This notice, effective April 14, 2003, is required by the federal Health Insurance Portability and Accountability Act of 1996 (”HIPAA”) to explain how The New School (TNS) protects the confidentiality of your health care information in its possession.  Protected Health Information (“PHI”) is defined as an individually identifiable information regarding a patient’s medical/dental history; mental or physical condition; or treatment.  Some examples of PHI include your name, address, telephone and/or fax number, electronic mail address (e-mail), social security number or other identification number, date of birth, date of treatment, treatment records, enrollment and claims records.  TNS receives, uses and/or discloses your PHI to administer your benefit plans or as permitted or required by law.  Any other disclosure of your PHI without your authorization is prohibited.  This applies to TNS’s medical and dental plans.

TNS must follow the privacy practices described in this notice and also comply with any other requirements under federal or state law that may apply to TNS’s administration of your benefits.  You should receive a copy of this notice upon enrollment in a Health plan.  Additionally, TNS will notify you every three (3) years as to how you can receive a copy of this notice.  TNS reserves the right to change this notice and make the new notice effective for all PHI that it maintains.  If TNS makes any substantive changes to its privacy practices, it will redistribute a revised notice to you within sixty (60) days of the date of the change to its practices.  You may request a copy of this notice at any time from TNS as listed in the contact section at the end of this notice.

Permitted Uses and/or Disclosures of Your PHI

Under HIPAA, TNS is permitted to use and/or disclose your PHI for certain purposes without your prior authorization.  These permitted uses and/or disclosures include disclosures to you; uses and/or disclosures for purposes of health care treatment, payment of claims, billing of premiums, and other health care operations.  Since our benefit programs are sponsored by TNS, we may provide PHI to health care providers for purposes of administering your benefits.  TNS may also disclose PHI to third parties that perform services for TNS in the administration of your benefits.  These parties are required by law to sign a contract agreeing to protect the confidentiality of your PHI.  Your PHI may be disclosed to an affiliate that performs services for TNS in the administration of your benefits.  These affiliates have implemented privacy policies and procedures and comply with applicable federal and state law.

TNS is also permitted to use and/or disclose your PHI to comply with a valid patient authorization; to notify or assist in notifying a family member, another person, or an authorized personal representative of your condition; to assist in disaster relief efforts; and to report victims of abuse, neglect, or domestic violence.  Other permitted uses and/or disclosures are for purposes of health oversight by government agencies; judicial, administrative, or other law enforcement purposes; information about decedents to coroners, medical examiners and funeral directors; for research purposes; for organ donation purposes; to avert a serious threat to health or safety; for specialized government functions such as military and veterans activities; for workers’ compensation purposes; and for use in creating summary information that can no longer be traced to you.  TNS is also permitted to incidentally use and/or disclose your PHI during the course of a permitted use and/or disclosure, but it must attempt to keep incidental uses and/or disclosures to a minimum.  TNS uses administrative, technical, and physical safeguards to maintain the privacy of your PHI, and it is required by law to limit the use and/or disclosures of your PHI to the minimum amount necessary to accomplish the purpose of the permitted use and/or disclosure.

Examples of Permitted Uses and/or Disclosures of Your PHI for Treatment, Payment or Health care Operations

TNS may use and/or disclose your PHI for purposes of administering your benefits with our business associates.  Specific examples of such uses and/or disclosures include the following:

• Uses and/or disclosures of PHI in facilitating treatment.
  For example, TNS may use and/or disclose your PHI to determine eligibility for services requested by a health care provider.

• Uses and/or disclosures of PHI for payment.
  For example, TNS may use and/or disclose your PHI to pay premiums.

• Uses and/or disclosures of PHI for health care operations.

Disclosures TNS is Permitted to Make Without an Authorization

Under HIPAA, TNS is permitted to disclose your PHI to you or your authorized personal representative (with certain exceptions), when required by the U.S. Secretary of Health and Human Services to investigate or determine TNS’s compliance with law, and when otherwise required by law.  TNS is also permitted to disclose your PHI without your prior authorization in response to one or more of the following:

• Court order;
• Order of a board, commission, or administrative agency for purposes of adjudication pursuant to its lawful authority;
• Subpoena in a civil action;
• Investigative subpoena of a government board, commission, or agency;
• Subpoena in an arbitration;
• Law enforcement search warrant; or
• Coroner’s request during an investigation.

Disclosures TNS Makes With Your Authorization

TNS will not use and/or disclose your PHI without your prior authorization if the law requires your authorization.  You can later revoke that authorization in writing to stop any future use and disclosure.  The authorization will be obtained from you by TNS or by a person requesting your PHI from TNS.

Your Rights Regarding Your PHI

You have the right to request an inspection of and obtain a copy of your PHI.  You may access your PHI, as well as request an explanation of this privacy notice by contacting TNS’s privacy officer as listed in the contact section below.  You must include (1) your name, address, telephone number and identification number and (2) a description of the PHI you are requesting.  TNS may charge a reasonable fee for providing you copies of your PHI.  TNS only maintains that PHI that it obtains or utilizes in providing your health care benefits.  You may need to contact your health care provider to obtain PHI that TNS does not possess.

You may not inspect or copy PHI compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding, or PHI that is otherwise not subject to disclosure under federal or state law.  In some circumstances, you may have a right to have this decision reviewed.  Please contact TNS if you have questions about access to your PHI.

You have the right to request a restriction on your PHI.  You have the right to ask that TNS limit how it uses and discloses your PHI.  TNS will consider your request but is not legally required to accept it.  If TNS accepts your request, it will put any limits in writing and abide by them except in emergency situations.  You may not limit the uses and/or disclosures that TNS is legally required or allowed to make.
You have the right to correct or update your PHI.  This means that you may request an amendment of your PHI for as long as TNS maintains this information.  In certain cases, TNS may deny your request for an amendment.  If TNS denies your request for amendment, you have the right to file a statement of disagreement with TNS.  TNS may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal.  If your PHI was sent to TNS by another entity, it may refer you to that entity to amend your PHI.  For example, TNS may refer you to your provider to amend your treatment chart, to amend your enrollment information.  Please contact TNS as noted below if you have questions about amending your PHI.

You have the right to request or receive confidential communications from TNS by alternative means or at a different address.  TNS will agree to accommodate a reasonable request if disclosure of your PHI through standard means of communication could endanger you.  You may be required to provide TNS with a statement of possible danger, a different address, another method of contact of information as to how payment will be handled.  Please make this request in writing to TNS.

You have the right to receive an accounting of certain disclosures TNS has made, if any, of your PHI.  This right does not apply to disclosures for purposes of treatment, payment, or health care operations of for information TNS disclosed after it received a valid patient authorization from you.  Additionally, TNS does not need to account for disclosures made to you, to family members or friends involved in your care, or for notification purposes.  TNS does not need to account for disclosures made for national security reasons or certain law enforcement purposes, disclosures made as part of a limited data set, incidental disclosures, or disclosures made prior to April 14, 2003.  Please contact TNS if you would like to receive an accounting of disclosures or if you have questions about this right.

You have the right to receive this notice via electronic mail address (e-mail).  Even if you have agreed to receive this notice via e-mail, you also have the right to request a paper copy of this notice.

Complaints

You may complain to TNS by contacting the privacy grievance officer as listed in the contact section below, or to the U.S. Secretary of Health and Human Services if you believe that TNS has violated your privacy rights.  You may file a complaint with TNS.  TNS will not retaliate against you for filing a complaint.

Contact