Joint Notice of Privacy Practices
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Describes how Presbyterian Healthcare Services and participating Organized Health Care Arrangement (OHCA) members collect, use, disclose, and protect members' protected health information and the rights patients have regarding that information. Applies to Presbyterian, OHCA members that share this Notice, and individuals whose health information they hold.
No material clinical or coverage changes in this revision.
Permitted Uses and Patient Options
PHI use/disclosure and patient options
Situations in which PHI may be used or disclosed without written authorization, and instances where patients may restrict or opt out:
ALL of the following
Permitted without authorization
- Treatment — use and share health information to provide medical treatment by our health care providers.
- Payment — use and share health information to receive or facilitate payment for treatment and services.
- Health Care Operations — use and share health information to operate the business and deliver quality care and services.
- Required by Law — use and share health information when required by federal, state, or local law.
- Emergency Situations — use professional judgment to share health information if in the patient’s best interest during a health emergency or if the patient is incapacitated.
- Public Health Activities — share health information with public health authorities to protect public welfare.
- Health Oversight Activities — share health information with oversight agencies that monitor our activities.
- Legal and Administrative Proceedings — share health information as part of administrative or legal proceedings.
- Law Enforcement — share only very limited health information if requested by law enforcement officials.
- Coroners, Medical Examiners, and Funeral Directors — share decedent’s health information so they can carry out duties.
- Organ and Tissue Donation — share health information with organizations that obtain, store, or transplant organs and tissues.
- Public Safety — share health information to prevent or lessen a serious and immediate threat to health or safety.
- Special Government Functions — share health information with federal officials for national security purposes as authorized by law.
- Correctional Institutions — if an inmate, share health information with correctional institutions or law enforcement to protect health and safety.
- Worker’s Compensation — use or share health information as required by worker’s compensation laws.
Coding and Billing References
| No billing or clinical code-level coverage criteria contained in this Notice. |
Authorization & Special Protections for Providers
Obtain written authorization for uses not described in this Notice
We will not use or share your health information without your written authorization unless required by law or as described in this Joint Notice of Privacy Practices. Authorizations may be revoked in writing at any time, except to the extent action has already been taken under the authorization. Written authorization is required for uses not described in the Notice, including most marketing (except a face-to-face conversation or a promotional gift of little or no monetary value) and research disclosures; sale of PHI is not permitted.
- Authorizations may be cancelled in writing at any time, except for actions already taken under the authorization.
- Marketing uses require written authorization unless the communication is face-to-face or a promotional gift of little or no monetary value; authorizations for marketing that involve remuneration will disclose that fact.
- Research disclosures require written authorization and IRB or similar research/privacy board approval.
- Sale of Protected Health Information is prohibited.
Treat Part 2 substance use disorder records as requiring separate written consent
Records and information that identify a patient as having or having had a substance use disorder are protected by 42 CFR Part 2 in addition to HIPAA and state law; separate written consent (distinct from other consents) is required to disclose Part 2 protected records. Part 2 records will not be disclosed or used in proceedings against the patient without that separate consent or a court order issued after notice and opportunity to be heard.
- Programs that diagnose or treat substance use disorders have additional Part 2 protections; see the 42 CFR Part 2 Addendum to this Notice for program-specific practices.
- Part 2 protections prevent testimony relaying the content of such records in civil, criminal, administrative, or legislative proceedings absent separate written consent or a court order following Part 2 procedures.
Key Definitions
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