Notice of Privacy Practices - We Care About Your Privacy

1. Your Medical Information — Our Pledge

The privacy of your medical information is important to us. We understand that your medical information is personal and we are committed to protecting it. We create a record of care and services you receive at Martin’s Point (your “medical record”). We need this record to provide you with quality care and to comply with certain legal requirements.

This notice will tell you about the ways we may use and share medical information about you and certain duties we have regarding the use and disclosure of medical information. It also describes your individual rights regarding your personal health information.

2. Our Legal Duties and Rights

We Have the Duty to:

 - Keep your medical information secure and private
 - Upon request, give you this notice describing our legal duties, privacy practices, and your rights regarding your medical information
 - Follow the terms of the current notice

We Have the Right to:
 - Change our privacy practices and the terms of this notice at any time, provided that the changes are permitted by law
 - Make the changes in our privacy practices and the new terms of our notice effective for all medical information that we keep, including information previously created or received before the changes

Notice of Change to Privacy Practices:
Before we make an important change in our privacy practices, we will change this notice and make the new notice available upon request and also on our website at

3. Use and Disclosure of Your Protected Health Information (PHI)

The following section describes different ways that we use and disclose Protected Health Information (PHI). Not every use or disclosure will be listed, but you may request a copy of our full Notice of Privacy Practices at our patient check-in area or view it on our website. Please know that we will not use or disclose your PHI for any purpose not listed below without your specific authorization. Any specific authorization may be revoked at any time at your request.

For Treatment:
Our Health Care Centers may use or disclose your PHI for treatment purposes, which includes the provision, coordination, or management of your health care and related services by our Health Care Centers and other health care providers involved in your care. We may disclose medical information about you to doctors, nurses, technicians, medical students or other people who are taking care of you. We may also share medical information about you with your other health care providers to assist them in treating you. Please note that psychotherapy notes will not be disclosed for treatment purposes without your authorization.

For Payment:
We may use and disclose your PHI for payment purposes. A bill may be sent to you or a third party payer. The information on or accompanying the bill may include your PHI.

For Health Care Operations:
We may use and disclose your PHI for our health care operations. This might include measuring and improving quality; evaluating the performance of employees; conducting training programs; and getting the accreditations, certificates, licenses, and credentials we need to serve you.

To Business Associates:
Martin’s Point Health Care may contract with other organizations called “business associates” to provide services on our or your behalf. We enter into agreements with business associates that explicitly set forth the requirements associated with the protection and safeguarding of your PHI as required under the HIPAA statute.

To HealthInfoNet (Health Information Exchange):
Our Health Care Centers in Maine participate in the State of Maine’s Health Information Exchange (“HIE”). Maine’s HIE is called HealthInfoNet. HealthInfoNet receives certain PHI about you and makes that information available to other health care providers who may be treating you. We provide you the choice of opting out of the health exchange program by furnishing you with a HealthInfoNet “Opt-Out Form” which is also available at our check-in area or upon the request of any health care staff members.

Other permitted or required uses and disclosures of PHI that do not require your authorization include the following:
We may disclose your PHI to others involved in your care, including family members, a close friend, or another person you identify.

In most cases, your minor child’s PHI may be disclosed to you. However, we may be required by law to deny a parent’s access to their child/minor’s PHI for certain diagnoses or treatment such as sexually transmitted diseases, family planning services, abortion services, substance abuse outpatient counseling, psychotherapy notes from outpatient counseling, etc.

We may use and disclose your PHI to contact you and remind you of an appointment or to inform you of potential treatment options or alternatives. Your appointment reminder may be automated in order to improve our operations.

Your PHI may be used or disclosed in order to comply with laws and regulations related to Workers’ Compensation.

Your PHI may be used or disclosed for public health activities such as assisting public health authorities or other legal authorities to prevent or control disease, injury or disability, tracking of prescription drug or medical device problems, or for other health-oversight activities.

We may use and disclose your PHI for research purposes in certain limited circumstances.

Your PHI may be disclosed in the course of any legal proceeding, in response to an order of a court or an administrative tribunal and, in certain cases, in response to a subpoena, discovery request, or other lawful process.

Your PHI may be disclosed to a government agency authorized to oversee the health care system or government programs or its contractors, (e.g., the US Department of Health and Human Services, a state insurance department or the US Department of Labor) for activities authorized by law, such as audits, examinations, investigations, inspections, and licensure activity.

In most circumstances, we are required by law to receive your written authorization before we use or disclose your health information for marketing purposes.

