MUNICIPAL EMPLOYEES’ RETIREMENT SYSTEM OF MICHIGAN HEALTH CARE SAVINGS PROGRAM
NOTICE OF HIPAA PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW PERSONAL HEALTH 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 (“Policy”) applies to Protected Health Information (defined below) associated with the HCSP, as defined below, provided by the Municipal Employees’ Retirement System of Michigan (“MERS”) to its participants, its participants’ dependents and, as applicable, retired participants (collectively, “participants”). This Policy describes how MERS may use and disclose Protected Health Information to carry out payment and health care operations, and for other purposes that are permitted or required by law.
MERS is required by the privacy regulations issued under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) to maintain the privacy of Protected Health Information and to provide participants with notice of MERS’s legal duties and privacy practices concerning Protected Health Information. MERS is also required to notify affected individuals following a breach of unsecured protected health information. MERS is required to abide by the terms of the Policy reflected by this Notice so long as it remains in effect. MERS reserves the right to change the terms of this Notice of Privacy Practices as necessary and to make the new Policy effective for all Protected Health Information maintained by MERS. If MERS makes material changes to privacy practices, copies of revised policies will be mailed to all participants then covered by the HCSP. Copies of the current Policy may be obtained by contacting MERS at the telephone number or address below.
HCSP means, for purposes of this Notice, the Health Care Savings Program that your employer or former employer established and maintains through MERS that provides tax-favored reimbursements of certain health-related expenditures defined by law.
Protected Health Information (“PHI”) means individually identifiable health information, as defined by HIPAA, that is created or received by MERS and that relates to the past, present, or future physical or mental health or conditions of an individual; the provision of health care to an individual; or the past, present, or future payment for the provision of health care to an individual; and that identifies the individual or for which there is a reasonable basis to believe the information can be used to identify the individual. PHI includes information of persons living or deceased.
Uses And Disclosures Of Your Protected Health Information
The following categories describe different ways that MERS uses and discloses PHI. For each category of uses and disclosures, MERS will explain what is covered, and where appropriate, provide examples for illustrative purposes. Not every use or disclosure in a category will be
listed. However, all of the ways MERS is permitted or required to use and disclose PHI will fall within one of the categories.
Your Authorization. Except as outlined below, MERS will not use or disclose your PHI unless you have signed a form authorizing the use or disclosure. You have the right to revoke that authorization in writing except to the extent that MERS has taken action in reliance upon the authorization or that the authorization was obtained as a condition of obtaining health coverage, and MERS has the right, to contest a claim under the coverage or the coverage itself.
Uses and Disclosures for Payment. MERS may make requests, uses, and disclosures of your PHI as necessary for payment purposes. For example, MERS may use information regarding your medical procedures and treatment to process and reimburse/pay claims. MERS may also disclose your PHI for the payment purposes of a health care provider or a HCSP.
Uses and Disclosures for Health Care Operations. MERS may use and disclose your PHI as necessary for health care operations, which are generally limited to processing medical reimbursement claims, making decisions on whether an expenditure qualifies for reimbursement, making coverage determinations and other functions related to the administration of the HCSP.
Family and Friends Involved in Your Care. If you are available and do not object, MERS may disclose your PHI to your family, friends, and others who are involved in your care or the reimbursement/payment of a claim. If you are unavailable or incapacitated and MERS determines that a limited disclosure is in your best interest, MERS may share limited PHI with such individuals. For example, MERS may use professional judgment to disclose PHI to your spouse concerning the processing of a claim.
Business Associates. At times, MERS consults outside persons or organizations to help provide you with the benefits of your HCSP. Examples of these outside persons and organizations might include vendors that help process your claims. At times, it may be necessary for MERS to provide certain of your PHI to one or more of these outside persons or organizations.
Other Products and Services. MERS may contact you to provide information about other health-related products and services that may be of interest to you. For example, MERS may use and disclose your PHI for the purpose of communicating to you about our health insurance exchange products that may add value to your HCSP.
Other Uses and Disclosures. MERS may make certain other uses and disclosures of your PHI without your authorization for any purpose required or authorized by law.
In the event applicable law, other than HIPAA, prohibits or materially limits MERS’s uses and disclosures of Protected Health Information, as described above, we will restrict the uses or disclosure of your Protected Health Information in accordance with the more stringent standard.
Rights That You Have
Access to Your PHI. You have the right of access to copy and/or inspect your PHI that MERS
maintains in designated record sets. Certain requests for access to your PHI must be in writing, must state that you want access to your PHI and must be signed by you or your representative. Access request forms are available from MERS at the address below.
Amendments to Your PHI. You have the right to request that PHI that MERS maintains about you to be amended or corrected. MERS is not obligated to make all requested amendments but will give each request careful consideration. To be considered, your amendment request must be in writing, must be signed by you or your representative, and must state the reasons for the amendment/correction request. Amendment request forms are available from MERS at the address below.
Accounting for Disclosures of Your PHI. You have the right to receive an accounting of certain disclosures made by MERS of your PHI. Examples of disclosures that MERS is required to account for include those to state insurance departments, pursuant to valid legal process, or for law enforcement purposes. To be considered, your accounting requests must be in writing and signed by you or your representative. Accounting request forms are available from MERS at the address below. The first accounting in any 12-month period is free; however, MERS may charge you a fee for each subsequent accounting you request within the same 12-month period.
Restrictions on Use and Disclosure of Your PHI. You have the right to request restrictions on certain uses and disclosures of your PHI for insurance payment or health care operations, disclosures made to persons involved in your care, and disclosures for disaster relief purposes. For example, you may request that MERS not disclose your PHI to your spouse. Your request must describe in detail the restriction you are requesting. MERS is not required to agree to your request but will attempt to accommodate reasonable requests when appropriate. MERS retains the right to terminate an agreed-to restriction if MERS believes such termination is appropriate. In the event of a termination by MERS you will be notify you of such termination. You also have the right to terminate, in writing or orally, any agreed-to restriction. You may make a request for a restriction (or termination of an existing restriction) by contacting MERS at the telephone number or address below.
Request for Confidential Communications. You have the right to request that communications regarding your PHI be made by alternative means or at alternative locations. For example, you may request that messages not be left on voice mail or sent to a particular address. MERS is required to accommodate reasonable requests if you inform MERS that disclosure of all or part of your information could place you in danger. Requests for confidential communications must be in writing, signed by you or your representative, and sent to MERS at the address below.
Right to a Copy of the Notice. You have the right to a paper copy of this Policy upon request by contacting MERS at the telephone number or address below.
Complaints. If you believe your privacy rights have been violated, you can file a complaint with MERS in writing at the address below. You may also file a complaint in writing with the Secretary of the U.S. Department of Health and Human Services in Washington, D.C., within 180 days of a violation of your rights. There will be no retaliation for filing a complaint.
For Further Information
If you have questions or need further assistance regarding this Notice, you may contact MERS’ HIPAA Privacy Officer by writing to: MERS, 1134 Municipal Way, Lansing, Michigan 48917, Attn: HIPAA Privacy Officer.