How We May Use and Disclose Your PHI
I. Uses and Disclosures for Treatment, Payment and Health Care Operations
Lighthouse Guild may use or disclose your PHI in connection with your treatment, our payment for such treatment and for our health care operations. Lighthouse Guild will make reasonable efforts not to disclose more than the minimum necessary amount of PHI to achieve the particular purpose of the disclosure.
For Treatment: We may share your health information with doctors or nurses or therapists who are involved in taking care of you, and they may in turn use that information to diagnose or treat you. A doctor treating you at one of our facilities may share your health information with another doctor within our facilities, or with a doctor at another health care facility, to determine how to diagnose or treat you. Your doctor may also share your health information with another doctor to whom you have been referred for further health care.
For Payment: We may use your health information or share it with others so that we may obtain payment for your health care services. For example, we may share information about you with your health insurance provider in order to obtain reimbursement for treatment or care we have provided to you, or to determine whether it will cover your future treatment or care. Finally, we may share your information with other providers and payors for their payment activities.
For Business Operations: We may use your health information or share it with others in order to conduct our business operations. For example, we may use your health information to evaluate the performance of our staff in caring for you or to educate our staff on how to improve the care they provide you. Finally, we may share your health information with other health care providers and payors for certain business operations if the information is related to a relationship the provider or payor currently has or previously had with you, and if the provider or payor is required by federal law to protect the privacy of your health information.
Disclosure to Third Parties: In any circumstance where we disclose PHI to a third party that performs a service on behalf of Lighthouse Guild (i.e., a Business Associate), we will have a written contract with that entity which requires the entity to also protect the privacy of your PHI.
II. Disclosures to Your Representatives
Individuals Involved in Your Care or Payment For Your Care: Unless you object in writing, Lighthouse Guild may disclose PHI to a close friend or family member involved in or who helps pay for your health care, but only to the extent relevant to that friend or family member’s involvement in your care or payment for your care. For example, if a family member or a caregiver calls Lighthouse Guild with prior knowledge of a claim, Lighthouse Guild may confirm whether or not the claim has been received and paid. We may also disclose your PHI to any authorized public or private entities assisting in disaster relief efforts.
Disclosure to Your Personal Representatives: We may disclose your PHI to your personal representative in accordance with applicable state law and HIPAA. In addition, you may authorize a personal representative to receive your PHI and act on your behalf. Contact the Privacy Officer to obtain a copy of the appropriate form to authorize the people who may receive this information.
III. Other Permitted Uses and Disclosures
Lighthouse Guild may also use or disclose your PHI for any of the following purposes:
Required By Law: We may use or disclose your PHI to the extent that we are required to do so by federal, state or local law. You will be notified, if required by law, of any such uses or disclosures.
Public Health: We may disclose your PHI for public health and safety purposes to a public health authority that is permitted by law to collect or receive the information. Your PHI may be used or disclosed for the purpose of preventing or controlling disease (including communicable diseases), injury or disability. If directed by the public health authority, we may also disclose your PHI to a foreign government agency that is collaborating with the public health authority.
Health Oversight: We may disclose your PHI to a health oversight agency for activities authorized by law, such as audits, investigations, inspections and legal actions. Oversight agencies seeking this information include government agencies that oversee the health care system, government benefit programs, other government regulatory programs and civil rights laws.
Abuse or Neglect: We may disclose your PHI to any public health authority authorized by law to receive information about abuse, neglect or domestic violence if we reasonably believe that you have been a victim of abuse, neglect or domestic violence. In this case, the disclosure will be made consistent with the requirements of applicable federal and state laws, and we will inform you that such a disclosure has been or will be made unless that notice will cause a risk of serious harm.
To Avert a Serious Threat to Health or Safety: We may use or disclose your PHI when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone reasonably able to help prevent or lessen the threat.
Legal Proceedings: We may disclose your PHI in the course of any judicial or administrative proceeding, in response to an order of a court or administrative tribunal. In addition, we may disclose your PHI under certain conditions in response to a subpoena, court-ordered discovery request or other lawful process, in which case reasonable efforts must be undertaken by the party seeking the PHI to notify you and give you an opportunity to object to the disclosure.
Law Enforcement: We may disclose your PHI if requested by a law enforcement official as part of certain law enforcement activities.
Coroners, Funeral Directors, and Organ Donation: We may disclose your PHI to a coroner or medical examiner for identification purposes, or other duties authorized by law. We may also disclose your PHI to a funeral director, as authorized by law, in order to permit the funeral director to carry out his/her duties. We may disclose such information in reasonable anticipation of death. We may also disclose PHI for cadaveric organ, eye or tissue donation purposes.
Research: We are permitted to disclose your PHI to researchers when their research has been approved by an institutional review board that has established protocols to ensure the privacy of your PHI.
Military Activity and National Security: When the appropriate conditions apply, we may use or disclose PHI of individuals who are Armed Forces personnel: (1) for activities deemed necessary by military command authorities; or (2) to a foreign military authority if you are a member of that foreign military service. We may also disclose your PHI to authorized federal officials conducting national security and intelligence activities.
Workers’ Compensation: We may disclose your PHI to comply with workers’ compensation laws and other similar legally established programs.
Inmates: 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 institution or official if the PHI is necessary for the institution to provide you with health care; to protect the health and safety of you or others; or for the security of the correctional institution.
Required Uses and Disclosures: We must make disclosures of PHI to the Secretary of the U.S. Department of Health and Human Services (“HHS”) to investigate or determine our compliance with the federal regulations regarding privacy.