AlaskaCare Health Plans Notice of Privacy Practices

Important: 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

The State of Alaska, Department of Administration, Division of Retirement and Benefits (the Division) is required by law to protect certain aspects of your health care information known as Protected Health Information or PHI and to provide you with this Notice of Privacy Practices.

This Notice describes our privacy practices, your legal rights, and lets you know, how the Division is permitted to:

  • Use and disclose PHI about you
  • How you can access and copy that information
  • How you may request amendment of that information
  • How you may request restrictions on our use and disclosure of your PHI

In most situations we may use this information described in this Notice without your permission, but there are some situations where we may use it only after we obtain your written authorization, if we are required by law to do so. We respect your privacy, and treat all health care information about our members with care under strict policies of confidentiality that all of our staff are committed to following at all times.

Please read the following detailed notice. If you have any questions about it, please contact the HIPAA Privacy Officer listed at the end of this document and someone will contact you.

Purpose of this Notice

This Notice describes your legal rights, advises you of our privacy practices, and lets you know how the Division is permitted to use and disclose Protected Health Information (PHI) about you.

Uses and Disclosures of PHI

The Division may use PHI for the purposes of treatment, payment, and health care operations, in most cases without your written permission.

For Payment

This includes any activities related to such things as management of billed claims for services rendered, medical necessity determinations and appeals, and utilization review audits.

For Health Care Operations

This includes training programs to ensure that our personnel meet our standards of care and follow established policies and procedures, obtaining legal and financial services, conducting business planning, processing grievances and complaints, and creating reports that do not individually identify you for data collection purposes.

Use and Disclosure of PHI Without Your Authorization

The Division is permitted to use PHI without your written authorization, or opportunity to object in certain situations, including:

  • For the treatment activities of health care provider;
  • To health care provider or entity for the payment activities of the provider or entity that receives the information (such as your hospital or insurance company);
  • For health care fraud and abuse detection or for activities related to compliance with the law;
  • To a public health authority in certain situations (such as reporting a birth, death or disease as required by law, as part of a public health investigation, to report child or adult abuse or neglect or domestic violence, to report adverse events such as product defects, or to notify a person about exposure to a possible communicable disease as required by law);
  • For health oversight activities including audits or government investigations, inspections, disciplinary proceedings, and other administrative or judicial actions undertaken by the government (or their contractors) by law to oversee the health care system;
  • For judicial and administrative proceedings or in some cases in response to a subpoena or other legal process;
  • For law enforcement activities in limited situations, such as when there is a warrant for the request, or when the information is needed to locate a suspect or stop a crime;
  • For military, national defense and security and other special government functions;
  • To avert a serious threat to the health and safety of a person or the public at large;
  • For workers’ compensation purposes, and in compliance with workers’ compensation laws;
  • We may use or disclose health information about you in a way that does not personally identify you or reveal who you are.

Any other use or disclosure of PHI, other than those listed above will only be made with your written authorization, (the authorization must specifically identify the information we seek to use or disclose, as well as when and how we seek to use or disclose it). You may revoke your authorization at any time, in writing, except to the extent that we have already used or disclosed medical information based upon that authorization.

Member Rights

As a member, you have a number of rights with respect to the protection of your PHI, including:

  • The right to access, copy or inspect your PHI. This means you may come to our offices and inspect and copy most of the medical information about you that we maintain. We will normally provide you with access to this information within 30 days of your request. We may also charge you a fee for you to copy any medical information that you have the right to access. In limited circumstances, we may deny you access to your medical information, and you may appeal certain types of denials. We have forms available for you to request access to your PHI. We will provide a written response if we deny you access and let you know your appeal rights. If you wish to inspect and copy your medical information, you should contact the Privacy Officer listed at the end of this Notice.
  • The right to amend your PHI. The right to request amending your PHI. You have the right to ask us to amend written medical information that we may have about you. If errors are found, we will generally amend your information within 60 days of your request and will notify you when we have amended the information. We are permitted by law to deny your request to amend your medical information, but only in certain circumstances. For example, if we believe the information is correct and no errors exist, your request will be denied. If you wish to request that we amend the medical information that we have about you, you should contact in writing the Privacy Officer listed at the end of this Notice.
  • The right to request an accounting of our use and disclosure of your PHI. You may request an accounting from us of certain disclosures of your medical information that we have made in the last six years prior to the date of your request. We are not required to give you an accounting of information we have used or disclosed for purposes of treatment, payment or health care operations, or when we share your health information with our business associates, such as our billing company or a medical facility from/to which we have transported you. We are also not required to give you an accounting of our uses of protected health information for which you have already given us written authorization. If you wish to request an accounting of the medical information about you that we have used or disclosed that is not exempted from the accounting requirement, you should contact the Privacy Officer listed at the end of this Notice.
  • The right to request that we restrict the uses and disclosures of your PHI. You have the right to request that we restrict how we use and disclose your medical information that we have about you for payment or health care operations, or to restrict the information that is provided to family, friends and other individuals involved in your health care. However, if you request a restriction and the information you asked us to restrict is needed to assist a provider in providing you with emergency treatment, then we may use the PHI or disclose the PHI to a health care provider to provide you with emergency treatment. The Division is not required to agree to any restrictions you request, but any restrictions agreed to by the Division are binding on the Division.

Internet, Electronic Mail, and the Right to Obtain Copy of Paper Notice on Request

We will prominently post a copy of this Notice on our web site and make the Notice available electronically through the web site. If you allow us, we may forward you this Notice by electronic mail instead of on paper and you may always request a paper copy of the Notice.

Revisions to the Notice

The Division reserves the right to change the terms of this Notice at any time, and the changes will be effective immediately and will apply to all PHI that we maintain. Any material changes to the Notice will be promptly posted to our web site. You can get a copy of the latest version of this Notice by contacting the Privacy Officer identified below.

Your Legal Rights and Complaints

You also have the right to complain to us, or to the Secretary of the United States Department of Health and Human Services if you believe your privacy rights have been violated. You will not be retaliated against in any way for filing a complaint with us or to the government. Should you have any questions, comments or complaints you may direct all inquiries to the Privacy Officer listed at the end of this Notice. Individuals will not be retaliated against for filing a complaint.

If you have any questions or if you wish to file a complaint or exercise any rights listed in this Notice, please contact:

  • Julie L. Wilson
  • HIPAA Privacy Officer
  • Division of Retirement and Benefits
  • P.O. Box 110203
  • Juneau, Alaska 99811-0203
  • Telephone: (907)465-4460
  • Toll Free: (800)821-2251
  • Fax: (907)465-4668
  • E-mail: doa.drb.benefits@alaska.gov

Effective Date of the Notice: June 1, 2010