If you have any questions about this notice, please
contact your local Military Treatment Facility (MTF) Privacy Officer or, if
necessary, the TRICARE Management Activity (TMA) Privacy Officer at www.tricare.osd.mil.
This Notice of Privacy Practices is provided to you as a requirement of the
Health Insurance Portability and Accountability Act (HIPAA). It describes how
we may use or disclose your protected health information, with whom that information
may be shared, and the safeguards we have in place to protect it. This notice
also describes your rights to access and amend your protected health information.
You have the right to approve or refuse the release of specific information
outside of our system except when the release is required or authorized by law
or regulation.
ACKNOWLEDGEMENT OF RECEIPT OF THIS NOTICE
You will be asked to provide a signed acknowledgment of receipt of this notice.
Our intent is to make you aware of the possible uses and disclosures of your
protected health information and your privacy rights. The delivery of your health
care services will in no way be conditioned upon your signed acknowledgment.
If you decline to provide a signed acknowledgment, we will continue to provide
your treatment, and will use and disclose your protected health information
for treatment, payment, and health care operations when necessary.
WHO WILL FOLLOW THIS NOTICE
This notice describes the Military Health System (MHS) practices regarding
your protected health information. For this notice, the MHS includes the following:
- Any Department of Defense (DoD) health plan
- Military Treatment Facilities (References to MTFs within this notice include
both medical and dental treatment facilities and all providers/staff who operate
under their auspices.)
- TRICARE Regional Offices
- Headquarters activities, such as the Surgeons General of the Military Departments
and the TRICARE Management Activity
The MHS is part of an organized health care arrangement with the Coast Guard.
The Coast Guard and its treatment facilities will also follow these practices.
OUR DUTIES TO YOU REGARDING PROTECTED HEALTH INFORMATION
“Protected health information” is individually identifiable health
information. This information includes demographics, for example, age, address,
e-mail address, and relates to your past, present, or future physical or mental
health or condition and related health care services. The MHS is required by
law to do the following:
- Make sure that your protected health information is kept private.
- Give you this notice of our legal duties and privacy practices related to
the use and disclosure of your protected health information.
- Follow the terms of the notice currently in effect.
- Communicate any changes in the notice to you.
We reserve the right to change this notice. Its effective date is at the top
of the first page and at the bottom of the last page. We reserve the right to
make the revised or changed notice effective for health information we already
have about you as well as any information we receive in the future. You may
obtain a Notice of Privacy Practices by accessing your local MTF web site or
TMA web site www.tricare.osd.mil,
calling the local MTF Privacy Officer and requesting a copy be mailed to you,
or asking for a copy at your next appointment.
HOW WE MAY USE OR DISCLOSE YOUR PROTECTED HEALTH INFORMATION
Following are examples of permitted uses and disclosures of your protected
health information. These examples are not exhaustive.
Required Uses and Disclosures
By law, we must disclose your health information to you unless it has been determined
by a competent medical authority that it would be harmful to you. We must also
disclose health information to the Secretary of the Department of Health and
Human Services (DHHS) for investigations or determinations of our compliance
with laws on the protection of your health information.
Treatment
We will use and disclose your protected health information to provide, coordinate,
or manage your health care and any related services. This includes the coordination
or management of your health care with a third party. For example, we would
disclose your protected health information, as necessary, to a TRICARE contractor
who provides care to you. We may disclose your protected health information
from time-to-time to another MTF, physician, or health care provider (for example,
a specialist, pharmacist, or laboratory) who, at the request of your physician,
becomes involved in your care by providing assistance with your health care
diagnosis or treatment. This includes pharmacists who may be provided information
on other drugs you have been prescribed to identify potential interactions.
In emergencies, we will use and disclose your protected health information
to provide the treatment you require.
Payment
Your protected health information will be used, as needed, to obtain payment
for your health care services. This may include certain activities the MTF might
undertake before it approves or pays for the health care services recommended
for you such as determining eligibility or coverage for benefits, reviewing
services provided to you for medical necessity, and undertaking utilization
review activities. For example, obtaining approval for a hospital stay might
require that your relevant protected health information be disclosed to obtain
approval for the hospital admission.
Health Care Operations
We may use or disclose, as needed, your protected health information to support
the daily activities related to health care. These activities include, but are
not limited to, quality assessment activities, investigations, oversight or
staff performance reviews, training of medical students, licensing, communications
about a product or service, and conducting or arranging for other health care
related activities.
For example, we may disclose your protected health information to medical school
students seeing patients at the MTF. We may call you by name in the waiting
room when your physician is ready to see you. We may use or disclose your protected
health information, as necessary, to contact you to remind you of your appointment.
We will share your protected health information with third-party “business
associates” who perform various activities (for example, billing, transcription
services) for the MTF or any DoD health plan. The business associates will also
be required to protect your health information.
