Notice of Privacy Practices
Last Update: 16 March 2023
This notice describes how medical information about you may be used and disclosed, and how you can get access to that information. PLEASE REVIEW IT CAREFULLY.
The SUNY College of Optometry and its University Eye Center (collectively referred to as “UEC”) are required by law to protect the privacy of health information that may reveal your identity and to provide you with this notice of our legal duties and privacy practices. The UEC reserves the right to change this Notice of Privacy Practices at any time.
The UEC has the right to use and disclose your protected health information (“PHI”) for treatment, payment or health care operations once you have signed a general consent for treatment form. You may revoke your general written consent at any time (in writing), except to the extent that we have already relied on it. For example, if we provide you with treatment before you revoke your general written consent, we may still share your health information with your insurance company in order to obtain payment for that treatment. To revoke your general written consent, please contact us at 33 West 42nd Street, New York, NY 10036 or at (212) 938-4030.
HOW WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION:
Treatment: Your PHI can be used and disclosed to provide you with health care treatment and services. We will share your PHI, as appropriate, with optometrists, students in training programs, technicians, and personnel, volunteers, and others who are involved in your care, both within the UEC and elsewhere. For example, we may disclose your PHI to manufacturers when we order eyeglasses, contact lenses, or low vision devices for you, or to your primary care physician for continuity of your healthcare.
Payment: We may use your information or share it with others so that we can bill and obtain payment for services we provide to you. For example, we may share your PHI with your vision plan, health insurance company, and with other payers such as Medicare and Medicaid.
Health Care Operations: We may use your PHI or disclose it to others to conduct our business operations. For example, we may use your PHI to evaluate the treatment and services provided to you or to educate our staff on how to improve the care delivered. We may also use your PHI when we contact you, including via our automated appointment reminder system.
Alternative Treatment Services: We may use and disclose your PHI in order to recommend possible treatment options or health-related benefits or services that may be of interest to you, so long as we have not received a payment from a third party for communicating with you.
Fundraising: We may contact you to participate in fundraising activities. These communications may come from the College itself or from its related charitable foundation. You may opt out of receiving fundraising solicitations at any time, and your decision to do so will have no impact on your treatment or payment for services. To opt out of fundraising solicitations, you may contact the Institutional Advancement Office at 212-938-5600 or email your request, including your name and address to email@example.com.
DISCLOSURES TO OTHER INDIVIDUALS
We will provide you with an opportunity to agree or object to the following uses and disclosures of your PHI (unless you are incapacitated, otherwise unable to reply, or in the case of emergency).
Communication with those involved in your care: We may use and disclose your PHI to notify or assist in notifying a family member, personal representative or other person about your condition, or to provide such other information as may be needed for them to participate in your healthcare decisions, or to notify them of your death. If you are unable to agree or object to these communications, our health care professionals will use their best judgment in communicating with your family and others.
Marketing: We must obtain your written authorization before we can use your PHI to communicate with you about purchasing a product or service, unless the communication is done in person.
Sale of your PHI: We will not sell your PHI to a third party for marketing purposes without your written authorization.
Psychotherapy Notes: With limited exception, unless treatment, payment or health care operations are involved, we will not disclose psychotherapy notes without your written authorization.
OTHER SITUATIONS WHERE WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION WITHOUT AUTHORIZATION
Examples of permitted uses and disclosures of your PHI include, but are not limited to, the following:
Public Health Activities: We may disclose your PHI to authorized public health officials and agencies for the purpose of public health activities. These activities may include controlling or preventing disease, injury, or disability, reporting reactions to medications, products, or medical devices, or communicable disease reporting.
Abuse or Neglect: We are required by law to disclose PHI to a public health authority that is authorized to receive reports of suspected child abuse and/or neglect.
Health Oversight Activities: We may disclose your PHI to agencies authorized to perform health oversight activi-ties. These activities may include audits, investigations, inspections and licensure. These activities are necessary to monitor the operation of the health care system, government benefit programs such as Medicaid and Medicare, and ensure compliance with civil rights laws.
