Notice of Privacy Practices
Effective Date: November 1, 2020
This Joint Notice of Privacy Practices (“Joint Notice”) is provided to you pursuant to the Health Insurance Portability and Accountability Act of 1996, and its implementing regulations ("HIPAA"), as amended. It is designed to tell you how we may, under federal law, use or disclose your Protected Health Information.
Please read this document carefully.
Who/What is Covered by this Joint Notice
This Joint Notice covers all AtlantiCare facilities, programs, employees, volunteers, medical residents, and participating members of the physician staff and allied health professionals. The information contained in the record of your medical care generated by AtlantiCare is referred to as Protected Health Information. This Joint Notice applies to all Protected Health Information about you that is maintained by AtlantiCare, including any such information that is maintained in paper or electronic form, or spoken. This includes records of your care maintained by AtlantiCare, whether created by AtlantiCare employees, your physician, consulting physicians, or others covered by this Joint Notice.
This Joint Notice also describes how authorized health care providers may use and disclose your Protected Health Information electronically through the AtlantiCare Health Information Exchange (HIE). You can get additional information about the AtlantiCare HIE from your participating provider’s registrar or receptionist or by visiting our website, www.atlanticare.org.
If you have any questions about this Notice, you may ask a member of the staff where you receive healthcare services, or contact the AtlantiCare Privacy Office at (609) 407-2251.
You may obtain our most current Notice online at www.atlanticare.org, by calling or writing our Privacy Office to request that a copy be sent to you, or by asking for a copy when you come in for an appointment. The address for our Privacy Office is provided on the last page of the Notice.
Federal and New Jersey State Law Implications
HIPAA is a federal law, which places limitations on the types of uses and disclosures health care providers and others may make of protected health information. At times, State or other regulations may afford more protection of your protected health information or provide additional patient rights that exceed those under HIPAA.
Additional Rights under New Jersey Law
New Jersey law may further limit our uses and disclosures of your PHI. This includes AIDS/HIV-related information, venereal disease information, genetic information, tuberculosis information, mental/behavioral health information, psychotherapy notes, certain drug and alcohol treatment information and certain information related to the emancipated treatment of a minor (e.g., when the minor seeks emancipated treatment for pregnancy or treatment related to the minor's child or a sexually transmitted disease). In these cases, AtlantiCare will abide by the most stringent of the regulations as they pertain to PHI, including obtaining your prior written consent, if required, before any such information is disclosed to a third party. These restrictions also apply to the sharing of any special categories of information through the AtlantiCare Health Information Exchange.
New Jersey Health Information Exchanges
AtlantiCare and other health care providers participate in Health Information Exchanges (“HIEs”), including the AtlantiCare HIE, which allows patient information to be shared electronically through a secured connection network. We may use or disclose your PHI in connection with the AtlantiCare HIE, or another HIE that we may participate in for your treatment, to ascertain whether you have health insurance and what it may cover, and to evaluate and improve the quality of medical care provided to all of our patients. Other health care providers and health plans may also have access to your information in the HIE for similar treatment, payment and health care operations purposes or to the extent permitted by law.
- Right to Opt Out of HIEs
If you wish to opt out of sharing your data on the AtlantiCare HIE, call 888-569-1000 or download the Opt Out Form. If you opt out of the AtlantiCare HIE, your PHI will continue to be accessed and released, electronically or otherwise, as needed to provide treatment to you, but will not be made available for such purpose through the AtlantiCare HIE.
Required Uses and Disclosures
Under the law, disclosures must be made to you, upon your request (unless medically contraindicated) and when required by the Secretary of the Department of Health and Human Services to investigate or determine compliance with HIPAA.
Permitted Uses and Disclosures
Treatment
We will share your PHI with other professionals who are treating you. This includes disclosure of your PHI to doctors, hospitals, pharmacies and other third parties who are involved in your care. For example, we will disclose your PHI to another physician to whom you have been referred, to the physician who referred you to us or to a home health agency that will be caring for you. We will use your PHI during continuum of care rounds which may include, without limitation, physicians, nurses, care managers, social workers, pharmacists, physical therapists, spiritual care workers and nutrition staff who are involved in your care. We may call your name in our waiting room when your doctor or other provider is ready to see you.
Payment
We may access Protected Health Information and send relevant information to insurance companies and third party payers so that payment can be made for the services provided and/or for authorization for medical care.