We may use or disclose your protected health information, as necessary, to
provide you with information about treatment alternatives or other health-related
benefits and services that might interest you. For example, your name and address
may be used to send you a newsletter about our MTF and the services we offer.
We may also send you information about products or services that we believe
might benefit you.
Required by Law
We may use or disclose your protected health information if law or regulation
requires the use or disclosure.
Public Health
We may disclose your protected health information to a public health authority
who is permitted by law to collect or receive the information. The disclosure
may be necessary to do the following:
- Prevent or control disease, injury, or disability.
- Report births and deaths.
- Report child abuse or neglect.
- Report reactions to medications or problems with products.
- Notify a person who may have been exposed to a disease or may be at risk
for contracting or spreading a disease or condition.
- Notify the appropriate government authority if we believe a patient has
been the victim of abuse, neglect, or domestic violence.
Communicable Diseases
We may disclose your protected health information, if authorized by law, to
a person who might have been exposed to a communicable disease or might otherwise
be at risk of contracting or spreading the disease or condition.
Health Oversight
We may disclose protected health information to a health oversight agency for
activities authorized by law, such as audits, investigations, and inspections.
These health oversight agencies might include government agencies that oversee
the health care system, government benefit programs, other government regulatory
programs, and civil rights laws.
Food and Drug Administration
We may disclose your protected health information to a person or company required
by the Food and Drug Administration to do the following:
- Report adverse events, product defects, or problems and biologic product
deviations.
- Track products.
- Enable product recalls.
- Make repairs or replacements.
- Conduct post-marketing surveillance as required.
Legal Proceedings
We may disclose protected health information during any judicial or administrative
proceeding, in response to a court order or administrative tribunal (if such
a disclosure is expressly authorized), and in certain conditions in response
to a subpoena, discovery request, or other lawful process.
Law Enforcement
We may disclose protected health information for law enforcement purposes, including
the following:
- Responses to legal proceedings
- Information requests for identification and location
- Circumstances pertaining to victims of a crime
- Deaths suspected from criminal conduct
- Crimes occurring at an MTF site
- Medical emergencies (not on the MTF premises) believed to result from criminal
conduct
Coroners, Funeral Directors, and Organ Donations
We may disclose protected health information to coroners or medical examiners
for identification to determine the cause of death or for the performance of
other duties authorized by law. We may also disclose protected health information
to funeral directors as authorized by law. Protected health information may
be used and disclosed for cadaveric organ, eye, or tissue donations.
Research
We may disclose your protected health information to researchers when authorized
by law, for example, if their research has been approved by an institutional
review board that has reviewed the research proposal and established protocols
to ensure the privacy of your protected health information.
Criminal Activity
Under applicable Federal and state laws, we may disclose your protected health
information if we believe that its use or disclosure is necessary to prevent
or lessen a serious and imminent threat to the health or safety of a person
or the public. We may also disclose protected health information if it is necessary
for law enforcement authorities to identify or apprehend an individual.
Military Activity and National Security
When the appropriate conditions apply, we may use or disclose protected health
information of individuals who are Armed Forces personnel (1) for activities
believed necessary by appropriate military command authorities to ensure the
proper execution of the military mission including determination of fitness
for duty; (2) for determination by the Department of Veterans Affairs (VA) of
your eligibility for benefits; or (3) to a foreign military authority if you
are a member of that foreign military service. We may also disclose your protected
health information to authorized Federal officials for conducting national security
and intelligence activities including protective services to the President or
others.
Workers’ Compensation
We may disclose your protected health information to comply with workers’
compensation laws and other similar legally established programs.
Inmates
We may use or disclose your protected health information if you are an inmate
of a correctional facility, and an MTF created or received your protected health
information while providing care to you. This disclosure would be necessary
(1) for the institution to provide you with health care, (2) for your health
and safety or the health and safety of others, or (3) for the safety and security
of the correctional institution.
Disclosures by the Health Plan
DoD health plans may also disclose your protected health information. Examples
of these disclosures include verifying your eligibility for health care and
for enrollment in various health plans and coordinating benefits for those who
have other health insurance or are eligible for other government benefit programs.
We may use or disclose your protected health information in appropriate DoD/VA
sharing initiatives.
Parental Access
Some state laws concerning minors permit or require disclosure of protected
health information to parents, guardians, and persons acting in a similar legal
status. We will act consistently with the law of the state where the treatment
is provided and will make disclosures following such laws.
USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION REQUIRING YOUR
PERMISSION
In some circumstances, you have the opportunity to agree or object to the use
or disclosure of all or part of your protected health information. Following
are examples in which your agreement or objection is required.
MTF Directories
Unless you object, we will use and disclose in our MTF inpatient directory your
name, the location at which you are receiving care, your condition (in general
terms), and your religious affiliation. All of this information, except religious
affiliation, will be disclosed to people who ask for you by name. Only members
of the clergy will be told your religious affiliation.
