Los Angeles Police Relief Association, Inc. (“LAPRA”) is committed to maintaining the confidentiality of your private medical information. This Notice describes our efforts to safeguard your health information from improper or unnecessary use or disclosure. This Notice only applies to health-related information created or received by or on behalf of the LAPRA benefit programs listed below (collectively referred to in this Notice as the “Health Plans”). We are providing this Notice to you because privacy regulations issued under federal law, the Health Insurance Portability and Accountability Act of 1996, 45 CFR Parts 160 and 164 (“HIPAA”), require us to provide you with a summary of the Health Plans’ privacy practices and related legal duties, and your rights in connection with the use and disclosure of your Health Plans information.
This Notice applies to LAPRA Health Plans members, former members, and dependents who participate in any of the following benefit programs:
1. Medical Benefits
2. Dental Benefits
3. Vision Benefits
In this Notice, the terms “Health Plans,” “we,” “us,” and “our” refer to the Health Plans, all LAPRA employees involved in the administration of the Health Plans, and third parties to the extent they perform administrative services for the Health Plans.
LAPRA employees perform only limited Health Plans functions – most Health Plans administrative functions are performed by third party service providers. We require these third parties to appropriately safeguard the privacy of your information.
If you are enrolled in an HMO you will also receive a separate notice from your HMO provider that describes the HMO provider’s specific use and disclosure of your health information. Your rights with respect to their use and disclosure of your health information are set forth in that separate notice.
Federal law requires the Health Plans to have a special policy for safeguarding a category of medical information called “protected health information,” or “PHI,” received or created in the course of administering the Health Plans. PHI is health information that can be used to identify you and that relates to (1) your physical or mental health condition; (2) the provision of health care to you; or (3) payment for your health care.
Medical records, claims for benefits, and the explanation of benefits (“EOB’s”) sent in connection with payment of claims are all examples of PHI.
To protect the privacy of your PHI, the Health Plans not only guard the physical security of your PHI, but we also limit the way your PHI is used or disclosed to others. We may use or disclose your PHI in certain permissible ways described below. To the extent required under federal health information privacy law, we use the minimum amount of your PHI necessary to perform these tasks.
Absent your written permission, LAPRA employees will only use or disclose your PHI as described in this Notice. LAPRA employees will not access your PHI for reasons unrelated to Health Plans administration, and LAPRA does not use your PHI for any employment-related reason without your express written authorization.
If an applicable state law provides greater health information privacy protections than the federal law, we will comply with the stricter state law.
Before we use or disclose your PHI for any purpose other than those listed above, we must obtain your written authorization. You may revoke your authorization, in writing, at any time. If you revoke your authorization, the Health Plans will no longer use or disclose your PHI except as described above (or as permitted by any other authorizations that have not been revoked). However, please understand that we cannot retrieve any PHI disclosed to a third party in reliance on your prior authorization.
In no event will the Health Plans use or disclose your PHI that is “genetic information” for “underwriting purposes,” as such terms are defined by the Genetic Information Nondiscrimination Act of 2008.
Federal law provides you with certain rights regarding your PHI. Parents of minor children and other individuals with legal authority to make health decisions for a Health Plans participant may exercise these rights on behalf of the participant, consistent with state law.
Right to request restrictions: You have the right to request a restriction or limitation on the Health Plans’ use or disclosure of your PHI. For example, you may ask us to limit the scope of your PHI disclosures to a case manager who is assigned to you for monitoring a chronic condition. Because we use your PHI only to the extent necessary to pay Health Plans benefits, to administer the Health Plans, and to comply with the law, it may not be possible to agree to your request. Except in the limited circumstances described below, the law does not require the Health Plans to agree to your request for restriction. Except as otherwise required by law (and excluding disclosures for treatment purposes), the Health Plans are obligated, upon your request, to refrain from sharing your PHI with another health plan for purposes of payment or carrying out health care operations if the PHI pertains solely to a health care item or service for which the health care provider involved has been paid out-of-pocket in full. The Health Plans will not agree to any restriction which will cause it to violate or be noncompliant with any legal requirement. However, if we do agree to your requested restriction or limitation, we will honor the restriction until you agree to terminate the restriction or until we notify you that we are terminating the restriction with respect to PHI created or received by the Health Plans in the future.
You may make a request for restriction on the use and disclosure of your PHI by completing the appropriate request form available from the LAPRA Benefits Department at the number and address provided on the first page of this Notice.
Right to receive confidential communications: You have the right to request that the Health Plans communicate with you about your PHI at an alternative address or by alternative means if you believe that communication through normal business practices could endanger you. For example, you may request that the Health Plans contact you only at work and not at home.