Health Care Operations
We may access or release your medical information for healthcare operations. For example, we may use your information to evaluate the performance of our staff and for training and education purposes. We may access or send your information to our attorneys or accountants in the event we need the information in order to address one of our own business functions.
Protected Health Information will be provided to third party “business associates” that perform various activities and services on our behalf (e.g. billing, transcription and medical equipment) on behalf of AtlantiCare. In such situations, AtlantiCare will have a written contract in place that restricts the ability of the business associate to use or disclose your Protected Health Information in accordance with HIPAA requirements.
Appointment Reminders
We may contact you via mail, telephone, text or e-mail to remind you of an upcoming appointment. We may leave you a message that includes the date, time and general information about an upcoming appointment.
If you do not wish to receive appointment reminders, please notify your healthcare professional.
Patient Reunions
We may hold reunions for various patient groups to celebrate their success in treatment. If you are or were part of such a patient group, we may use your PHI to invite you.
Treatment Alternatives & Other Health Related Benefits and Services
We may use or disclose your PHI to contact you with information about treatment alternatives or other health-related benefits and services, including disease management, health promotion, preventive care, and wellness programs that may be of interest to you.
Fundraising
We may use or disclose certain information for the purposes of fundraising for AtlantiCare entities. The money raised will be used to expand and improve the services and programs we provide to the community. You are free to opt out of solicitation at any time and your decision will have no impact on your treatment or payment for services.
Hospital Directory
Unless you tell us not to, we will include certain information about you in the hospital directory if you are admitted to one of our hospitals. This information may include your name, your location in the hospital, your general condition, your religious affiliation and whether you wish to have our spiritual care chaplains visit you.
This information may also be disclosed to people who ask for you by name, such as your relatives, friends and the media. Your religious affiliation may be given to community clergy even if they don't ask for you by name.
You may opt out of participating in the Hospital Directory at the time of admission or anytime during your admission.
Spiritual Care Staff
Our doctors and other healthcare providers work with our spiritual care chaplains as part of the treatment team at our hospitals, unless you tell us that you do not want our spiritual care chaplains to be involved. Spiritual care chaplains may call on you during your hospital stay.
You may opt out at the time of your admission or anytime during your admission.
Individuals Involved in Your Care
Unless you inform us of your objection in writing, we will use or disclose your Protected Health Information in order to notify or assist in notifying your family, your personal representative or another person responsible for your care about your location, your condition, or of your death. We may also discuss your health care with your family and friends to the extent that they are involved in your care. We may share information in a disaster relief situation. If you are unable or unavailable to agree or object to our discussing these matters with your family and/or friends, our health professionals will use their judgment as to whether any communications with your family or others are necessary and/or appropriate.
As Required by Law or Legal Process
We will disclose your PHI when we are required to do so by local, state or federal law. Protected Health Information will be used and disclosed to the extent that such use or disclosure is required by law. Examples of these requirements include communicable disease reporting, incidence of burns, seizures, gun shots, abuse, organ donations, product recalls, product failures, birth/deaths and/or birth defects. Examples of the authorities/agencies to which PHI may be disclosed include: New Jersey Department of Health and Senior Services, the Division of Motor Vehicles, Local and/or State Police, the Medical Examiner and County Prosecutor, the Perinatal Co-operative, Organ Procurement Agencies, the Drug Enforcement Administration, the Ombudsman, the Office of Civil Rights, the Centers for Medicare and Medicaid Services and/or Peer Review Organizations.
Public Health Activities
We may disclose your PHI to local, state or federal public health authorities as authorized by law to prevent or control disease, injury or disability; to report child abuse or neglect; report domestic violence; report to the Food and Drug Administration problems with products and reactions to medications; and report disease or infection exposure.
We may use or disclose your PHI to a public or private entity authorized by law or by its charter to assist in disaster relief efforts, such as the Red Cross.
Health Oversight Activities
We may disclose your PHI to government agencies for activities authorized by law, including audits, investigations, surveys, accreditation, certification and other proceedings.
Response to Subpoenas or for Judicial and Administrative Proceedings
In general, Protected Health Information may be used and disclosed in the course of an administrative or judicial proceeding. However, we will attempt to ensure that you have been made aware of the use or disclosure of your protect health information prior to its release.
Law Enforcement
We may use or disclose your PHI if requested by law enforcement officials to identify or locate a suspect, fugitive, material witness or missing person, or, in some cases, to comply with a court order or subpoena and for other law enforcement purposes.
