Please contact Tuality Health Alliance (THA) if you need this notice in another language or format (e.g., large print, braille, audio tape recording, electronic format, or oral presentation). You may also contact THA if you have questions about this notice or need more information regarding THA Privacy Practices.

Tuality Health Alliance
P.O. Box 925
Hillsboro, OR 97123
Phone: 503-844-8104
Toll-Free Phone: 1-800-681-1901
TTY: 1-800-735-2900
Fax: 503-681-1927
Email: tha.customerservice@tuality.com

THA is required to provide you with this notice about its health information Privacy Practices. Please review this notice carefully. The notice outlines:

a.  The situations in which THA may use and disclose your protected health information (PHI) – though not all situations may be described.

b.  Your privacy rights, including the steps you can take access your PHI, to limit the sharing of your PHI, or to file a complaint about THA Privacy Practices.

THA May Use and Disclose Your PHI without Your Authorization

Treatment. THA may use or disclose your protected health information (PHI) with the healthcare providers who are involved in your care. For example, your information may be shared in order to create and carry out a plan for your treatment.

Payment. THA may use or disclose PHI to get payment or to pay for the healthcare services that you receive. For example, THA may request your PHI to pay for your medical appointment.

Appointment Reminders and Other Notifications. THA may use PHI when calling, mailing, or emailing you with reminders for medical care or checkups. THA may use PHI to send you written information about health services that may be of interest to you.

Healthcare Operations. THA may use or disclose PHI in order to manage THA programs and activities. For example, THA may review your PHI evaluate the quality of the services you receive.

Health Oversight Activities. THA may use or disclose PHI for healthcare oversight activities. Examples of oversight activities include audits, utilization investigations, etc.

Public Health Activities. THA may share PHI with official public health agencies. For example, THA may use and disclose PHI with the Department of Human Services, the public health agency that manages vital records, such as birth and death certificates, and that tracks diseases and population health issues.

Government Programs. THA may use and disclose PHI for public benefits under government programs. For example, THA may disclose information to the Social Security Administration for the determination of Supplemental Security Income (SSI) benefits.

Research. THA uses PHI for studies and to develop reports. The information used is de-identified. In other words, reports do not identify specific people.

Purposes Required by Law and Law Enforcement. THA will share PHI with law enforcement agencies as required or permitted by Federal or State law or by an administrative or court order. If you are involved in a lawsuit or dispute, THA may share your information in response to legal mandates.

Abuse Reports and Investigations. THA may use and disclose PHI to receive and investigate reports of abuse, as required by law.

Workers’ Compensation. THA may disclose PHI to workers’ compensation insurance programs or like programs, as allowed by law.

Avoidance of Harm. THA may use and disclose PHI in order to avoid a serious threat to your health and safety or to the health and safety of another person or the public.

Disclosures to Personal Representatives and Approved, Family, Friends, and Others. THA may disclose appropriate PHI to your family or other persons who are immediately involved in your medical care as long as you agree or do not object to the disclosure. In the case of an emergency, or if you are incapacitated, THA may use professional judgment to disclose your PHI as the disclosure is in your best interest.

Uses and Disclosures of PHI that Require Your Written Authorization

For other situations, THA will ask for your written authorization before using or disclosing your PHI. For example, THA must obtain your specific written authorization before disclosing information about your vocational rehabilitation, HIV/AIDS, mental health, developmental disability, genetic testing, or alcohol/drug abuse treatment.

You may write THA to cancel a written authorization at any time; however, THA cannot withdraw any uses or disclosures that were already made with your permission.

Breach of PHI

THA is required by law to notify you if you are affected by any breach (unintentional use or disclosure) of your PHI.

b.  You Have Privacy Rights to:

See and Get Copies of Your Health Records. In most cases, you have the right to look at or get copies of your health records. You must make the request to THA in writing and you may be charged a fee for the cost of copying your records. THA may deny your request in certain circumstances.