You may request confidential communication of your PHI by completing an appropriate form available from the LAPRA Benefits Department. We will accommodate all reasonable requests if you clearly state that you are requesting the confidential communication because you feel that disclosure in another way could endanger your safety.
Right to inspect and obtain a copy of your PHI: You have the right to inspect and obtain a copy of your PHI that is contained in records that the Health Plans maintain for enrollment, payment, claims determination, or case or medical management activities. If the Health Plans use or maintain an electronic health record with respect to your PHI, you may request such PHI in an electronic format, and direct that such PHI be sent to another person or entity
However, this right does not extend to (1) psychotherapy notes, (2) information compiled in reasonable anticipation of, or for use in, a civil, criminal, or administrative action or proceeding, and (3) any information, including PHI, as to which the law does not permit access. We will also deny your request to inspect and obtain a copy of your PHI if a licensed health care professional hired by the Health Plans has determined that giving you the requested access is reasonably likely to endanger the life or physical safety of you or another individual or to cause substantial harm to you or another individual, or that the record makes references to another person (other than a health care provider), and that the requested access would likely cause substantial harm to the other person.
In the event that your request to inspect or obtain a copy of your PHI is denied, you may have that decision reviewed. A different licensed health care professional chosen by the Health Plans will review the request and denial, and we will comply with the health care professional’s decision.
You may make a request to inspect or obtain a copy of your PHI by completing the appropriate form available from the LAPRA Benefits Department. We may charge you a fee to cover the costs of copying, mailing or other supplies directly associated with your request. You will be notified of any costs before you incur any expenses.
Right to amend your PHI: You have the right to request an amendment of your PHI if you believe the information the Health Plans have about you is incorrect or incomplete. You have this right as long as your PHI is maintained by the Health Plans in a designated record set. We will correct any mistakes if we created the PHI or if the person or entity that originally created the PHI is no longer available to make the amendment. However, we cannot amend PHI that we believe to be accurate and complete.
You may request amendments of your PHI by completing the appropriate form available from the LAPRA Benefits Department.
Right to receive an accounting of disclosures of PHI: You have the right to request a list of certain disclosures of your PHI by the Health Plans. The accounting will not include disclosures (1) to carry out treatment, payment and health care operations, (2) to you, (3) incident to a use or disclosure permitted or required by law, (4) pursuant to an authorization provided by you, (5) for directories or to people involved in your care or other notification purposes as permitted by law, (6) for national security or intelligence purposes, (7) to correctional institutions or law enforcement officials, (8) that are part of a limited data set, (9) that occurred prior to April 14, 2003, or more than six years before your request. Your first request for an accounting within a 12-month period will be free. We may charge you for costs associated with providing you additional accountings. We will notify you in advance of any costs, and you may choose to withdraw or modify your request before you incur any expenses.
You may make a request for an accounting by submitting the appropriate request form available from the LAPRA Benefits Department.
You may file a formal complaint with our Privacy Officer and/or with the United States Department of Health and Human Services at the addresses below. You should attach any evidence or documents that support your belief that your privacy rights have been violated. We take your complaints very seriously. LAPRA prohibits retaliation against any person for filing such a complaint.
Complaints should be sent to:
Privacy Officer Los Angeles Police Relief Association, Inc.
600 N. Grand Avenue
Los Angeles, California 90012
Phone: (213) 674-3701
Fax: (213) 674- 3715
Region IX, Office for Civil Rights
U.S. Department of Health and Human Services
90 7th Street, Suite 4-100
San Francisco, CA 94103
Phone: (415) 437-8310
FAX: (415) 437-8329
TDD: (415) 437-8311
Changes to this Notice: We reserve the right to change the Health Plans’ privacy practices as described in this Notice. Any change may affect the use and disclosure of your PHI already maintained by the LAPRA Health Plans, as well as any of your PHI that the Health Plans may receive or create in the future. If there is a material change to the terms of this Notice, a revised Notice will be made available to you upon your request or as otherwise required by HIPAA.
How to obtain a copy of this Notice: You can obtain a copy of the current Notice by contacting the Privacy Officer at the address listed on the front of this Notice.
No change to Health Plans benefits: This Notice explains your privacy rights as a current or former participant in LAPRA Health Plans. The Health Plans are bound by the terms of this Notice as they relate to the privacy of your protected health information. However, this Notice does not change any other rights or obligations you may have under the Health Plans. You should refer to the Health Plans documents for additional information regarding your Health Plans benefits.