Notice of UMDNJ-New Jersey Dental School Privacy Practices for Protected Health Information
This notice describes how health information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
We, at UMDNJ, understand that health information about you is personal. We therefore are committed to and required by law to maintain the privacy of your health information and to provide you with notice of legal duties and privacy practices with respect to your health information. We will not use or disclose your health information except as described in this Notice. This Notice applies to all of the health information maintained by our patient care units including our schools, clinics, centers and institutes that are collectively referred to as UMDNJ.
For a complete listing of the schools, clinics, centers and institutes of UMDNJ, please go to our web site: http://www.umdnj.edu/complweb/center-inst.htm
The patient care units of UMDNJ may share your health care information with each other, as necessary to carry out treatment, payment, or health care operations.
How We May Use and Disclose Your Health Information
We may use and disclose your health information as described below. However, this is only meant to give you a general overview and not to describe all specific possible uses and disclosures that may occur.
We may use your health information to provide medical/dental treatment, items or services. For example, we may disclose all or any portion of your health information to your physician, dentist, dental students, and other health care professionals who have a need for such information for your care and treatment.
Also, different departments may share health information about you in order to coordinate specific services, such as prescriptions, lab work and x-rays. We may also disclose your health information to people outside UMDNJ who may be involved in your medical/dental care, such as family members, social service, clergy and others. Also, our faculty, staff and students may discuss your care in a case conference.
We may use and disclose your health information to tell you about possible treatment options or alternatives and other health related benefits or services that may be of interest to you.
We may use and disclose health information about you so that we may bill and receive payment for treatment and services that you receive. Your information may also be necessary for purposes of determining coverage, medical necessity, pre-authorization or certification and for utilization management. The information may be released to an insurance company, third party payer or other entity (or their authorized representatives) involved in the payment of your health care bill and may include copies or portions of your medical/dental record, which are necessary for payment of your account. Also, your health information maybe disclosed to consumer reporting and/or to collection agencies.
Health Care Operations
We may use and disclose your health information for our health care operations, including quality assurance, utilization review, medical/dental review, internal auditing, accreditation, social services certification, licensing or credentialing activities of UMDNJ, certain medical/dental research, and educational purposes.
Other Health Care Providers, Health Plans, and Clearinghouses
We may use and disclose your health information to your treating provider or health plan, or a clearinghouse involved in the billing of services and treatment provided to you, for the purpose of providing you treatment, receiving or processing payment, and to conduct certain operational activities as permitted by law.
Activities of Organized Health Care Arrangements in Which We Participate
We may disclose information about you to health care providers and administrators participating in our Organized Health Care Arrangements as necessary to carry out our treatment, payment, or health care operations. For example, UMDNJ has an arrangement with Medicaid, where accepted. All participants in our Organized Health Care Arrangements have agreed to abide by the terms of this Notice with respect to your health care information created or received as part of the delivery of health care services to you at UMDNJ.
We may use and disclose your health information to contact you as a reminder that you have an appointment for dental care at UMDNJ.
Persons Involved in Your Care
Unless you object, we may disclose your health information to family members, other relatives, close personal friends, or any other person(s) who are involved with your dental care, or payment.
Unless you object, we may use or disclose your health information to a public or private entity authorized by law or by charter to assist in disaster relief efforts including notifying your family about your condition, status and location.
We may use and disclose health information to business associates. A business associate is an individual or entity under contract with us to perform or assist UMDNJ in a function or activity, which requires the use or disclosure of health information. Examples of business associates, include, but are not limited to, copy services used by us to copy medical/dental records, consultants, accountants, lawyers, and medical transcriptionists. We require the business associate to enter into an agreement to protect the confidentiality of your health information.
While most uses and disclosures related to research require your authorization, in some limited situations we may disclose your health information to researchers when their research has been approved by an Institutional Review Board or a similar privacy board that has waived the individual authorization requirement in accordance with the regulations covering this area.
As UMDNJ-New Jersey Dental School is an educational institution, we may use and disclose health information about you for educational purposes. This includes the use of written, audio, photo and video records along with any models developed as part of your treatment. For example, your health information may be used for case conferences, course materials or published case reports.
De-Identified Data or Limited Data Sets
We may use or disclose health information about you if we remove all information that could be used to identify you, i.e. “de-identified” information. We may also use or disclose a limited amount of health information about you in a “limited data set” for the purposes of research, public health, or health care operations if we enter into a data use agreement with the recipient of the data.
We may use and disclose certain health information to contact you in an effort to raise money for UMDNJ, including the New Jersey Dental School. We may disclose certain health information to a foundation related to UMDNJ so that the Foundation may contact you in its effort to raise money. The information released would only be contact information, such as your name, address, phone number, and the dates you received treatment or services at UMDNJ. If you do not want UMDNJ to contact you for fundraising efforts, you must notify the Foundation of UMDNJ, 120 Albany Street, Tower II, Suite 850, New Brunswick, NJ 08901 in writing.
Health Oversight Agencies
We may use and disclose your health information to a health oversight agency for activities authorized by law, including, but not limited to, licensure, certification, audits, investigations and inspections. These activities are necessary for the government and certain private health oversight agencies to monitor the healthcare system, government programs, and compliance with civil rights.
We may use and disclose your health information for law enforcement purposes to a law enforcement official if required by law, or where permitted by law, or in response to a valid subpoena. Also, we may disclose health information if it is necessary for law enforcement authorities to identify or locate an individual.