Correctional Facilities
If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may disclose your PHI to the respective correctional institution or law enforcement official in accord with laws, rules, regulations and our policies.
Coroners, Medical Examiners and Funeral Directors
We may disclose certain PHI to a coroner or medical examiner. We may also disclose certain PHI about deceased patients to funeral directors so that they may carry out their duties.
Organ Donation
We may disclose the PHI of organ donors to organizations involved in procuring, banking or transplanting organs and tissues.
Research
We may use or disclose your PHI for certain research purposes when such research is approved by an Institutional Review Board as appropriate.
To Avert a Serious Threat to Health or Safety
We may use or disclose your PHI in order to prevent or lessen a serious and imminent threat to the health or safety of a particular person or the general public.
Specialized Government Functions
We may use or disclose your PHI for specialized government functions such as military, national security and presidential protective services. We may use and disclose the PHI of patients who are Armed Forces personnel (1) for activities deemed necessary by appropriate military command authorities; (2) for the purpose of a determination by the Department of Veterans Affairs of your eligibility for benefits; or (3) to a foreign military authority if you are a member of that foreign military service.
Worker’s Compensation
We may use and disclose your PHI for purposes of handling your workers’ compensation claims in compliance with applicable laws, rules and regulations.
Marketing
Unless allowed by law, we may not receive payment directly or indirectly for your PHI without your authorization. Without your authorization, we will not disclose your PHI for marketing purposes as set forth under the HIPAA rules.
Business Associates
Some of the services we provide are performed through contractual relationships with outside parties or business associates. These services may include (but are not limited to) financial, auditing and legal. We take efforts to only provide business associates with the minimum necessary amount of PHI to carry out their contractual duties. All business associate contracts restrict the ability of the business associate to further use or disclose your PHI so that it is appropriately safeguarded in compliance with HIPAA regulations.
Authorizations
Use and disclosure of your PHI for purposes other than those listed above requires your authorization. When you complete an authorization form that complies with the law, we will disclose your PHI as you have directed, however we are not able to take back any uses or disclosures that we already made with your authorization.
If you provide us with a written authorization to disclose your PHI, you may revoke it at any time. Your revocation must be in writing. Please contact our Health Information Management Department at (609) 441-8987 or visit online at www.atlanticare.org to obtain a copy of the Authorization.
Other uses of your PHI
Other uses and disclosures of your PHI not covered by the categories included in this Notice or applicable laws, rules or regulations will be made only with your written permission or authorization.
You Have Rights Regarding Your Protected Health Information
Right to Inspect and Copy
You have the right to inspect and receive a copy (paper or electronic) of your PHI, usually within 30 days of your request that may be used to make decisions about your care. You may choose a personal representative to act on your behalf to access your medical information. If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action. You may also direct us in writing to transmit your PHI to another entity or individual. To do so, you must complete a Patient Access Request Form, which you can obtain by contacting our Health Information Management Department or the Privacy Office. Contact information for those offices may be found on the last page of this Notice.
You will be charged a reasonable cost-based fee. We may deny your request in very limited circumstances. If you are so denied, in some cases, you may request that the denial be reviewed. We will comply with the outcome of the review.
Right to Amend
You have the right to request an amendment of PHI contained in your designated record if you believe the information is incorrect or incomplete. However, we may deny such a request in the following circumstances:
- The record was not created by AtlantiCare, unless you provide us with a reasonable basis to believe that the originator of PHI is no longer available to act on the requested amendment;
- The record is not part of the designated record set;
- The record would not be available for inspection under 45 CFR 164.524;
- The record is accurate and complete.
Generally, we must respond in writing to your request within sixty (60) days. However, we may extend the time for such action by no more than thirty (30) days as provided under HIPAA. If we do not agree to your request, we will provide you with information about our denial and explain how you can disagree with the denial by filing a statement of disagreement with us. We may then prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal. All of these documents will be placed in the appropriate part of your Designated Record Set.
If you are requesting that we amend your records because you believe that you are a victim of medical identity theft, we will use reasonable efforts to assist you in making corrections to your record which are determined to be appropriate under the circumstances.
To request an amendment, please contact our Health Information Management Department or the Privacy Office to obtain an Amendment Request Form. Contact information for those offices may be found on the last page of this Notice.
