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Humana Government Business privacy

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. If at any time, you have any questions about this notice, please contact us by emailing the Humana Government Business Privacy Official at hmhsprivacyoffice@humana.com

Notice of privacy practices

This Notice of Privacy Practices is provided to you as a requirement of the Health Insurance Portability and Accountability Act (HIPAA). It describes how we may use or disclose your protected health information, with whom that information may be shared, and the safeguards we have in place to protect it. This notice also describes your rights to access and amend your protected health information. You have the right to approve or refuse the release of specific information outside of our system except when the release is required or authorized by law or regulation. There are several other privacy laws that also apply including the Freedom of Information Act, the Privacy Act and the Alcohol, Drug Abuse, and Mental Health Administration Reorganization Act. These laws have not been superseded and have been taken into consideration in developing our policies and this notice of how we will use and disclose your protected health information.

The privacy of your personal and health information is important. You don't need to do anything unless you have a request or complaint. Relationships are built on trust. One of the most important elements of trust is respect for an individual’s privacy. We at Humana Government Business value our relationship with you, and we take your personal privacy seriously. This notice explains Humana Government Business’ privacy practices, our legal responsibilities, and your rights concerning your personal and health information. We follow the privacy practices described in this notice and will notify you of any changes.

We reserve the right to change our privacy practices and the terms of this notice at any time, as allowed by law. This includes the right to make changes in our privacy practices and the revised terms of our notice effective for all personal and health information we maintain. This includes information we created or received before we made the changes as well as any information we receive in the future. When we make a significant change in our privacy practices, we will change this notice, post the revised notice on appropriate websites and have copies of the notice available upon request.

What is personal and health information?

Personal and health information - from now on referred to as “information” - includes both medical information and individually identifiable information, like your name, address, telephone number, or social security number. The term “information” in this notice includes any personal and health information created or received by a healthcare provider or health plan that relates to your physical or mental health or condition, providing healthcare to you, or the payment for such healthcare. We protect this information in all formats including electronic, written and oral information.

Why were you asked to acknowledge receipt of this notice?

For your benefit and protection under the HIPAA Final Privacy Regulations, we are required to make a good faith effort in obtaining an acknowledgment of receipt of this notice. Our intent is to make you aware of the possible uses and disclosures of your protected health information and your privacy rights. The delivery of your health care services will in no way be conditioned upon your acknowledgment. If you decline to provide acknowledgment, we will continue to provide your treatment, and will use and disclose your protected health information for treatment, payment, and health care operations when necessary.

Who will follow this notice?

This notice describes Humana Government Business practices regarding your information on behalf of itself, its affiliates and its business associates. We may share your information with affiliates and third-party “business associates” who perform various activities (for example, billing, transcription services) for the health plan. The business associates will also be required to protect your information.

What are our duties to you regarding protection of your information?

In keeping with federal and state laws, policy of organizations to which we provide services and our own policy, we are responsible to maintain the privacy of your information. We have safeguards in place to protect your information in various ways including:

  • Limiting who may see your information
  • Limiting how we use or disclose your information
  • Providing this notice, informing you of our legal duties about your information including our policy and privacy practices related to the use and disclosure of your information
  • Following the terms of the notice currently in effect
  • Communicating any changes in the notice to you
  • Training our associates about our privacy policies and procedures

What are your rights regarding the filing of a complaint?

If you believe your privacy rights have been violated, you may file a written complaint with any of the entities identified immediately below, or the Department of Health and Human Services. No retaliation will occur against you for filing a complaint.

How do you exercise your rights?

You may exercise your rights under this notice at any time by contacting the Privacy Official. Likewise, you may obtain a copy of this notice by requesting a copy be sent to you by:

  • E-mailing: hmhsprivacyoffice@humana.com
  • Contacting: 1-866-838-8242
  • Sending a request to:
    Humana Government Business, Privacy Office
    305 N. Hurstbourne Parkway
    Forum III/2B
    Louisville, KY 40222.

