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 Villanova University Health and Welfare Plan (the "Welfare Plan") and the Villanova University Cafeteria Plan (the "Cafeteria Plan") (collectively the "Plan" or the "Plans") are committed to protecting the privacy of your protected health information. Protected health information is information that identifies you and relates to a physical or mental condition, or to the provision or payment of health services for you. The Plan also pledges to provide you with certain rights related to your protected health information.
Both the Welfare Plan and the Cafeteria Plan are hybrid entities under HIPAA. This means that HIPAA only applies to the health care benefits provided under the Plans – specifically, under the Welfare Plan, the medical reimbursement (for HMO participants only), dental and employee assistance program (EAP) benefits, and under the Cafeteria Plan, the health care reimbursement benefit. You will receive a separate Notice of Privacy Practices from the carrier of your medical plan, if applicable. Please note that you are only entitled to the rights under this Notice to the extent that you are enrolled and participate in a covered health care benefit (as described above) under the Welfare or Cafeteria Plans.
By this Notice of Privacy Practices ("Notice"), the Plan informs you that it has the following legal obligations under the federal health privacy provisions contained in the Health Insurance Portability and Accountability Act of 1996 ("HIPAA") and the related regulations ("federal health privacy law"):
This Notice also informs you how the Plan uses and discloses your protected health information and explains the rights that you have with regard to your protected health information maintained by the Plan. For purposes of this Notice, "you" and "yours" refers to participants and dependents who are eligible for benefits described under the Plan.
IMPORTANT: Receipt of this notice does not mean you are eligible or enrolled under the Welfare or Cafeteria Plan. Eligibility and enrollment are determined by the Plan documents and your elections.
The Plan collects certain health information about you to help provide health benefits to you, as well as to fulfill legal requirements. The Plan collects this information, which identifies you, from applications and other forms that you complete, through conversations you may have with the Plan’s administrative staff and health care providers, and from reports and data provided to the Plan by health care service providers or other employee benefit plans. The health information the Plan has about you includes, among other things, your name, address, phone number, birth date, social security number, and medical and health claims information. This is the information that is subject to the privacy practices described in this Notice.
This Notice does not apply to health information collected or maintained by Villanova University (the "University") on behalf of the non-health employee benefits that it sponsors, including disability benefits, life insurance, accidental death and dismemberment insurance, tuition benefits, and workers’ compensation insurance. This Notice also does not apply to health information that the University requests, receives, and maintains about you for employment purposes, such as determining your eligibility for medical leave benefits under the Family and Medical Leave Act or disability accommodations under the Americans with Disabilities Act.
Except as described in this section, as provided for by federal, state or local law, or as you have otherwise authorized, the Plan only uses and discloses your protected health information for the administration of the Plan and for processing claims. The uses and disclosures that do not require your written authorization are described below.
The Plan may disclose your protected health information to third parties that assist the Plan in its operations. For example, the Plan may share your protected health information with its business associate if the business associate is responsible for paying medical claims for the Plan. The Plan's business associates have the same obligation to keep your protected health information confidential as the Plan does. The Plan must require its business associates to ensure that your protected health information is protected from unauthorized use or disclosure.
The Plan may disclose your protected health information, without your consent, to the University for administration purposes, such as determining the amount of benefits you or your eligible dependent is entitled to from the Plan, determining or investigating facts that are relevant to a benefit claim, determining whether your benefits should be terminated or suspended, performing duties that relate to the establishment, maintenance, administration and/or amendment of the Plan, communicating with you about the status of a claim, recovering any overpayment or mistaken payments made to you, and handling issues related to subrogation and third party claims.
The federal health privacy law provides for specific uses or disclosures of your protected health information that the Plan may make without your authorization, which are described below.
In most situations, reasonable measures will be taken to limit the use and disclosure of protected health information to the individuals who need it and to the amount of information necessary to perform a particular function.
The Plan does not use your protected health information for fundraising or marketing purposes.
Uses and disclosures of your protected health information other than those described above will be made only with your express written authorization. You may revoke your authorization in writing. If you do so, the Plan will not use or disclose your protected health information authorized by the revoked authorization, except to the extent that the Plan already has relied on your authorization.
Once your protected health information has been disclosed pursuant to your authorization, the federal privacy protections may no longer apply to the disclosed health information, and that information may be re-disclosed by the recipient without your or the Plan’s knowledge or authorization.