Right to an Accounting of Disclosures
You have the right to an accounting of disclosures. This is a list (accounting) of the times we've disclosed your PHI for six years prior to the date you ask, who we've shared it with and why. In compliance with the law, we will include all the disclosures except for those about treatment, payment and healthcare operations, and certain other disclosures (such as any you have asked us to make). We will provide one accounting a year for free, but will charge a reasonable, cost-based fee if you ask for another one within 12 months. We will provide you with an accounting of disclosures if you request it in accordance with the law. To request an accounting, please contact our Health Information Management Department or the Privacy Office to obtain an Accounting of Disclosure Request Form. Contact information for those offices may be found on the last page of this Notice.
Right to Request Restrictions
You have the right to request restrictions on the uses and disclosures of your PHI for treatment, payment or healthcare operations. You may also request that any part of your PHI not be disclosed to family members or friends who may be involved in your care, or for notification purposes as described in this Notice. Please contact the Privacy Office to obtain a Restriction Request Form.
Restriction requests must be in writing and state the specific restriction requested and to whom you want the restriction to apply. Please note that AtlantiCare is not required to comply with your request, unless you are asking us to restrict the use and disclosure of your PHI to a health plan for payment or health care operation purposes and such information you wish to restrict pertains solely to a health care item or service for which you have paid us “out-of-pocket” in full.
Right to Request Confidential Communications
You have the right to request your Protected Health Information be received by you through confidential means, i.e. alternative address or other method of contact. Your request must be in writing to the Privacy Office. We may condition this accommodation by asking you for information as to how payment will be handled for services we provide to you. We will not request an explanation from you as to the basis for the request. Please send your written request to the Privacy Office and state the specific alternate means or location.
Right to Notification
In accordance with law, AtlantiCare has a duty to notify you in accordance with federal and state notification laws if there is a breach of your unsecured Protected Health Information. This will be done by mail or by other means if necessary.
Right to a Paper Copy of this Notice
You have a right to a paper copy of this Notice of Privacy Practices upon request, even if you have agreed to accept the Notice electronically. You may obtain a paper copy of this Notice at the registration desk at your next appointment.
Changes to this Notice
We are required by law to maintain the privacy of your Protected Health Information and to provide you with a copy of this Notice. We are also required to abide by the terms of this Notice. We reserve the right to amend this Notice at any time in the future and to make the new Notice provisions applicable to all your Protected Health Information – even if it was created prior to the change in the Joint Notice. If such amendment is made, we will immediately display the revised Notice at our office, and on our Web Site at https://www.atlanticare.org/about-us/notice-of-privacy-practices. We will also provide you with a copy, at any time, upon request.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer and/or the Secretary of the U.S. Department of Health and Human Services. We have provided both addresses on the last page of this Notice. To file a complaint with the AtlantiCare Privacy Office, call (609) 407-7788.
The covered entities of AtlantiCare value your right to privacy. You will not be retaliated against for filing a complaint.
Contact Information
AtlantiCare Health Information Management
1925 Pacific Avenue
Atlantic City, NJ 08401
Phone: (609) 441-8987
Email: HIMROI@atlanticare.org
Forms: Medical Records
AtlantiCare Privacy Office:
Timothy J. Koob, Privacy Officer
(609) 272-6649
Sonya Love, Privacy Manager
(609) 407-2251
AtlantiCare Privacy Office
2500 English Creek Ave., Bldg. 500
Egg Harbor Twp., NJ 08234
United States Department of Health & Human Services
200 Independence Ave., SW
Washington, DC 20201
(877) 696-6775
Website: www.hhs.gov/ocr/privacy/hipaa/complaints
This Notice is being provided to you on behalf of AtlantiCare Health System, Inc. and its’ affiliated entities (an “OCHA”). All of the AtlantiCare hospitals, our physicians, doctor offices, service locations, facilities, entities and our foundation follow the terms of this Notice. AtlantiCare affiliated entities locations are listed on our website at www.atlanticare.org.
AtlantiCare Health System, Inc.
AtlantiCare Physicians Group, PA (Captive PC – All sites)
AtlantiCare UrgentCare Physicians, LLC (All sites)
AtlantiCare Regional Health Services Inc.
AtlantiCare Regional Medical Center Inc. (All sites)
AtlantiCare Behavioral Health Inc. (All sites)
AtlantiCare Health Services Inc.
Acuity Hospital of New Jersey LLC
AtlantiCare Surgery Center LLC (All sites)
AtlantiCare Health Solutions Inc. (All sites)
AtlantiCare Health Engagement Inc. (All sites)
AtlantiCare Foundation