Humana Government Business as a business associate maintains multiple prime and other contracts with the U.S. Government departments, agencies and other covered entities, or as a subcontractor to others with prime contracts, thereby providing services to and on behalf of certain federal departments and agencies.

In the alternative you may contact, as appropriate the healthcare plan with which you are associated:
Defense Health Agency (DHA) is a field activity under the policy guidance and direction of the Assistant Secretary of Defense (Health Affairs) (ASD (HA)), and was formally established under Department of Defense (DoD) Directive.

You may contact your local MTF Privacy Officer or the DHA Privacy Officer for further information. The DHA Privacy Officer may be contacted at Defense Health Agency, Privacy and Civil Liberties Office, 7700 Arlington Boulevard, Suite 5101, Falls Church, Virginia 22042-5101. You may also email questions to PrivacyMail@tma.osd.mil. For additional information regarding your privacy rights visit the TRICARE Web site at tricare.mil/tma/privacy

U.S. Department of Veterans Affairs can be contacted via VA Privacy Service online at privacyservice@va.gov, or you can mail your question or concern at Department of Veterans Affairs, Privacy Service, 810 Vermont Avenue, N.W. (005R1A) Washington, DC 20420.

Your inquiry will be treated confidentially and will not be shared with third parties, except as necessary to respond to your inquiry and for other purposes as authorized by the Privacy Act and other relevant legal authority.

The VA Privacy Service works to minimize the impact on veteran's privacy, particularly veteran's personal information and dignity, while achieving the mission of the Department of Veteran Affairs.

How does Humana Government Business use and disclosure your information?

We must use and disclose your information:

  • To you or someone who has the legal right to act on your behalf. Unless, it has been determined by a competent medical authority that the disclosure could be harmful to you or another person.
  • To parents, guardians, and persons acting in a similar legal status as permitted or required by the applicable state laws concerning disclosure of minor’s information. We will make disclosures only to the extent of such laws, provided the parents, guardians, or persons have the legal right to act consistently with the law of the state where the treatment is provided.
  • To the Secretary of the Department of Health and Human Services (DHHS) for investigations or determinations of our compliance with laws on the protection of your health information.
  • Where required by law or where regulation requires the use or disclosure

We have the right to use and disclose your information:

  • To a doctor, a hospital, or other healthcare provider so you can receive medical care (for example, a specialist, pharmacist, or laboratory) who, at the request of your physician, becomes involved in your care by providing assistance with your health care diagnosis or treatment. This includes pharmacists who may be provided information on other drugs you have been prescribed to identify potential interactions.
  • In emergencies, we will use and disclose your information to provide the treatment you require
  • For payment activities, including claims payment for covered services provided to you by healthcare providers and for health plan premium payments
  • For healthcare operation activities including processing your enrollment, responding to your inquiries and requests for services, coordinating your care, resolving disputes, conducting medical management, improving quality, reviewing the competence of healthcare professionals, determining premiums, training of medical students, licensing, communications about a product or service, and conducting or arranging for other health care related activities
  • For compliance with workplace medical surveillance laws, programs, requirements and activities such as: Occupational Safety and Health Administration, Workers’ Compensation, Mine Safety and Health Administration, Family and Medical Leave Act (FMLA) and disability benefits, Department of Transportation and non-mandated drug and alcohol test results, life insurance eligibility, employment physicals, workplace safety, and to determine whether prospective and current employees are able to perform their job duties.
  • For performing underwriting activities. However, we will not ask questions regarding family history, use genetic information, including results of genetic testing, for underwriting purposes is prohibited under HIPAA law
  • To your health plan sponsor to permit them to perform plan administration functions such as eligibility, enrollment and disenrollment activities. We may share summary level health information about you with your plan sponsor in certain situations such as to allow your health plan sponsor to obtain bids from other health plans. We will not share detailed health information to your health plan sponsor unless you provide us your permission or your health plan sponsor has certified they agree to maintain the privacy of your information other than as permitted or required by the plan documents or as required by law
  • To contact you with information about health-related benefits and services, appointment reminders, refill reminders, or about treatment alternatives that may be of interest to you if you have not opted out as described below.
  • To your family and friends if you are unavailable to communicate, such as in an emergency
  • To your family and friends or any other person you identify, provided the information is directly relevant to their involvement with your health care or payment for that care. For example, if a family member or a caregiver calls us with prior knowledge of a claim, we may confirm whether or not the claim has been received and paid
  • To provide payment information to the subscriber for Internal Revenue Service substantiation
  • To public health agencies if we believe there is a serious health or safety threat.
  • To appropriate authorities when there are issues about abuse, neglect, or domestic violence
  • In response to a court or administrative order, subpoena, discovery request, or other lawful process
  • For law enforcement purposes, to military authorities and as otherwise required by law
  • For military activities believed necessary by appropriate military command authorities to ensure the proper execution of the military mission including determination of fitness for duty;
  • For national security purposes to authorized federal officials for conducting national security and intelligence activities including protective services to the President or others
  • To assist in disaster relief efforts
  • For compliance programs and health oversight activities
  • To fulfill Humana Government Business obligations under any workers’ compensation law or contract
  • To avert a serious and imminent threat to your health or safety or the health or safety of others e.g., Food and Drug Administration adverse events, product defect reporting, enable product recalls, and etc.,
  • For research purposes in limited circumstances
  • For procurement, banking, or transplantation of organs, eyes, or tissue
  • To a coroner, medical examiners, organ donations, or funeral directors