Martin’s Point Health Care is a not-for-profit organization. As such, we may engage in fundraising efforts to support our mission. We may use and disclose your PHI to contact you regarding our fundraising efforts. You have the right to “opt out” of receiving future fundraising communications by following the opt-out instructions on the communication or contacting our Privacy Officer and making a request to opt out of receiving fundraising communications.

We may use your PHI to create de-identified information or we may disclose your information to a business associate so that the business associate can create de-identified information on our behalf.

We may use and disclose a limited data set that does not contain specific readily identifiable information about you for research, public health, and health care operations.

We may use and disclose information about you as required by law. For example, we may disclose information for the following purposes:
 - To report information related to victims of abuse, neglect, or domestic violence
 - To assist law enforcement officials in performing their duties
 - To prevent or reduce a serious and imminent threat to the health or safety of a person or the public

Your PHI may be disclosed to prevent serious threat to your or any person’s health or safety pursuant to applicable law. We may also disclose your PHI to authorized federal officials for national security purposes.

If you are an inmate, your PHI may be disclosed to a correctional institution or a law enforcement official having lawful custody, if the provision of such information is necessary to provide you with health care, protect your or another’s health and safety, or maintain the safety and security of the correctional institution.

PHI may be disclosed to funeral directors or coroners to enable them to carry out their lawful duties.

Your PHI may be used or disclosed to organ procurement organizations to facilitate cadaveric organ, eye, or tissue donation/transplantation purposes only subsequent to your prior authorization.

4. Your Rights Regarding Your PHI

You Have the Right to:
Access and Receive Copies of Your PHI

You have the right to request and receive a copy of your health care records. We may ask you to make your request in writing and to provide us with the specific information we need to fulfill your request. We will furnish you the PHI within 30 days unless your records are located at another Health Care Center or hospital. You also have the right to receive a copy of your PHI in electronic format, if we maintain your PHI in an electronic format and we can readily produce a readable electronic copy. We reserve the right to charge a reasonable fee for the cost of producing and mailing these copies. There are certain cases in which we are not permitted to fulfill your request to access or receive your records.

Amend Your PHI
If you believe that your PHI is incorrect or incomplete, you have the right to ask us to amend it. All requests for amendment must be in writing. In certain cases, we may deny your request. All denials will be made in writing. You may respond by filing a written statement of disagreement with our Health Care Centers or Privacy Officer, and we have the right to rebut that statement.

Request Confidential Communications
You have the right to request, and we must accommodate reasonable requests by you to receive, “confidential communications” of PHI from our Health Care Centers.

Accounting of Disclosures of PHI
You have the right to request an accounting of those instances in which we have disclosed your PHI for any purpose other than treatment, payment, or health care operations. Information disclosed to correctional institutions, law enforcement agencies, or health oversight agencies; and information that was disclosed or used as part of a limited data set for research, public health, or health care operations purposes would not be included in the Accounting of Disclosures.

Request Restrictions on Uses and Disclosures of Your PHI
You have the right to ask us to place restrictions on the way we use or disclose your PHI for treatment, payment, or health care operations or as described in the section of this notice entitled “Other Permitted or Required Uses and Disclosures of PHI.” In most cases, we are not required by law to agree to any requested restrictions.

Receive Notice of Privacy Practices
You have a right to receive a paper copy of the Notice of Privacy Practices upon request at any time by asking the check-in area or any Health Care Center staff member at this location.

Breach Notification
Pursuant to the Health Information Technology for Economic and Clinical Health Act of 2009 (the “HITECH Act”) and the HIPAA Omnibus Final Rule (January, 2013), you have a right to receive notice of any breach of your unsecured PHI. We have implemented policies and procedures to comply with the breach notification requirements of the HITECH Act.

State Law
To the extent Maine or New Hampshire law is stricter than HIPAA, we are required to follow Maine or New Hampshire law, as applicable. You may be entitled to additional rights under Maine or New Hampshire law.

Questions and Complaints

If you have any questions about this notice, please let a check-in staff member know you would like to speak to our Privacy Officer.
If you believe your privacy rights have been violated, you may file a written complaint with our Privacy Officer at:
 Privacy Officer
 c/o Compliance Department
 331 Veranda Street
 PO Box 9746
 Portland, ME 04104
Phone: 207-791-3867

You may also notify the Secretary of the Department of Health and Human Services (HHS) by sending your complaint to: Medical Privacy, Complaint Division, Office for Civil Rights (OCR) United States Department of Health and Human Services, 200 Independence Avenue SW, Room 509F, HHH Building, Washington DC, 20201.You may also contact OCR’s Voice Hotline Number at (800) 368-1019 or send the information to their Internet address
Martin’s Point Health Care will not take retaliatory action against you if you file a complaint.
Revision dates:
November 2011
September 23, 2013
September 29, 2014