Disclosures in Judicial/Legal Proceedings
We may use and disclose your health information to a court or administrative agency when a judge or administrative agency orders us to do so. We may also use and disclose information about you in legal proceedings, such as in a response to a discovery request, subpoena, court order, etc. Also, UMDNJ may use or disclose your health information in preparation for any dispute or litigation between you and UMDNJ.
Public Health Risk
We may use and disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury or disability. For example, we are required by law to report the existence of a communicable disease, such as acquired immune deficiency syndrome (“AIDS”), to the New Jersey State Department of Health to protect the health and well being of the general public. Other activities generally disclosed include the following:
To prevent or control disease, injury or disability.
To report births and deaths.
To report child abuse and neglect.
To report reactions to medications or problems with products.
To notify a person who may have been exposed to a communicable disease or may be at risk for
contracting or spreading a disease or condition.
To notify the appropriate government authority if UMDNJ believes a patient has been the victim
of abuse, neglect or domestic violence.
Safety of a Person or the Public
We may use and disclose your health information to prevent or lessen a serious and imminent threat to the health or safety of a person or the public.
We may use and disclose health information about you for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illnesses.
We may use and disclose your health information as required by military command authorities, if you are a member of the armed forces.
If you are an inmate of a correctional institution or under the custody of a law enforcement officer, we may release your medical/dental record information to the correctional institution or law enforcement official. This release would be necessary: (1) for the institution to provide you with health care; (2) to protect your health and safety and that of others; and (3) for the safety and security of the correctional institution.
Required by Law
We may use and disclose health information about you when required to do so by State or Federal law. For example, we may disclose certain health information to those persons who have a risk exposure related to a communicable disease, as required by New Jersey law.
National Security and Intelligence Activities
We may use and disclose your medical/dental information about you to authorized federal officials for intelligence, counterintelligence, and other National Security activities as authorized by law. We may also disclose health information about you to authorized federal officials so they may provide protection to the President or other authorized persons.
Coroners, Medical Examiners, Funeral Directors
We may release your health information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or to determine a cause of death. UMDNJ may also release your health information to funeral directors as necessary to carry out their duties.
We may use and disclose your health information to your employer to conduct medical surveillance of the workplace, or to evaluate whether you have a work-related illness or injury.
Secretary of the Department of Health and Human Services
We may use and disclose your health information when required by the Secretary of Health and the Department of Health and Human Services for purposes of investigating or determining compliance with the privacy law.
Any other uses and disclosures of your health information will be made only with your written authorization.
Your Rights Regarding Your Health Records
Although your health records are UMDNJ’s property, you have the following rights:
You have the right to receive confidential communications of your health information by alternative means or at alternative locations. To exercise your right, please write to the address at the end of this section.
You have the right to inspect and to obtain a copy of your health information. However, such requests may be denied as permitted under the law. You have the right to appeal such denials. To exercise your right, please write to the address at the end of this section. (Copying fees may be imposed.)
You have the right to request to amend your health information. However, UMDNJ may deny your request to amend your health information under certain circumstances. All requests for amendments must be in writing and provide a reason supporting your request for an amendment. To exercise your right, please write to the address at the end of this section.
You have the right to request restrictions on certain uses and disclosures of your health information. However, UMDNJ is not required to agree to such request. You must communicate your specific request in writing by using the proper form. To exercise your right, please write to the address at the end of this section.
You have the right to request that we provide you with an accounting of disclosures we have made of your health information. An accounting is a list of disclosures. This list will not include disclosures of your health information made for treatment, payment, or health care operations, made to you, or made pursuant to an authorization signed by you. The request should state the time period for which you wish to receive an accounting. This time period should not be longer than six (6) years and should not include dates before April 14, 2003. The first accounting you request within a twelve (12) month period will be free. For additional requests during the same twelve-month period, we will charge you for costs of the accounting. We will notify you of the amount we will charge and you may choose to withdraw or change your request before you are charged any costs. To exercise your right, please contact the address below.
You have the right to receive a paper copy of this Notice, upon request. You may also obtain a copy of this notice at our website.
You have the right to revoke your authorization (your permission) to use or disclose your health information except to the extent that action has already been taken in reliance on your prior authorization. To exercise your right, please contact the address below.
For More Information or to Make a Complaint or to exercise your rights above must be made in writing to: NJDS HIPAA Privacy Officer, UMDNJ-New Jersey Dental School, 110 Bergen Street, Suite B-813, Newark, New Jersey 07101.
If you have questions and would like additional information, you may call the Ethics Hotline: (800) 215-9664. If you believe your privacy rights have been violated, you may file a complaint with UMDNJ or with the Secretary of the Department of Health and Human Services. To file a complaint, please contact the HIPAA Compliance Office at the above address. There will be no retaliation for filing a complaint.
Changes to This Notice
UMDNJ will abide by the terms of the Notice currently in effect. However, UMDNJ reserves the right to change the terms of its Notice and to make the new Notice provision(s) effective for all health information that it maintains. UMDNJ will promptly post the revised Notice on the UMDNJ web site.
Reliance on this Notice by Other Healthcare Entities
UMDNJ may sometimes participate in an organized healthcare arrangement with providers and entities that may not be employed by UMDNJ, but participate in your health care. Any providers or entities participating in this arrangement may rely on this Notice as providing you with notice of their privacy practice.
Information about Bloodborne Pathogens is available here.
The effective date of the Notice is April 14, 2003.