You have the following rights regarding your protected health information that the Plan collects and maintains. If you are required to submit a written request related to these rights, as described below, you should address such requests to HIPAA Privacy Officer, Office of Human Resources, Villanova University, 800 Lancaster Avenue, Villanova, PA 19085, (610) 519-7900.
You have the right to inspect and obtain a copy of your health record. This includes, among other things, health information about your plan eligibility, plan coverages, claim records, and billing records. To inspect and copy your health record maintained by the Plan, submit your request in writing. The Plan charges a reasonable fee for the cost of copying your health record, and charges you the cost of mailing your health record to you. If the Plan maintains your protected health information in an electronic format, you can receive it electronically or have it sent electronically to a designated person. In certain limited circumstances, the Plan may deny your request to inspect and copy your health record. If the Plan does so, it will inform you in writing. In certain instances, if you are denied access to your health record, you may request a review of the denial.
You have the right to request that the Plan communicate your protected health information to you in confidence by alternative means or in an alternative location. For example, you can ask that the Plan only contact you at work or by mail, or that the Plan provide you with access to your protected health information at a specific location. To request confidential communications by alternative means or at an alternative location, submit your request in writing, including, the reason(s) for your request and the alternative means by or location at which you would like to receive your protected health information. If appropriate, your request should state that the disclosure of all or part of your protected health information by non-confidential communications could endanger you. The Plan will accommodate reasonable requests and will notify you appropriately.
You have the right to request that the Plan amend your protected health information if you believe the information is incorrect or incomplete. To request an amendment, submit a detailed request in writing that provides the reason(s) that support your request. The Plan may deny your request if you have asked to amend information that:
The Plan will notify you in writing as to whether it accepts or denies your request for an amendment to your protected health information. If the Plan denies your request, it will explain the reason(s) for the denial, and describe how you can continue to pursue the denied amendment.
You have the right to receive a written accounting of disclosures. The accounting is a list of disclosures of your protected health information by the Plan to others, except that disclosures for treatment, payment or health care operations, disclosures made to or authorized by you, and certain other disclosures are not part of the accounting. The accounting covers up to six years prior to the date of your request. If you want an accounting that covers a time period of less than six years, please state that in your written request for an accounting.
To request an accounting of disclosures, submit your request in writing. The first accounting that you request within a twelve month period will be free. For additional accountings in a twelve month period, the Plan will charge you for the cost of providing the accounting, but the Plan will notify you of the cost involved before processing the accounting so that you can decide whether to withdraw your request before any costs are incurred.
You have the right to request restrictions on your protected health care information that the Plan uses or discloses about you to carry out treatment, payment or health care operations. Also, you have the right to request restrictions on your protected health information that the Plan discloses to someone who is involved in your care or the payment for your care, such as a family member or friend. The Plan is not required to agree to your request for such restrictions, and the Plan may terminate its agreement to the restrictions you requested. However, the Plan will agree to appropriate restrictions if your protected health information pertains to health care items or services that you paid for entirely out-of-pocket and the disclosure of the protected health information is for purposes of payment or health care operations. To request restrictions, submit your request in writing, and advise the Plan as to what information you seek to limit, and how and/or to whom you would like the limit(s) to apply. The Plan will notify you in writing as to whether it agrees to your request for restrictions. The Plan will also notify you in writing if it terminates an agreement to the restrictions that you requested.
You have the right to complain to the Plan and/or to the Department of Health and Human Services if you believe your privacy rights have been violated. To file a complaint with the Plan, submit your complaint in writing to HIPAA Privacy Officer, Office of Human Resources, Villanova University, 800 Lancaster Avenue, Villanova, PA 19085, (610) 519-7900.
You may contact the Department of Health and Human Services at the Office of Civil Rights, 200 Independence Avenue, S.W., Washington, DC, 20201, (202) 619-0251/(877) 696-6775, http://www.hhs.gov/contactus.html.
You will not be retaliated or discriminated against and no services, payment, or privileges will be withheld from you because you file a complaint with the Plan or with the Department of Health and Human Services.
You have the right to a paper copy of this Notice. To make such a request, submit a written request to HIPAA Privacy Officer, Office of Human Resources, Villanova University, 800 Lancaster Avenue, Villanova, PA 19085, (610) 519-7900.
You may also obtain a copy of this Notice at the University’s Web site, www.hr.villanova.edu
The Plan reserves the right to change its privacy practices and make the new practices effective for all health information that it maintains. If the Plan materially changes any of its privacy practices covered by this Notice, it will provide you with a revised Notice.
This Notice is effective as of February 17, 2010, and will remain in effect unless and until the Plan publishes a revised Notice.