This notice describes how medical information about you may be used and disclosed and how you can get access to this information with regard to your health benefits. Please review carefully.

The original effective date of this notice was July 1, 2018. The most recent revision date is shown at the end of this notice.

Your Information. Your Rights. Our Responsibilities.

Please read this notice carefully. This tells you who can see your protected health information (PHI). It tells you when we have to ask for your OK before we share it. It tells you when we can share it without your OK. It also tells you what rights you have to see and change your information.

Information about your health and money is private. The law says we must keep this kind of information, called PHI, safe for our members. That means if you’re a member right now or if you used to be, your information is safe.

We get information about you from state agencies for Medicaid after you become eligible. We also get it from your doctors, clinics, labs and hospitals so we can OK and pay for your health care.

Federal law says we must tell you what the law says we have to do to protect PHI that’s told to us, in writing or saved on a computer. We also have to tell you how we keep it safe. To protect PHI:

• On paper (called physical), we:
  • Lock our offices and files
  • Destroy paper with health information so others can’t get it
• Saved on a computer (called technical), we:
  • Use passwords so only the right people can get in
  • Use special programs to watch our systems
• Used or shared by people who work for us, doctors or the state, we:
  • Make rules for keeping information safe (called policies and procedures)
  • Teach people who work for us to follow the rules

Your Rights

This section explains your rights and some of our responsibilities to help you.

Get a copy of health and claims records:

• You can ask to see or get a copy of your health and claims records and other health information we have about you. We don’t have your whole medical record, though. If you want a copy of your whole medical record, ask your doctor or health clinic.

Ask us to correct health and claims records:

• You can ask us to correct your health and claims records if you think they are incorrect or incomplete.

Request confidential communications:

• You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
• We can do this if sending it to the address we have for you may put you in danger.

Ask us to limit what we use or share:

• You can ask us not to use or share certain health information for treatment, payment or our operations.
• We are not required to agree to your request, and we may say “no” if it would affect your care.

Get a list of those with whom we’ve shared information:

• You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with and why.
• We will include all the disclosures except for those about treatment, payment and health care operations and certain other disclosures (such as any you asked us to make).

Get a copy of this privacy notice:

• You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

Choose someone to act for you:

• If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
• We will make sure the person has this authority and can act for you before we take any action.

File a complaint if you feel your rights are violated:

• You can file a complaint with Colorado Community Health Alliance (CCHA) Member Support Services at 1-855-627-4685 or www.cchacares.com/contact. If you’re deaf or hard of hearing, call TTY 711.
• You can also file a complaint with HHS/Office for Civil Rights:

Andrea Oliver, Regional Manager
HHS/Office for Civil Rights
1961 Stout Street
Room 08-148
Denver, CO 80294
Customer Response Center: 1-800-368-1019
Fax: 202-619-3818
TDD: 1-800-537-7697
Email: ocrmail@hhs.gov

• We will not retaliate against you for filing a complaint.

Our Uses and Disclosures

When is it OK for us to use and share your PHI?

We typically use or share your health information in the following ways:

• Help manage the health care treatment you receive
  • We can use your health information and share it with professionals who are treating you.
• Run our organization
  • We can use and disclose your information to run our organization and contact you when necessary.
  • We are not allowed to use genetic information to decide whether we will give you coverage and the price of that coverage. This does not apply to long term care plans.
• For your medical care
  • We can use and disclose your information to help doctors, hospitals and others get you the care you need.
• With others who help with or pay for your care
  • We can use and disclose your health information as we pay for your health services.
  • We can share your health information with your family or a person you choose who helps with or pays for your health care, if you tell us it’s OK.
  • We can share your health information with someone who helps with or pays for your health care, if you can’t speak for yourself and it’s best for you.

Other ways we can — or the law says we have to — use your PHI:

We are allowed or required to share your information in other ways — usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.

Help with public health and safety issues:

• We can share health information about you for certain situations such as:
  • Preventing disease
  • Helping with product recalls
  • Reporting adverse reactions to medications
  • Reporting suspected abuse, neglect or domestic violence
  • Preventing or reducing a serious threat to anyone’s health or safety

Comply with the law:

We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.

Respond to organ and tissue donation requests and work with a medical examiner or funeral director:

• We can share health information about you with organ procurement organizations.
• We can share health information with a coroner, medical examiner or funeral director when an individual dies.

Address workers’ compensation, law enforcement and other government requests:

• We can use or share health information about you:
  • For workers’ compensation claims
  • For law enforcement purposes or with a law enforcement official
  • With health oversight agencies for activities authorized by law
  • For special government functions such as military, national security and presidential protective services

Respond to lawsuits and legal actions:

We can share health information about you in response to a court or administrative order or in response to a subpoena.

Our Responsibilities

What do we have to do?

• We are required by law to maintain the privacy and security of your protected health information.
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in this notice and give you a copy of it.
• We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

For more information see: https://www.colorado.gov/hcpf/notice-privacy-practices.

Changes to the terms of this notice:

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request and on our website, and we will mail a copy to you.

Contacting you:

We, along with our affiliates and/or vendors, may call or text you using an automatic telephone dialing system and/or an artificial voice. We only do this in line with the Telephone Consumer Protection Act (TCPA). The calls may be to let you know about treatment options or other health-related benefits and services. If you do not want to be reached by phone, just let the caller know, and we won’t contact you in this way anymore. Or you may call 1-844-203-3796 to add your phone number to our Do Not Call list.

Race, ethnicity and language:

We receive race, ethnicity and language information about you from the state Medicaid agency. We protect this information as described in this notice.

We use this information to:

• Make sure you get the care you need
• Create programs to improve health outcomes
• Develop and send health education information
• Let doctors know about your language needs
• Provide translator services

We do not use this information to:

• Issue health insurance
• Decide how much to charge for services
• Determine benefits
• Disclose to unapproved users

Your personal information:

We must follow state laws if they say we need to do more than the HIPAA Privacy Rule. We may ask for, use and share personal information (PI) as we talked about in this notice. Your PI is not public and tells us who you are. It’s often taken for insurance reasons.

• We may use your PI to make decisions about your:
  • Health
  • Habits
  • Hobbies
• We may get PI about you from other people or groups like:
  • Doctors
  • Hospitals
  • Other insurance companies
• We may share PI with people or groups outside of our company without your OK in some cases. For example, we may share PI with claims and billing vendors who we hire to help us run our business.
• We’ll let you know before we do anything where we have to give you a chance to say no.
• We’ll tell you how to let us know if you don’t want us to use or share your PI.
• You have the right to see and change your PI.
• We make sure your PI is kept safe.

Revised August 6, 2020

If you have questions, need help accessing information or have concerns, please contact Privacy@cchacares.com.

Si tiene preguntas, necesita ayuda para acceder la información o tiene inquietudes, comuníquese con Privacy@cchacares.com.

Do you need help with your health care, talking with us, or reading what we send you? We provide our materials in other languages and formats at no cost to you. Call us toll free at 1-855-627-4685 (TTY 711).

¿Necesita ayuda con el cuidado de la salud, para hablar con nosotros o para leer lo que le enviamos? Le ofrecemos nuestros materiales en otros idiomas y formatos sin costo alguno. Llame a nuestra línea gratuita al 1-855-627-4685 (TTY 711).