Request a Correction or Update to Your Records. You may ask THA to change or add missing information to your records if you think they contain any error. You must make the request in writing and provide the reason for your request. THA may deny your request in certain circumstances.

Get a List of PHI Disclosures. You have the right to ask THA for a list of PHI disclosures as they pertain to you. The list may include disclosures made after April 14, 2003. You must make the request in writing. The disclosures list will not include situations in which PHI was disclosed for treatment, payment, or healthcare operations. The list will not include situations in which information was provided directly to you or your family, or that was disclosed with your authorization. If you request a list of PHI disclosures more than once during a 12-month period, you may be charged a fee.

Request Limits on Uses or Disclosures of PHI. You have the right to ask THA to limit the use or disclosure of your PHI. You may make the request verbally or in writing, explaining what information you want to limit and to whom you want the limits to apply. THA is not required to agree to your request.

Revoke Authorization. Once you have signed an authorization for the use or disclosure of your PHI, you may cancel that authorization at any time. You must make the request in writing. The request will not affect information that has already been used or disclosed.

Choose Your Means of PHI Communication. You have the right to ask that THA share information with you in a certain way or in a certain place. For example, you may ask THA to send information to your work address instead of your home address. You must make this request in writing. You do not have to explain the basis for your request.

File a Complaint or Report a Problem Regarding Privacy Practices. You have the right to file a complaint if you do not agree with the manner in which THA has used or disclosed your PHI. For more information, review the section below:

How to File a Complaint or Report a Problem

Get a Paper Copy of this Notice. You have the right to contact THA for a paper copy of this notice at any time.

Note: THA may deny your request to look at, copy, or change your records. THA may also deny your request to limit the use or disclosure of your PHI. If THA denies your request, THA will send you a letter that explains why your request is being denied and how you can ask for a review of the denial. You will also receive information about how to file a complaint with THA, the Oregon Department of Human Services, or the U.S. Department of Health and Human Services.

Note: Any public health records that THA uses or discloses are governed by State and
Federal laws and are not subject to the rights described above.

How to File a Complaint or Report a Problem

You may contact any of the organizations listed below if you want to file a complaint or report a problem with the THA use or disclosure of your PHI.

Tuality Health Alliance
P.O. Box 925
Hillsboro, OR 97123
Phone: 503-844-8104
Toll-Free Phone: 1-800-681-1901
TTY: 1-800-735-2900
Fax: 503-681-1927
Email: tha.customerservice@tuality.org

Compliance Officer
Health Share of Oregon
208 SW 5th Ave., Ste. 400
Portland, OR 97204
Phone: 503-416-8090
Toll-Free Phone: 1-888-519-3845
TTY/TDD: 711

Governor’s Advocacy Office
Oregon Department of Human Services
500 Summer St. NE, E17
Salem, OR 97301-1097
Toll-Free Phone: 1-800-442-5238
Fax: 503-378-6532
Email: GAO.info@state.or.us

Privacy Officer
Oregon Department of Human Services
500 Summer St. NE, E24
Salem, OR 97301
Phone: 1-503-945-5780
Fax: 1-503-947-5396
Email: dhs.privacyhelp@state.or.us

Medical Privacy Complaint Division
Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Ave. SW, HHH Building, Room 509H Washington, D.C. 20201
Toll-Free Phone: 1-866-627-7748
TTY: 1-866-788-4989
Email: OCRComplaint@hhs.gov

Note: Your benefits will not be affected by any complaints that you make or any investigation that ensues; THA cannot hold it against you if you complain about or refuse to agree to something that you believe to be unlawful.

Notice Effective: March 31, 2003

Notice Revised: July 2006, November 2007, September 2010, September 2013

THA may change its Notice of Privacy Practices at any time. Any changes will apply to current and future PHI. A copy of the changes/a new notice will be posted on THA’s Website and otherwise provided to you as required by law.