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PRIVACY NOTICE OF
MINNESOTA COMPREHENSIVE HEALTH ASSOCIATION (MCHA) HEALTH PLAN
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.
This notice describes the duties and practices of Minnesota Comprehensive Health Association (“MCHA”) concerning the privacy of health information about you. MCHA provides benefits as described in your MCHA policy. MCHA receives and maintains health information in the course of providing these benefits to you. MCHA hires business associates, such as Medica Self-Insured, to help it provide these benefits to you. These business associates also receive and maintain health information in the course of assisting MCHA.
What types of personal information does MCHA obtain?
In order to provide benefits to covered persons, and otherwise to manage its operations, MCHA and its business associates must obtain, maintain, use and disclose information about covered persons. This includes information such as name, address, date of birth, gender, marital status, telephone numbers, Social Security number, dependent information and health history. It also may include health survey data, and information from telephone calls, complaints (grievances) or appeals. MCHA and its business associates may also obtain claims data and medical records from health care providers. This and other similar information is called "personal information" in this notice.
What does MCHA do with the personal information it obtains?
MCHA and its business associates obtain, maintain, use and share personal information to carry out certain routine activities. These include treatment-related activities, such as coordination of care. They also include payment-related activities, such as paying a claim for medical services rendered. And they include health care operations, such as professional peer review. Other examples of such routine activities include:
- Enrollment and eligibility, benefits management, and utilization management
- Customer service
- Health improvement and disease management (for example, sending information on treatment alternatives or other health-related benefits)
- Billing and claims administration
- Complaints (grievances) and appeals
- Determining employee contributions
- Regulatory and accreditation oversight and legal compliance
- Credentialing and quality assessment
- Business planning or management and general administrative activities (for example, employee training and supervision, legal consultation, accounting, auditing)
- Anti-fraud activities
With whom does MCHA share information?
MCHA and its business associates may share personal information for such routine purposes with health care providers, accrediting organizations, regulatory agencies, law enforcement, MCHA Sponsor and other business associates who are under contract to provide services to or on behalf of MCHA.
MCHA requires written authorization to use or disclose personal information for most non-routine purposes, and to respond to a request from you to review your personal information. If MCHA or its business associate asks for such an authorization from you, you may give it or refuse it. You also may revoke an authorization that you have given in the past, except if MCHA or its business associate has already acted based on your permission. As permitted or required by law, MCHA or its business associate will accept the authorization of a person with authority to represent you (for example, a court-appointed guardian).
There are some non-routine uses and disclosures of personal information that MCHA and its business associates must make without your authorization. These include disclosures to the Department of Health and Human Services, if necessary, to make sure your privacy is protected. They also include other uses and disclosures that are required by law.
There are some other non-routine purposes for which MCHA or its business associate may use or disclose your personal information without your authorization, as permitted by law. These purposes include:
- For public health activities (such as disease intervention)
- For government healthcare oversight activities (such as professional licensing or health benefits regulation)
- For law enforcement purposes (such as fraud prevention)
- To avoid a serious and imminent threat to health or safety
MCHA has policies that limit the disclosure of personal information. However, MCHA or its designee must receive some personal information for plan administrative purposes. This includes enrollment and disenrollment information and may include summary health information, which is information that does not disclose your name or other distinguishing characteristics. MCHA or its business associate(s) may also disclose other personal for plan administrative purposes.
What rights do members have in their personal information held by or for MCHA?
You have the following rights in the personal information that MCHA has about you. You, or your personal representative on your behalf, may:
- Inspect or obtain a copy. Call MCHA's privacy officer Lynn Gruber, President at (952) 593-9609 to get a copy of personal information MCHA and its business associates hold about you. The method will be explained to you, and you will be sent an authorization form for your signature.
- n Request an amendment or deletion. You may have personal information about you amended if you believe it is wrong or that information is missing, and MCHA or its designee agrees. If MCHA or its designee disagrees, you may have a statement of your disagreement added to your personal information.
- n Request restrictions of disclosure. You may ask in writing that MCHA limit how personal information about you is used and disclosed for routine purposes. Please note that MCHA or its designee is not required to agree to such restrictions.
- n Accounting of disclosures. You may ask in writing for a listing of disclosures of personal information about you that meet certain criteria and were made in the past six years (but not before April 14, 2003).
- n Confidential communications. You may ask that MCHA and its designees correspond with you in a different manner or at a different place (for example, by sending letters to you at a different address). MCHA and its designees will honor your request if it is reasonable and if doing otherwise could endanger you.
- n Notice. You may ask for and obtain a separate paper copy of this notice.
To exercise these rights or for questions about this notice, call MCHA's privacy officer at (952) 593-9609, or write to Lynn Gruber, President, Minnesota Comprehensive Health Association, 5775Wayzata Boulevard, Suite 910, St Louis Park, MN 55416.
What should you do if you believe your privacy rights have been violated?
If you believe your privacy rights have been violated, you may file a complaint (grievance). You will not be retaliated against for filing a complaint (grievance). To file a complaint (grievance) with MCHA, please call MCHA's privacy officer at (952) 593-9609. You may also file a complaint (grievance) with the Secretary of the U.S. Department of Health and Human Services. To do so, write to the Office for Civil Rights, U.S. Department of Health & Human Services, 233 N. Michigan Ave. Suite 240, Chicago, IL 60601.
About this notice.
MCHA is required by law to maintain the privacy of personal information and to provide this notice. MCHA reserves the right to change the terms of its notice and to make the new notice effective for all personal information that MCHA or its business associates maintain. If MCHA makes such a change, a revised notice will be sent to you by mail or electronically. By law, MCHA must abide by the terms of the privacy notice currently in effect. This notice is in effect April 14, 2003.
This notice is provided to enrollees in MCHA for the benefit of themselves and their dependents.
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