Notice of Privacy Practices
Privacy of Your Confidential Member Information
This notice describes how information about you may be used and disclosed and how
you can get access to this information. Please review it carefully.
As your health plan, we care about the privacy of your confidential member
information. Federal law also requires all health plans to maintain this privacy.
This notice describes our privacy practices, our legal duties, and your rights
regarding confidential member information. This notice took effect on April 14,
2003, and will stay in effect until it is updated or changed. We will not make any
changes to our privacy practices without letting you know in advance. It may be
necessary to revise or update them over time, but we will let you know before the
changes go into effect.
Your Confidential Member Information
Each member generates confidential information. For example, when you visit a doctor,
a record of your visit is made. This record may have details about your symptoms,
injury or illness, exam, treatment, test results, and more. Claims sent to HMSA may
have some of these details. Information about you and the services that you received
is called your confidential member information.
In today's health care system, this information is used in a number of ways. For
example, it may be used to plan or coordinate your care. As such, it may be shared
among your health care providers. Or it may be used to process claims, pay for your
health care services, or review services.
Your Rights
The law gives you certain rights that pertain to your confidential member information.
As an HMSA member, you have the right to:
- Request and receive a copy of this privacy notice at any time.
- View or request a copy of your confidential member information. (A copying fee will be applied.)
- Ask for added limits on permitted uses of your confidential member information. There may be reasons we cannot agree to this request. If we agree to your request, we will keep our agreement except to make records available to a provider when necessary for your treatment in a medical emergency or disaster.
- Request and receive a list of third parties we disclose your information to for certain, permitted reasons described in this notice.
- Ask that your confidential member information be sent by reasonable means other than mail or be sent to a different address to avoid putting your life in danger.
- Request to change or add to your confidential member information. We may deny your request if we did not create the information or for certain other reasons. If we deny your request, we will explain why in writing. If you do not agree with our denial, you may send us a written statement of disagreement that will be added to your record.
Our Duties
The law clearly spells out the duties of health plans. HMSA must:
- Protect the privacy of your confidential member information.
- Give you a notice of our privacy practices.
- Follow the terms of this privacy notice.
- Fulfill your request to send information by other means or to another address to avoid putting your life in danger. Your request must be reasonable and must state the other address or the means you wish us to use. The alternate address or means must allow us to pay claims and collect dues under your health plan.
- Use and share only the information needed to do our jobs.
- Make sure our business partners agree to protect your information the same way that we do.
We will not use or share your confidential member information except as required by
law or described in this notice. Also, we will not ask you to waive your privacy
rights in order to enroll in an HMSA plan or to receive services.
How Confidential Member Information is Used
In today's health care system, there are three key areas where we need to use your
confidential member information. We may use it for treatment, payment and other
health care operations. We may also contract with other parties to do the work for
us, as long as they promise to protect your information the same way we do. Each
area is described below.
Treatment: This includes services needed to provide, coordinate or manage your
health care. As your health plan, we may need to share confidential member information
with your doctor or other health care providers for treatment reasons.
Payment: We need to pay claims from doctors, hospitals and other providers
for the care you receive. This key area includes our efforts to collect dues, see if
you are eligible for care, determine the level of coverage, work with other plans to
determine benefits, and pay claims.
Health Care Operations: We want all HMSA members to receive quality health
care services. This may include our quality review and improvement activities, case
management, care coordination, reviewing provider credentials, setting dues,
resolving complaints and appeals, managing our business, and other operations. We may
also use your information to send you communications to describe a health-related
product or service. This may include information on our participating providers, new
health-related products or services available only to HMSA members, or to recommend
other treatments, health care providers, or settings of care that may be of interest
to you.
Other Uses of the Information
There may be a time when the use of your confidential member information is needed
because it benefits you, serves the public interest, or is required by law. In these
cases, we will use and share only the confidential member information needed or as
required by law. Please read all of these other uses carefully.