Will Humana Government Business use my information for purposes not described in this notice?

In all situations of use and disclosure other than described in this notice, Humana Government Business will request your written permission. Before using or disclosing your information for any reason, other than those described in the notice, we will obtain your permission or authorization. You may revoke your permission at any time by notifying us in writing. We will not use or disclose your information for any reason not described in this notice without your permission. The following uses and disclosures will require an authorization:

  • Most uses and disclosures of psychotherapy notes.
  • Marketing purposes.
  • Sale of protected health information.

What does Humana Government Business do with your information when you are no longer comprehended under one of Humana Government Business’ legal or contractual obligations?

Your information may continue to be used for purposes described in this notice when your membership is terminated by your health plan or you do not obtain coverage under another health plan to which Humana Government Business has legal or contractual obligations. After the required legal or contractual retention period, we destroy the information following strict procedures to maintain the confidentiality.

What are your rights concerning your information? The following are your rights with respect to your information:

  • Access – You have the right to review and obtain a copy of your information that may be used to make decisions about you, such as claims and case or medical management records. You also may receive a summary of this health information. If you request copies, we may charge you a fee for each page, a per hour charge for staff time to locate and copy your information, and postage. This right does not include inspection and copying of the following records: psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding; and protected health information that is subject to law that prohibits access to protected health information.
  • Access to Psychotherapy Notes - You do not have the right to access a provider’s psychotherapy notes. Psychotherapy notes are notes taken by a mental health professional during a conversation with the patient and kept separate from the patient’s medical and billing records.
  • Alternate Communications – You have the right to receive confidential communications of information in a different manner or at a different place to avoid a life threatening situation. We will accommodate your request if it is reasonable.
  • Amendment – You have the right to request an amendment of information we maintain about you if you believe the information is wrong or incomplete. We may deny your request if we did not create the information, we do not maintain the information, or the information is correct and complete. If we deny your request, we will give you a written explanation of the denial.
  • Directory – You have the right to agree or to object to the use or disclosure for directory purposes your information
  • Disclosure – You have the right to receive a notice that a breach has resulted in your unsecured private information being inappropriately used or disclosed. Humana will notify you in a timely manner if such a breach occurs. Additionally, you have the right to receive a listing of instances in which we or our business associates have disclosed your information for purposes other than treatment, payment, health plan operations, and certain other activities. We maintain this information and make it available to you for a period of six years at your request. If you request this list more than once in a 12-month period, we may charge you a reasonable, cost-based fee for responding to these additional requests.
  • Marketing and Subsidized Treatment – You have the right to grant authorization for the use of your information to receive Marketing and Subsidized Treatment communications. Without your prior signed authorization, we are prohibited from using your information for these purposes. You have the right to subsequently revoke the authorization. Once revoked, future Marketing and Subsidized Treatment communications will cease. Communication is considered Marketing if it does not constitute face to face communications and if financial remuneration is made in exchange for making the communications.
  • Notice – You have the right to receive a written copy of this notice any time you request.
  • Psychotherapy notes - You have the right to grant authorization for another provider to use your psychotherapy notes. Without your prior signed authorization, The Privacy Rule also does not permit us to make most disclosures of psychotherapy notes. You have the right to subsequently revoke the authorization. Once revoked, future disclosure will cease. An authorization for a use or disclosure of psychotherapy notes may only be combined with another authorization for a use or disclosure of psychotherapy notes.
