Health Insurance Portability and Accountability Act (HIPAA) Notice

Notice of Health Information Practices

Effective Date: September 23, 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.

Who will follow this notice:

This notice describes the health information practices of the University Medical Center (UMC), a health care component of The University of Alabama (a covered hybrid entity) and to the administrative departments at the University of Alabama that provide legal, billing, auditing, or other administrative support for UMC , including but not limited to The University of Alabama Office of Counsel, The University of Alabama System Office of Internal Audit, the University’s Privacy and Security Officers, the Office of Information Technology, Human Resources, and UA and UAB Risk Management. In addition, this Policy applies to the Capstone Health Services Foundation (CHSF) and to all members of its workforce. These two entities (UMC and CHSF) are hereby designated as an organized health care arrangement under HIPAA. For purposes of this Notice and HIPAA policies, these covered entities and the University’s affiliated administrative support departments shall collectively be referred to as “University Medical Center” or UMC.

Our pledge regarding medical information:

We understand that medical information about you and your health is personal. We are committed to protecting medical information about you. We create a record of the care and services you receive at UMC. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated or maintained by UMC, whether made or maintained by UMC personnel or your personal doctor.

This notice will tell you about the ways in which we may use and disclose medical information about you. We also describe your rights and certain obligations we have regarding the use and disclosure of medical information. We are required by law to:

How we may use and disclose medical information about you:

The following categories describe different ways that we use and disclose medical information. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.

Your rights regarding medical information about you:

Although all records concerning your treatment obtained at UMC are the property of UMC, you have the following rights regarding medical information we maintain about you:

Changes to This Notice

We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future. We will post a copy of the current notice in the UMC facility and on our website noted above. The notice will contain on the first page, in the top right-hand corner, the effective date. In addition, each time you visit UMC to receive health care services, we will make available a copy of the current notice in effect.

For more information or to report a problem

If you have questions and would like additional information, you may contact the UMC Privacy Officer [805 Peter Bryce Boluevard, Tuscaloosa, AL 35401].

If you believe your privacy rights have been violated, you may file a complaint with UMC Privacy Officer or with the Secretary of the Department of Health and Human Services. To file a complaint with UMC Privacy Officer, contact Jan Chaisson, Director of Medical Records, 348-1231. All complaints must be submitted in writing. Your complaint may be shared with the UA Privacy and Security Officers and others at the University who assist the UMC Privacy Officer with HIPAA compliance.

You will not be penalized or retaliated against for filing a complaint.

Notice Effective Date:

The effective date of the notice is September 23, 2013.