Individuals Involved in Your Health Care
Unless you object, we may disclose to a member of your family, a relative, a
close friend, or any other person you identify, your protected health information
that directly relates to that person’s involvement in your health care.
We may also give information to someone who helps pay for your care. Additionally
we may use or disclose protected health information to notify or assist in notifying
a family member, personal representative, or any other person who is responsible
for your care, of your location, general condition, or death. Finally, we may
use or disclose your protected health information to an authorized public or
private entity to assist in disaster relief efforts and coordinate uses and
disclosures to family or other individuals involved in your health care.
YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION
You may exercise the following rights by submitting a written request or electronic
message to the MTF Privacy Officer. Depending on your request, you may also
have rights under the Privacy Act of 1974. Your local MTF Privacy Officer can
guide you in pursuing these options. Please be aware that the MTF might deny
your request; however, you may seek a review of the denial.
Right to Inspect and Copy
You may inspect and obtain a copy of your protected health information that
is contained in a “designated record set” for as long as we maintain
the protected health information. A designated record set contains medical and
billing records and any other records that the MTF uses for making decisions
about you.
This right does not include inspection and copying of the following records:
psychotherapy notes; information compiled in reasonable anticipation of, or
use in, a civil, criminal, or administrative action or proceeding; and protected
health information that is subject to law that prohibits access to protected
health information.
Right to Request Restrictions
You may ask us not to use or disclose any part of your protected health information
for treatment, payment, or health care operations. Your request must be made
in writing to the MTF Privacy Officer where you wish the restriction instituted.
Restrictions are not transferable across MTFs. If the restriction is to be throughout
the MHS, the request may be made to the TMA Privacy Officer. In your request,
you must tell us (1) what information you want restricted; (2) whether you want
to restrict our use, disclosure, or both; (3) to whom you want the restriction
to apply, for example, disclosures to your spouse; and (4) an expiration date.
If the MTF believes that the restriction is not in the best interest of either
party, or the MTF cannot reasonably accommodate the request, the MTF is not
required to agree. If the restriction is mutually agreed upon, we will not use
or disclose your protected health information in violation of that restriction,
unless it is needed to provide emergency treatment. You may revoke a previously
agreed upon restriction, at any time, in writing.
Right to Request Confidential Communications
You may request that we communicate with you using alternative means or at an
alternative location. We will not ask you the reason for your request. We will
accommodate reasonable requests, when possible.
Right to Request Amendment
If you believe that the information we have about you is incorrect or incomplete,
you may request an amendment to your protected health information as long as
we maintain this information. While we will accept requests for amendment, we
are not required to agree to the amendment.
Right to an Accounting of Disclosures
You may request that we provide you with an accounting of the disclosures we
have made of your protected health information. This right applies to disclosures
made for purposes other than treatment, payment, or health care operations as
described in this Notice of Privacy Practices. The disclosure must have been
made after April 14, 2003, and no more than 6 years from the date of request.
This right excludes disclosures made to you, for an MTF directory, to family
members or friends involved in your care, or for notification. The right to
receive this information is subject to additional exceptions, restrictions,
and limitations as described earlier in this notice.
Right to Obtain a Copy of this Notice
You may obtain a paper copy of this notice from your MTF or view it electronically
at your local MTF web site or TMA web site at www.tricare.osd.mil.
FEDERAL PRIVACY LAWS
This MHS Notice of Privacy Practices is provided to you as a requirement of
the Health Insurance Portability and Accountability Act (HIPAA). There are several
other privacy laws that also apply including the Freedom of Information Act,
the Privacy Act and the Alcohol, Drug Abuse, and Mental Health Administration
Reorganization Act. These laws have not been superseded and have been taken
into consideration in developing our policies and this notice of how we will
use and disclose your protected health information.
COMPLAINTS
If you believe these privacy rights have been violated, you may file a written
complaint with your local MTF Privacy Officer, the TMA Privacy Officer, or the
Department of Health and Human Services. No retaliation will occur against you
for filing a complaint.
CONTACT INFORMATION
You may contact your local MTF Privacy Officer or the TMA Privacy Officer for
further information about the complaint process, or for further explanation
of this document. The TMA Privacy Officer may be contacted at TRICARE Management
Activity, Information Management, Technology and Reengineering Directorate,
HIPAA Office, Five Skyline Place, Suite 810, 5111 Leesburg Pike, Falls Church,
VA 22041-3206, by phone at 1-888-DOD-HIPA
(1-888-363-4472 – Toll Free from the continental United States)/TTY 877-535-6778.
You may also email questions to hipaamail@tma.osd.mil.
For additional information regarding your privacy rights visit the TRICARE Web
site at www.tricare.osd.mil/hipaa/.
This notice is effective in its entirety as of April 14,
2003.