Clinical Laboratories of Hawaii, LLP
Pan Pacific Pathologists, LLC
MEDICAL INFORMATION PRIVACY NOTICE
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.
This Notice tells you about your privacy rights, the duty of Clinical Laboratories of Hawaii, LLP and Pan Pacific Pathologists, LLC, (these companies together and individually are referred to as "CLH/PPPI") to protect medical information that identifies you, and how CLH/PPPI may use and disclose medical information that identifies you without your written permission. This Notice does not apply to medical information that does not identify you or anyone else.
In this Privacy Notice, "medical information" means any information that identifies you and relates to:
your past, present, or future physical or mental health or condition;
providing health care to you; or
the past, present, or future payment for your health care.
CLH/PPPI's Duty to Protect Medical Information That Identifies You
CLH/PPPI is required by law to protect the privacy of your medical information. This means that CLH/PPPI will not use or disclose your medical information without your authorization except in the ways we tell you in this, and any future, Notice. CLH/PPPI is also required to give you notice of its duties and privacy practices related to your medical information.
CLH/PPPI will ask you for your written authorization to use or disclose your medical information in ways other than those stated in this, and any future, Notice. If you give an authorization, you may revoke it in writing at any time, but CLH/PPPI will not be liable for uses or disclosures made before you revoked your authorization. Written revocations must be sent to: Privacy Officer; Clinical Laboratories of Hawaii, LLP; Pan Pacific Pathologists, LLC; 91-2135 Fort Weaver Road, #300; Ewa Beach, Hawaii 96706.
CLH/PPPI is required to give you a copy of this Notice upon your request.
CLH/PPPI may make changes to this Notice. If CLH/PPPI does change this Notice, it will make the new Notice available upon request at its facilities and on its website, www.clhlab.com, within 15 days of the effective date of the changed Notice. The new Notice will apply to all medical information maintained by CLH/PPPI, no matter when CLH/PPPI got or created the information. CLH/PPPI is required by law to abide by its Privacy Notice then in effect.
CLH/PPPI employees must protect the privacy of your medical information as part of their jobs. CLH/PPPI does not give employees access to your medical information unless they need it as part of their jobs. CLH/PPPI will discipline employees who do not protect the privacy of your medical information.
CLH/PPPI will treat a person who by law has the right to act for you as though that person were you.
Your Privacy Rights
The law gives you the right to:
Look at or get a copy of some of the medical information that CLH/PPPI has about you, in most situations. You must put your request for information in writing and send it to the CLH/PPPI Privacy Officer. See the last paragraph of this Notice for the address. However, by law CLH/PPPI cannot let you see or give you laboratory results, for example blood and urine test results and results of tissue examination. You must get that kind of medical information from your doctor or other person who ordered the test.
Ask CLH/PPPI to amend certain information, including certain medical information, about you if you believe the information is wrong or incomplete. You must submit your request in writing to CLH/PPPI. If CLH/PPPI denies your request to change the information, you can have your written disagreement placed in your records.
Ask for a list of the times CLH/PPPI has disclosed medical information about you for reasons other than treatment, payment, health care operations, certain other reasons as provided by law, and when you have authorized or asked that CLH/PPPI disclose the information. You must submit this request in writing.
Ask CLH/PPPI to limit the use or disclosure of medical information about you more than the law requires. However, the law does not require CLH/PPPI to agree to limit uses and disclosures.
Make reasonable requests for CLH/PPPI to send you mail or other messages that include medical information about you to an alternate address or by an alternate means. CLH/PPPI will grant your request if it is reasonable and if appropriate means for payment are made. You must put this request in writing, and you must be specific about where and how to contact you.
Ask for and get a paper copy of this Notice from CLH/PPPI.
Withdraw authorization you have given CLH/PPPI to use or disclose medical information that identifies you, unless CLH/PPPI has already taken action based on your permission. You must withdraw your authorization in writing.
You may exercise any of the above rights contacting the CLH/PPPI Privacy Officer as described at the end of this notice.
How CLH/PPPI Uses and Discloses Medical Information That Identifies You
1. Treatment
CLH/PPPI may use or disclose your medical information to provide, coordinate, or manage health care or related services. This includes providing care to you and consulting with another health care provider about you. For example, CLH/PPPI can use or disclose your medical information to give test results to your doctor.
2. Payment
CLH/PPPI may use or disclose medical information about you to pay or collect payment for your health care. For example, CLH/PPPI can use or disclose your medical information to bill your insurance company for health care provided to you.
3. Health care operations
CLH/PPPI may use or disclose medical information about you for health care operations. A partial list of health care operations activities include:
Conducting quality assessment and improvement activities;
Reviewing the competence, qualifications, and performance of health care professionals or health plans;
Training health-care professionals and others;
Conducting accreditation, certification, licensing, or credentialing;
Providing medical review, legal services, or auditing functions; and
Engaging in business management or the general administrative activities of CLH/PPPI.
For example, CLH/PPPI may use or disclose your medical information to make sure we are performing tests accurately.
4. Family member, other relative, close personal friend, or personal representative
CLH/PPPI may disclose medical information about you to a family member, other relative, close personal friend or someone else you identify when:
The medical information is related to that person's involvement with your care or payment for your care; and
You have had an opportunity to object to or limit the disclosure before it happens; or we infer from the circumstances that you do not object; or, if you are unable to object, we determine it is in your best interests.
CLH/PPPI may also use or disclose medical information about you to notify a family member, your personal representative or another person responsible for your care about your location, general condition or death when:
Except in cases of disaster relief, you have had an opportunity to stop or limit the disclosure before it happens; or we infer from the circumstances that you do not object; or, if you are unable to object, we determine it is in your best interests.