Lawsuits, Disputes, and Other Legal Matters: We may disclose your PHI in response to a court or administrative order, if you are involved in a lawsuit or administrative proceeding, or as required by law. In some cases, we may also disclose your PHI to law enforcement agencies, or in response to a discovery request, subpoena or other lawful process.
Workers’ Compensation: We may use and disclose your PHI as authorized by and to the extent necessary to comply with laws related to workers’ compensation or similar programs.
Inmates and Correctional Institutions: We may disclose your PHI to correctional officers and law enforcement of-ficials if necessary to provide you with health care, to protect your health and safety or the health and safety of others, and to protect the safety and security of the correctional institution.
Military and Veterans: We may use and disclose your PHI if you are a member of the Armed Forces or to a foreign military if certain criteria are met.
Research: The SUNY College of Optometry is committed to the improvement of health care, in part, through research involving human subjects. We may use and disclose your PHI without your written authorization for research purposes if the research is approved through a special review process where it is determined that the use or disclosure of your PHI in the research activity poses minimal risk to your privacy. This is achieved, in part, by removing most, if not all, of the information that has the potential to identify you.
YOUR RIGHTS REGARDING YOUR PROTECTED HEALTH INFORMATION
We are required by law to maintain the privacy of your PHI, to provide you with a notice of our legal duties and privacy practices, and to notify you in the event that we discover a breach of PHI. As a patient, you have the rights set forth below regarding your PHI. While we will endeavor to grant your request, there are circumstances where we will not be able to do so. In those circumstances, we will provide you with a written explanation of our reason for denying the request. Please submit any requests identified below to the Privacy Officer by email at firstname.lastname@example.org or by calling 212-938-4030.
Right to Request Confidential Communication: You have the right to request that we communicate with you about your health care or medical matters through a reasonable alternative way or at an alternative location.
Right to Request Restrictions on Use and Disclosures: You have the right to request that we limit certain uses and disclosure of your PHI, such as limiting the information that we share with family or friends involved in your care, or by not sharing information with your insurance company if you are paying fully out of pocket.
Right to Access Your Health Information: You have the right to request access to and obtain a copy of your health information, except for psychotherapy notes and information pertaining to an ongoing clinical trial. We may impose a reasonable fee to cover the costs of copying the records. We will notify you of any anticipated fees prior to sending the records, if production of the records will be delayed, or if the health information cannot be provided in the requested format.
Right to Amend Your Records: You have the right, for as long as the information is kept in our records, to request an amendment to your health information if you believe that the information we have about you is incomplete or incorrect. Your request for an amendment must explain why you feel an amendment is necessary. Under certain circumstances, we may deny your request. If we do so, we will provide you with a written explanation as to why the request was denied.
Right to Receive an Accounting of Disclosures: You have the right to obtain a listing of those persons or organizations who received your health information from us. The listing will not cover health related information that was disclosed to you, information disclosed for treatment, payment or health care operations, or information used to conduct routine UEC operations.
Right to Notice in the Event of a Breach: You have the right to be notified when your PHI has been acquired, accessed, used or disclosed in a manner that is not legally permitted, and where we determine that your PHI has potentially been compromised (“breached”). If a breach of your PHI occurs, you will be notified of the breach in writing, within 60 days of the date when the breach was discovered.
Right to a Paper Copy of this Notice of Privacy Practices (“NPP”): You may obtain a copy of the current NPP by downloading a copy from our website at www.UniversityEyeCenter.org, by asking a member of our staff, or by calling us at 212-938-4001.
If you have questions about any part of this notice or would like to discuss our privacy practices, please contact us at SUNY College of Optometry, University Eye Center, ATTN: Clinical Administration, 33 West 42nd Street, New York, New York 10036 or by calling us 212-938-4030.
If you believe your privacy rights have been violated, you may file a complaint with us by emailing email@example.com, calling the confidential hotline at 888-906-6777, or by writing to the following address: Privacy Officer, SUNY College of Optometry, University Eye Center, ATTN: Clinical Administration,33 West 42nd Street, New York, New York 10036. You may also file a complaint with the Office for Civil Rights of the US Department of Health and Human Services. You will not be penalized for filing a complaint.