  • Opt out – You have the right to ask to opt out of use of your information for the communication types listed below. Your opt-out request will continue to apply until you revoke your opt out request.
  • Appointment and refill reminders
  • Treatment alternatives – Unless you opt out, we may use your information to provide you with treatment alternatives or other health-related benefits and services that might interest you. For example, your name and address may be used to send you a newsletter about the services we offer. We may also send you information about products or services that we believe might benefit you.
  • Fundraising, including receiving future fundraising communications
  • Other health related services
  • Restriction – You have the right to ask to restrict uses or disclosures of your information for treatment, payment and healthcare operations purposes. We are not required to agree to these restrictions, but if we do, we will abide by our agreement. Any request to restrict disclosure to a health plan of your information related to services or expenses paid out of pocket in full, not otherwise required by law will be honored, provided the request must be made to the healthcare provider and the disclosure must be for payment or healthcare operation for example service/treatment including prescribed medication. You also have the right to agree to or terminate a previously submitted restriction.

Privacy notice concerning financial information

Humana Government Business and our affiliates understand that the privacy of your personal information is important to you. We take your privacy seriously and your trust in our ability to protect your private information is very important to us. This notice describes our policy regarding the confidentiality and disclosure of personal financial information.

How does Humana Government Business collect information about you?

We collect information about you and your family when you complete applications and forms or when your information is provided by your health plan. We also collect information from your dealings with us, our affiliates, or others. For example, we may receive information about you from participants in the healthcare system, such as your doctor or hospital, as well as from employers or plan administrators, credit bureaus, and the Medical Information Bureau.

What information does Humana Government Business receive about you?

The information we receive may include such items as your name, address, telephone number, date of birth, social security number, premium payment history, and your activity on our website. This also includes information regarding your medical benefit plan, your health benefits, and health risk assessments.

Where will Humana Government Business disclose your information?

We may share your information with affiliated companies and non-affiliated third parties, as required by law or for everyday business operation activities such as processing your enrollment, certain activities that might be undertake before it approves or pays for the services recommended for you such as determining eligibility or coverage for benefits, reviewing services provided to you for medical necessity, undertaking utilization review activities, responding to your inquiries or requests for services, processing premium payment or claim payment transactions, as part of compliance programs and oversight activities.

Additionally, we may disclose protected health information during any judicial or administrative proceeding, in response to a court order, legal investigations, report to credit bureaus or administrative tribunal (if such a disclosure is expressly authorized), and in certain conditions in response to a subpoena, discovery request, or other lawful process.

Only after obtaining your signed authorization, we may provide your information to other financial institutions with which we have joint marketing agreements in order to provide you with offers for products and services you may find of value or which are health-related. You have the right to grant authorization for the use of your information to receive marketing and subsidized treatment communications. However, without your prior signed authorization, we are prohibited from using your information for these purposes. You have the right to subsequently revoke the authorization. Once revoked, all future marketing and subsidized treatment communications will cease. Communication is considered marketing if it does not constitute face to face communications and if financial remuneration is made in exchange for making the communications.