5. Government programs providing public benefits
CLH/PPPI may disclose medical information about you as needed for the administration of a government benefit program, such as Medicare.
6. Health oversight activities
CLH/PPPI may sometimes use or disclose medical information about you for health oversight activities. A partial list of health oversight activities include:
Audits or inspections;
Investigations of possible fraud; and
Investigations of whether someone is providing good care.
7. Public health
CLH/PPPI may disclose medical information about you to:
A public health authority for such purposes as preventing and controlling disease, injury, and disability, or, for example, reporting vital statistics;
An official of a foreign government agency who is acting with the public health authority;
A government agency allowed to receive reports of child abuse or neglect;
The Food and Drug Administration (FDA) to report problems with FDA-regulated medications, products, or activities;
A person who may have been exposed to a communicable disease or who is at risk of contracting or spreading a disease or condition; or
A person or agency investigating work-related illness or injury or conducting workplace medical surveillance.
8. Victims of abuse, neglect, or domestic violence
If CLH/PPPI believes you are the victim of abuse, neglect, or domestic violence, CLH/PPPI may sometimes disclose medical information about you to a government agency that receives reports of abuse, neglect, or domestic violence if:
A law requires the disclosure; or
You agree to the disclosure; or
A law allows the disclosure and the disclosure is needed to prevent serious harm to you or someone else; or
A law allows the disclosure, you are unable to agree or disagree, the information is needed for immediate action, and the information is not intended to be used against you.
If CLH/PPPI makes a report under this section, CLH/PPPI will tell you or your representative about the report unless it believes that telling you would place you at risk of harm or it would not be in your best interests.
9. Serious threat to health or safety
CLH/PPPI may use or disclose medical information about you if it believes the use or disclosure is needed:
To prevent or lessen a serious and immediate threat to the health and safety of a person or the public;
For law enforcement authorities to identify or catch an individual who has admitted participating in a violent crime that CLH/PPPI believes resulted in serious physical harm to the victim; or
For law enforcement authorities to catch an individual who has escaped from lawful custody.
10. For other law enforcement purposes
CLH/PPPI may disclose medical information about you to a law enforcement official for the following law enforcement purposes:
To comply with a subpoena, summons, investigation, or similar lawful process issued by a grand jury, judicial officer or administrative body;
To identify and locate a suspect, fugitive, witness, or missing person;
In response to a request for information about an actual or suspected crime victim;
To alert a law enforcement official of a death that CLH/PPPI suspects is the result of criminal conduct;
To report evidence of a crime on CLH/PPPI's property;
To provide information learned while providing emergency treatment to an individual regarding criminal activity; or
As necessary for a correctional institution or other entity having lawful custody of an individual to provide health care to the individual, for the health and safety of other inmates or its employees, for law enforcement or administration of the correctional institution.
11. For judicial or administrative proceedings
CLH/PPPI may disclose medical information about you in response to an order or subpoena issued by a court or administrative body, or in some other cases in response to a discovery request.
12. As required by law
CLH/PPPI may use or disclose medical information about you when a law requires the use or disclosure.
13. Contractors
CLH/PPPI may disclose medical information about you to a CLH/PPPI contractor if the contractor:
Needs the information to perform services for CLH/PPPI; and
Agrees to protect the privacy of the information.
14. Secretary of Health and Human Services
CLH/PPPI must disclose medical information about you to the Secretary of Health and Human Services when the Secretary wants it to enforce privacy protections.
15. Purposes relating to death
CLH/PPPI may disclose medical information about you to:
Coroners or medical examiners for the purpose of identifying a deceased person or determining the cause of death;
Funeral directors for the purpose of preparing a deceased person for burial or cremation; or
Organ procurement organizations for the purpose of organ, eye, or tissue donation.
16. Research
CLH/PPPI may use or disclose medical information about you for research if a research board approves the use. The board will ensure that your privacy is protected when your medical information is used in research. CLH/PPPI may also use or disclose your medical information:
To allow a researcher to prepare for research, as long as the researcher agrees to keep the information confidential; or
After you die, for research that involves information about people who have died.
17. Other uses and disclosures
CLH/PPPI may use or disclose medical information about you:
To create medical information that does not identify any specific individual;
To the U.S. or a foreign military, or other government offices, for military or veterans purposes, if you are or have been a member of the group asking for the information;
For purposes of lawful national security activities;
To federal officials to protect the President and others;
For security clearances and medical suitability determinations required by the U.S. government; and
To comply with workers' compensation laws or similar laws.
Complaint Process
If you believe that CLH/PPPI has violated your privacy rights, you have the right to file a complaint with:
CLH/PPPI Privacy Officer, by mail: Privacy Officer; Clinical Laboratories of Hawaii, LLP; Pan Pacific Pathologists, LLC; 91-2135 Fort Weaver Road, #300; Ewa Beach, Hawaii 96706; or by e-mail: privacy.officer@HawaiiLabs.com; or by telephone: 1.888.258.3590; or
U.S. Secretary of Health and Human Services.
There will be no retaliation for filing a complaint.
Further Information
For further information, contact the CLH/PPPI Privacy Officer:
by e-mail: privacy.officer@HawaiiLabs.com; or
by telephone: 1.888.258.3590; or
by mail: Privacy Officer
Clinical Laboratories of Hawaii, LLP
Pan Pacific Pathologists, LLC
91-2135 Fort Weaver Road, #300
Ewa Beach, Hawaii 96706.
Effective Date: April 14, 2003
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