected with CareFirst CHPDC?

At CareFirst CHPDC we know your information and your health are personal. We follow the guidelines of the federal Health Insurance Portability and Accessibility Act or HIPAA to ensure that the information is kept as private as possible.  As required by this law, we have outlined your rights and responsibilities under this law below.

Under HIPPA, CareFirst CHPDC is required to:

• Ensure that all of your protected health information (PHI) is kept private.
• Inform you of our legal duties and privacy practices when it comes to your PHI as outlined in this notice.
• Strictly adhere to the terms outlined in this notice. 

What is protected under my PHI?

Your Protected Health Information includes all oral, written or electronic information outlined below:

• Information regarding your physical or mental health, provided care, treatments, or medical record numbers

How does CareFirst CHPDC use or share my PHI?

The use and disclosure of your PHI is allowed/ required as described below.  Not all allowable uses or disclosures are listed; only the ones that pertain directly to the way we may use or share the information.

Treatment

Your PHI may be used when enrolling into a disease or health management program.  Or it may be shared with a case manager who is overseeing your treatment.

Payments to Caregivers

We may use or share your PHI when paying for health care that you have received or are currently receiving. This could be in the form of a bill sent from your doctor outlining identifying information, the injury or illness, the treatment, and any tests or supplies that might have been used.

Health Care Operations

Your PHI may be used within our plan in order to process everyday business activities that involve your health care. This information is only viewed by employees directly involved in our business activities and who require access in order to, for example, review and improve your health care services.

Additional Covered Entity's Needs

CareFirst CHPDC may share your PHI with a doctor or a health plan provider so that it can be used in determining payments, health care treatments, and certain business tasks associated with those activities.

Reminders of Appointments and Benefits/ Services Related to Your Health Care

Appointment reminder notifications and information regarding additional health care treatments, services or benefits may be sent to your using your PHI.

In Compliance with the Law

By law, we are required to share your PHI with a court or other legal proceeding if requested.  For example, if the law says we must report PHI about people who have been abused, we will disclose your PHI to the proper authorities.

Public Health Activity Reports

Information such as births, deaths, and some diseases may be shared with government officials in order to track trends and disease growth.

Health Oversight Activities

Your PHI may be shared with government agencies conducting activities such as audits, investigations, licensure, or disciplinary actions. This can include agencies that review the healthcare system, Medicaid, SCHIP, Healthy Kids, and other benefit programs.

Disposal of Your Remains

PHI may be shared with funeral directors, medical examiners, and coroners. Your PHI may also be shared with organizations that deal with organ donation and transplantation, if permitted by law.

To Avoid Harm

We may share your PHI in order with health or law enforcement in order to stop or lessen the harm of a serious threat to a person or public safety.

Government Functions

For national security reasons, your PHI may be shared with governmental representatives in order to, for example, protect the President from an infectious disease.

Worker's Compensation

To obey the laws governing worker’s compensation, we may be required to share your PHI.

Lawsuits and Disputes

Court or administrative orders may require us to share your PHI as it concerns lawsuits or disputes in which you are involved.

For Research

HIPAA approved researchers with an institutional review board or privacy board may be given your PHI when conducting research into types and quality of treatments, progression of illnesses or diseases, etc.

Use and Sharing of Your Health Information

Before we make an additional use or disclosure of your PHI, we will ask for written permission followed by an authorization call. If permission is given and you change your mind later, you may rescind this permission in writing and we will discontinue the use of your PHI in this manner.

More information regarding the use of your Personal Health Information and our Privacy Practices may be found in your Alliance Enrollee Handbook or Medicaid Enrollee Handbook.