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Notice of Privacy Practices

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED BY MORECARE, YOUR HEALTH PLAN, AND HOW YOU CAN GET ACCESS TO YOUR INFORMATION. PLEASE REVIEW IT CAREFULLY.

MoreCare is a health insurer licensed by the State of Illinois.

Effective Date: March 1, 2019

We respect member confidentiality and only release confidential information about you as allowed under Illinois and Federal law. This Notice describes our policies related to the use of the records of the coverage of your care generated by MoreCare.

Privacy Contact. If you have any questions about this policy or your rights, contact the Privacy Officer at the contact information provided below.

HOW WE CAN USE AND SHARE YOUR HEALTH INFORMATION

“Health information” means any information that includes details that identify you (such as your name and date of birth), as well as details about health care you received, or amounts paid for your care.

In order to effectively provide health insurance services for you, there are times when we will need to share your health information with others beyond MoreCare. This includes for:

Treatment. We may use or disclose treatment information about you to provide, coordinate, or manage your care or any related services, including sharing information with others outside MoreCare that we are consulting with or referring you to.

For Example: A doctor sends information to us about your diagnosis and treatment plan so we can arrange additional services for you.

For Example: We may share your health information with a service agency that arranges health care supportive housing services or food bank services to support your treatment plan.

Payment. With your written consent, information will be used to obtain payment for the treatment and services provided. This will include contacting your health insurance company for prior approval of planned treatment or for billing purposes. You have a right to restrict certain disclosures of your protected health information if you pay out of pocket in full for the services provided to you.

For Example: We share information about you with your prescription plan to coordinate payment for your prescriptions.

Healthcare Operations. We may use information about you to coordinate our business activities.

For Example: This may include setting up your appointments, reviewing your care, training staff.

For Example: We share information with a health information exchange so that your providers can coordinate your care.

Information Disclosed Without Your Consent. Under Illinois and federal law, information about you may be disclosed without your consent in a variety of circumstances, including the following:

    • Emergencies. Sufficient information may be shared to address an immediate emergency.
    • Follow Up Appointments/Care. We may be contacting you to remind you of future appointments or information about treatment alternatives or other health-related benefits and services that may be of interest to you. We may leave appointment information on your voice mail or leave an email or text messages unless you tell us not to.

As Required by Law.

    • This includes situations where we have received a subpoena, court order, or
    • Are required to provide public health information to help prevent or control disease, or
    • To report adverse reactions to medications or unsafe products, or
    • For public safety reasons, to prevent suspected abuse and neglect such as child abuse, elder abuse, or institutional abuse.
  • Workers Compensation. We may share your health information with agencies or individuals to follow workers compensation laws or other similar programs.
  • Coroners, Medical Examiners and Funeral Directors. We are required to disclose information about the circumstances of your death to a coroner who is investigating it.
  • Organ and Tissue Donation. If you are an organ donor, we may release health information to the organizations in charge of  getting, transporting or transplanting an organ, eye or tissue.
  • Governmental Requirements. We may disclose information to a health oversight agency for activities authorized by law, such as audits, investigations inspections and licensure. We are also required to share information, if requested with the U.S. Department of Health and Human Services to determine our compliance with federal laws related to health care and to Illinois  state agencies that fund our services or for coordination of your care.
  • Criminal Activity or Danger to Others. If a crime is committed on our premises or against our personnel, we may share information with law enforcement to apprehend the criminal. We also have the right to involve law enforcement when we believe an immediate danger may occur to someone.
  • Sensitive Health Information. Some health information is subject to additional protections under Illinois and federal law, but still may be disclosed without your consent if additional requirements are satisfied. For example, we may share certain types of information regarding the treatment of substance use disorders with specific categories of contractors (referred to as  “Qualified Service Organizations” or “QSOs”). QSOs must agree to protect the sensitive substance use disorder information from further disclosure.
  • With Business Associates. We may share your health information with another company, called a business associate, which we hire to provide a service to us or on our behalf. We will only share your information if the business associate has agreed in  writing to keep health information private and secure.
  • For Disaster Relief. We may share your health information in a disaster relief situation.

MEMBER RIGHTS

You have the following rights under Illinois and federal law:

Copy of Record. You are entitled to inspect and get a copy of the record that MoreCare has about your health and claims information. If you request a copy of your health and claims record, we may charge you a reasonable fee for copying and mailing your record.

You Also Have a Right to a Paper Copy of This Notice. You have the right to ask for a paper copy of this notice at any time. We will provide you with a paper copy promptly.

Release of Records. You may consent in writing to release of your records to others, for any purpose you choose. This could include your attorney, employer, or others who you wish to have knowledge of your care. You may revoke this consent at any time, but only to the extent no action has been taken in reliance on your prior authorization. Except as described in this Notice or as required by Illinois or Federal law, we cannot release your protected health information without your written consent.

Restriction on Record. You may ask us not to use or disclose part of the clinical information. This request must be in writing. MoreCare is not required to agree to your request if we believe it is in your best interest to permit use and disclosure of the information. The request should be given to the Privacy Officer, at the contact information provided below.

Contacting You. You may request that we send information to another address or by alternative means. We will honor such request as long as it is reasonable, and we are assured it is correct. We have a right to verify that the payment information you are providing is correct. We also will be glad to provide you information by email if you request it.

Amending Record. If you believe that something in your record is incorrect or incomplete, you may request we amend it. To do this contact the Privacy Officer and ask for the Request to Amend Health Information form. In certain cases, we may deny your request. If we deny your request for an amendment you have a right to file a statement you disagree with us. We will then file our response and your statement, and our response will be added to your record.

Accounting of Disclosures. You may request an accounting of any disclosures we have made related to your confidential information, except for information we used for treatment, payment, or health care operations purposes or that we shared with you or your family, or information that you gave us specific consent to release. It also excludes information we were required to release. To receive information regarding disclosure made for a specific time period no longer than six years, please submit your request in writing to our Privacy Officer. We will notify you of the cost involved in preparing this list.

Notification of Breach. You have a right to be notified if there is a breach of your unsecured protected health information. This would include information that could lead to identity theft. You will be notified if there is a breach or a violation of the HIPAA Privacy Rule and there is an assessment that your protected information may be compromised.

You Have a Right to Choose Someone to Act for You. 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.

Questions, Requests, and Complaints. If you have any questions, wish to submit a request in writing relating to any of the rights summarized above, wish to receive a paper copy of this Policy, or have any complaints you may contact our Privacy Officer in writing at our office:
Privacy Officer
MoreCare
180 N. Stetson, Suite 600-1
Chicago IL 60601
Email: compliance_mc@morecareil.com.

If you believe MoreCare has violated your privacy rights, you may file a complaint with the Office for Civil Rights, U.S. Department of Health and Human Services. You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to:

U.S. Department of Health and Human Services Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201

You can also call 1-877-696-6775 or you may visit www.hhs.gov/ocr/privacy/hipaa/complaints/

We will not retaliate against you for filing a complaint.

Changes in Policy. MoreCare reserves the right to change its Privacy Policy based on the needs of MoreCare and changes in state and federal law.