CaliforniaKids Healthcare Foundation

NOTICE OF PRIVACY RIGHTS

We protect the confidentiality of our membersí personal financial and health information as required by law, accreditation standards and our internal policies and procedures. This Notice of Privacy Rights explains your rights, our legal duties and our privacy practices.

Your Financial Information

In order to make available certain preventive and primary health services to uninsured children in California, we collect and use several different types of financial information. This includes information that you provide directly to us on applications or other forms, such as your name, address, age, and information about dependents, as well as information regarding your personal and/or family income and other financial data. We accumulate such information in order to make determinations regarding your childís or childrenís eligibility for participation in CaliforniaKids (ìCalKidsî) to receive health care services through participating health plans and insurers. We also obtain such information in order to determine the premium you will be required to pay so your child/children to receive health care services under CalKids program. We also accumulate information about your transactions with our affiliates, others, or us such as the requirement for payment of premiums and co-payments and your payment history. We also retain any information we may receive from a consumer-reporting agency such as your credit history.

Safeguarding Confidentiality. We use physical, electronic, and procedural safeguards to protect your confidential information. We make it available only to our employees, affiliates or others who need it to determine eligibility, effect enrollment, or maintain your childís/childrenís coverage, to conduct insurance transactions and functions, or for other legally permitted or required purposes.

Your Health Information

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOUR CHILD OR CHILDREN MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

We collect, use and disclose information provided by and about you, your child or children for health care operations and premium payment, or when we are otherwise permitted or required by law to do so.

For Payment: We may use and disclose information about you and your child to verify eligibility, to enroll your child with participating health plans and insurers, and pay for your childís health benefits arranged through CalKids. In addition, we may use and disclose information about you and your child to coordinate the payment of claims for the medical care your child receives through participating health plans and insurers. For example, we will use and disclose the information to enroll your child to receive certain health care benefits from participating health plans and insurers as well as to make payments for coverage.

For Health Care Operations: We may use and disclose medical information about you or your child for our operations, including the collection of premiums. For example, we may use or disclose information to review the quality of care and services you receive from participating health plans and insurers or to assist you with problems concerning payment of claims or questions about health care benefits provided by participating health plans and insurers.

We may contact you to provide information about changes in levels or types of care arranged through CalKids or changes in health-related benefits and services offered through participating health plans and insurers. For example, when you or your dependents reach a certain age, we may notify you about additional products or programs for which you may become eligible, such as Medicare supplements or individual coverage.

As Permitted or Required by Law: Information about you, your child or children may be used or disclosed to regulatory agencies, such as during audits, licensure or other proceedings involving our activities; for administrative or judicial proceedings; to public health authorities; for law enforcement activities, such as to comply with a court order or subpoena; or to federal officials for intelligence, counterintelligence, and other national security activities to the extent authorized by law.

Fundraising: We may use information about you to contact you in an effort to raise money for CalKids its operations.

Business Associates: We may disclose medical information to those that we contract with as business associates so that they may perform services for us or on our behalf. For example, we may send tapes to an outside vendor for transcription. We require that business associates implement appropriate safeguards to protect your medical information.

Authorization: Other uses and disclosures of protected health information will be made only with your written permission, referred to as an authorization, unless otherwise permitted or required by law. An authorization will state the information to be disclosed, the particular individual(s) to which such information may be disclosed, and the purposes for such disclosure. It will include a specific date or event after which the authorization will no longer be valid. Also, you may revoke an authorization, at any time, in writing. We will then stop using or disclosing your information for that purpose. However, if we have already used your information based on your authorization, you cannot take back your agreement for those past situations.

Your Rights

You have the following rights regarding medical information we maintain about you:

  • Inspect and Copy Your Health Information. You have the right to send us a written request to see or get a copy of information that we have about you.

  • Amend Your Health Information. You have the right to amend health information about your child or children that you believe is incomplete or inaccurate. If we did not create the information, we will refer you to the source, such as your physician or hospital. We may deny the request if it does not include a reason to support the amendment.

  • Request Restrictions. You have the right to request additional restrictions on uses and disclosures of your health information. We are not required to agree to these requests.

  • Receive Confidential Communications. You have the right to request that we communicate with you about medical matters using reasonable alternative means or at an alternative address or telephone number, if communications to your home address could endanger you.

  • Receive an Accounting. You have the right to request in writing and receive an accounting of our disclosures of your medical information, except when those disclosures that are made for treatment, payment or health care operations, or the law otherwise provides an exception to the accounting. We are not required to give you a list of disclosures made before April 14, 2004. Your request should specify the time period for which you are requesting the information but may not start before April 14, 2004.

Copies of Notice

You have the right to receive an additional copy of this Notice of Privacy Rights at any time. Even if you have agreed to receive this notice electronically, for example, by e-mail, you are still entitled to a paper copy.

Changes to Notice

We reserve the right to revise this Notice of Privacy Rights. A revised notice will be effective for information we already have about you as well as any information we may receive in the future. We are required by law to comply with whatever privacy notice is currently in effect. We will promptly communicate any changes to our privacy notice through subscriber newsletters, direct mail, and/or our website.

Complaints

If you believe your privacy rights have been violated, you have the right to file a complaint with us, or with the federal government. You will not be penalized for filing a complaint. (See ìContact Informationî (below) for information as to where to file a complaint.)

Contact Information

If you want to exercise your rights under this notice or if you wish to communicate with us about privacy issues or to file a complaint with us, please contact Michael Koch, Executive Director and Privacy Official at (818) 755-9706.

If you would like hard copy of the HIPAA Notice of Privacy Rights in English or Spanish, please contact our customer service department, at (818) 755-9700.