For Underwriting: We may receive your confidential member information to create,
renew or replace a contract of health insurance or health benefits. We will not use or
further disclose this information for any other reasons except as required by law. If
the contract of health insurance or health benefits is placed with us, then we will
use and share your confidential member information only as described in this notice.
With Your Written Permission: You may give us written permission to use your
information or share it with someone you name for any purpose. You may withdraw your
permission in writing at any time. We will honor your request unless the timing is
such that the information has already been shared.
During an Emergency or Disaster: During a medical emergency or disaster, if it
is believed that disclosure of the information would be in your best interest, then we
may disclose it. This would be done to make sure you have access to the services you
need or to process payment for those services.
To Plan Sponsors: We may disclose your confidential member information -- and
the information of others enrolled in your group health plan -- to your plan sponsor
or its authorized representative. Employers are often plan sponsors, and this
disclosure helps them administer your group health plan. Plan sponsors may use your
confidential member information only as permitted or required by law.
To Report to Authorities: We may need to share confidential member information
if we suspect abuse, neglect or domestic violence. As required by law, we may need to
make such a report to the authorities.
For Research Purposes: We may use or share information with researchers when
their work has been approved by an institutional review board that has gone over the
research project and set rules to make sure that your confidential member information
is kept private.
To Comply with the Privacy Law: We may use or share information as required by
the privacy law. For example, to see if we are complying with the law, the U.S.
Department of Health and Human Services may review our practices and ask us for some
confidential member information.
For Workers' Compensation: We may disclose information to comply with laws on
workers' compensation or other similar programs.
For Public Health: We may share your confidential member information with public
health or legal authorities who work to prevent or control disease, injury or
disability in the community. For example, we may share information about problems
related to food, drugs, supplements and product defects with the U.S. Food and Drug
Administration (FDA).
For Health Oversight: We may share information with authorities for activities
to prevent fraud and abuse, audits, investigations, inspections, licenses and other
government activities to monitor health care.
For Judicial and Administrative Proceedings: We may share your information in
response to a court or administrative order, subpoena or other lawful process, under
certain circumstances.
For Law Enforcement Purposes: Under limited circumstances, such as a court
order, warrant or grand jury subpoena, we may disclose your information to law
enforcement officials.
For Military or National Security Purposes: Under certain conditions, we may
share the confidential member information of armed forces staff with military
authorities. We may also share your information with federal officials for
intelligence, counterintelligence and other national security activities.
For More Information or to Report a Problem
If you have questions or would like more information on HMSA's privacy practices,
you may contact us using the information at the end of this notice.
If you believe your privacy rights have been violated, you may file a complaint with
us using the contact information at the end of this notice. You may also send a
written complaint to the U.S. Department of Health and Human Services. If you choose
to file a complaint, you have our assurance we will not retaliate in any way.
Thank you for taking the time to review this Notice to HMSA Members. As your health plan, we
work hard to protect your confidential member information. We know the privacy of this
information is important to you, and we take our duties very seriously.
Send HMSA correspondence to:
HMSA Privacy Office
Attention: Privacy Official, 10th Floor
P.O. Box 860
Honolulu, HI 96808-0860
Honolulu, Oahu |
Group/Individual Plans |
(808) 948-6111 |
Federal/State/County Plans |
(808) 948-6499 |
HMO Plans |
(808) 948-6372 |
Blue Cross Blue Shield |
Federal Employee Program |
(808) 948-6281 |
QUEST |
(808) 948-6486 |
Senior Plan/65C Plus |
(808) 948-6000 |
Text Telephone (TTY) |
(808) 948-6222 |
Hilo, Hawaii |
(808) 935-5441 |
Kona, Hawaii |
(808) 329-5291 |
Lihue, Kauai |
(808) 245-3393 |
Kahului, Maui |
(808) 871-6295 |
Send U.S. Department of Health and Human Services correspondence to:
U.S. Department of Health and Human Services
200 Independence Ave., S.W.
Washington, D.C. 20201
(202) 619-0257
Toll free: 1 (877) 696-6775