This notice describes how your medical information may be
used and disclosed and how you can obtain access to your information.
Please review the summary carefully. If you need additional detailed
information on your right to privacy or would like to speak with someone
regarding this notice, please call the hospital at 522-8641 and ask to
speak with the Privacy Officer.
I. When Medical Information Can Be Used Without Your Authorization
Treatment: The doctors, nurses, technicians and other Team Members
of Memorial Medical Center (MMC) and companies that act on behalf of us
the hospital can use medical information so you can get treatment and
care. For example, we can tell the doctor that might be treating you for a
broken leg about your diabetes because that medical information is
important for healing.
Payment: We can use and share medical information about you to the
company or person who is paying your medical bills. For example, we can
share medical information on your surgery to get your broken leg fixed so
they will pay us or pay you back if you paid for the surgery.
Health Care Operations: We can use or share medical information
about you as part of our health care operations. For example, we may use
your medical information to review our treatment and services and to see
how well the doctors, nurses and other medical staff cared for you while
you were in the hospital.
Other Permitted Purposes: We may also share medical information
about you if we are required to do so by state or federal law. We may also
use or release medical information about you if a court, police or other
law enforcement personnel, the public health office, or other government
agencies, requires it. For example, we may be required to give the court
medical information about the treatment you received in the emergency
department if that information is necessary for the court. We may be
required to report to the New Mexico Department of Health that you have a
communicable disease, like tuberculosis. We may be required to call the
police and provide specific information about violent crimes.
II. When Medical Information Cannot be Used Without Your
Authorization
We cannot use or share medical information about you in other situations.
Specifically, we cannot share medical information about you with people
who are doing marketing, fund-raising, or research studies without your
permission. We will not release the notes made by a psychotherapist about
you, without your permission, except under specific circumstances.
III. Your Rights to Your Medical Information
You have a right to request that we restrict access to your medical
information for only treatment, payment, or health care operations. We may
not be able to agree with your request but will do our best to restrict
access. For example, you may not want us to tell the Department of Health
that you have tuberculosis but we are required by state law to report this
disease and will not be able to honor your request. You also have a right
to request that we provide medical information to you by an alternative
means or at an alternative location. For example, if you request that we
send appointment reminders to your work address rather than to your home
address, we will try to honor that request.
You also have a right to inspect your medical information and request a
copy of it. You have a right to request that your medical information be
amended. You also have a right to request a list of people or companies we
provided your medical information to for a six-year period (beginning on
April 14, 2003) which is not related to treatment, payment, health care
operations, or other permitted purposes.
IV. OUR RESPONSIBILITIES
We pledge to keep medical information about you private and not use that
information or share that information in a manner that invades your
privacy. We are required to provide you with this notice so that you will
understand your rights and our responsibility with respect to your medical
information. We will abide by the terms of the Notice of Privacy that is
currently in effect. We reserve the right to change the Notice and use the
terms of that Notice to protect new medical information about you.
However, we will make a revised Notice available to you if you contact us
at the number listed at the top of this Notice or when you come to our
facilities again.
If you believe that we have violated your right to keep your medical
information private, please call the MMC Privacy Officer. You also have a
right to file a complaint with the Secretary of Health and Human Services.
We will not punish you for filing a complaint.
Effective Date: April 14, 2003
If you would like to receive this information in Spanish,
please call the Privacy Officer at (575) 522-8641.