Notice of Privacy Practices - HIPAA

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Effective Date of this Notice

​This notice has been updated and is effective October 28, 2024.​

Why am I receiving this notice?
​​Partnership HealthPlan of California (“Partnership”) is required by law to maintain the privacy and confidentiality of your medical information and protected health information (“PHI”), provide you with adequate written notice of our legal duties and privacy practices, and to notify you following a breach of your unsecured PHI. Any disclosure of PHI beyond the provisions of the law is prohibited. 

We agree to follow the terms of this Notice of Privacy Practices. We also have the right to change the terms of this Notice if it becomes necessary, and to make the new Notice effective for all health information we maintain. If we need to make any changes, we will post it on our website and notify you via mail in our next annual mailing to you at your address in our records. If you received this Notice electronically, you have the right to request a paper copy from us at any time.​

What is PHI?

​PHI is individually identifiable health information, such as your name, Social Security number, birthdate, medical condition or diagnosis, prescriptions, lab tests, and payment history.  PHI also includes race/ethnicity, language, gender identity, sexual orientation, and pronoun data. Your disclosure of this type of information does not negatively affect how we make decisions about your Medi-Cal benefits or impact your access to covered services. PHI may be in oral, written or electronic form.  

Partnership collects this information from you, your health care provider or other health care providers on your behalf, and the State of California; and protects this information consistent with privacy laws, including the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) and the California Confidentiality of Medical Information Act (“CMIA”).  For example, to ensure the confidentiality of your PHI, Partnership staff complete HIPAA and CMIA trainings, utilize password protections, and access your information only at a level necessary to do their job.​

How does Partnership HealthPlan of California use and disclose my health information?
Partnership stores health-related records about you, including your claims history, health plan enrollment information, case management records, and prior authorizations for treatment you receive. We use this information and disclose it to others for the following purposes:

Treatment. Partnership uses your health information to coordinate your health care, and we disclose it to hospitals, clinics, physicians and other health care providers to enable them to provide health care services to you. For example, Partnership maintains your health information in electronic form, and allows pharmacies to have on-line access to it to provide appropriate prescriptions for you.​

Payment. Partnership uses and discloses your health information to facilitate payment for health care services you receive, including determining your eligibility for benefits, and your provider's eligibility for payment. For example, we inform providers that you are a member of our plan, and tell them your eligible benefits.

Health care operations. Partnership uses and discloses your health information as necessary to enable us to operate our health plan. For example, we use our members' claims information for conducting quality assessment and improvement activities, patient safety activities, business management and general administrative activities, and reviewing competence or qualifications of health care professionals.

Underwriting. For underwriting or related purposes, such as premium rating or other activities related to the creation, renewal or replacement of a contract of health insurance or benefits as required by law, but we are prohibited from using or disclosing genetic information for these purposes.

Business Associates. Partnership may contract with business associates to perform certain functions or activities on our behalf, such as facilitating a health-information exchange, where your health information can be quickly accessed by your provider or to provide appointment reminders.

Health Information Exchange (HIE). Partnership participates in multiple Health Information Exchanges (HIEs), which allow providers to coordinate care and provide faster access to our members. HIEs assist providers and public health officials in making more informed decisions, avoiding duplicate care (such as tests), and reducing the likelihood of medical errors. By participating in an HIE, Partnership may share your health information with other providers and participants as permitted by law. If you do not want your medical information shared in the HIE, you must make this request directly to Partnership. The ‘Individual Rights’ section below tells you how.

(Note: In some circumstances, your health information may not be disclosed. For example, mental health diagnosis and treatment, diagnosis or treatment for substance use disorder, and STD; birth control; or HIV test results are all considered ‘Protected Records’ and require your direct authorization to be shared.  Any identifiable information about abortion or abortion-related services will not be shared on an HIE or to an out-of-state individual, agency or department, unless you provide written authorization or a legal exception exists.)


When working to process payment, provide care to our members, or within our daily operations, Partnership may disclose your health information to our contractors. Before we make any disclosures for payment or operational purposes, we obtain a confidentiality agreement from each contractor. For example, companies that provide or maintain our computer services may have access to health information within the course of providing services. Partnership works to ensure that our contractors have as minimal contact with your health information as possible.​

Communication and Marketing. Partnership will not use your health information for marketing purposes for which we receive payment without your prior written authorization. Partnership may use your health information for case management or care coordination purposes and related functions without your authorization. Partnership may provide appointment or prescription refill reminders or describe a product or service that is included in your benefit plan, such as our health provider network. Partnership may also discuss health-related products or services available to you that add value, but are not part of your benefit plan.

Sale of your health information. We will not sell your health information for financial payment without your prior written authorization.

Fundraising. For fundraising for Partnership, you can tell us your choices about what we share. If you have a preference for how we share your information or contact you for fundraising purposes, talk to us. Tell us what you want us to do, and we will follow your instructions. You have both the right and choice to tell us not to contact you for fundraising purposes.
Can my health information ever be released without my permission?

Yes, Partnership may disclose health information without your authorization to government agencies and private individuals and organizations in a variety of circumstances in which we are required or authorized by law to do so. Certain health information may be subject to restrictions by federal or state law that may limit or prevent some uses or disclosures. For example, there are special restrictions on the disclosure of health information relating to HIV/AIDS status, genetic information, mental health treatment, developmental disabilities, and substance use disorder treatment. We comply with these restrictions in our use of your health information.

Examples of the types of disclosures Partnership may be required or allowed to make without your authorization include:

When Legally Required: Partnership will disclose your health information when it is required to do so by any federal, state or local law.

When there are Risks to Public Health: Partnership may disclose your health information:

To public health authorities or to other authorized persons in connection with public health activities, such as for preventing or controlling disease, injury or disability or in the conduct of public health surveillance or investigations

To collect information or report adverse events related to the quality, safety or effectiveness of FDA regulated products or activities

To report abuse, neglect, or domestic violence: Partnership is mandated to notify government agencies if we believe a member is the victim of abuse, neglect or domestic violence.​

In Connection with Judicial and Administrative Proceedings: Partnership may disclose your health information in the course of any judicial or administrative proceeding in response to an order of a court or administrative tribunal as expressly authorized by such order or in response to a subpoena, discovery request or other lawful process, but only when Partnership makes reasonable efforts to either notify you about the request or to obtain an order protecting your health information. Partnership may also use and disclose PHI to the extent permitted by law without your authorization to defend a lawsuit or arbitration.  Any substance use disorder treatment records will not be used or disclosed in civil, criminal, administrative, or legislative proceedings against you unless you give written consent, or unless a court orders the disclosure after giving you notice and an opportunity to object and the order is accompanied by a subpoena or other legal requirement compelling disclosure.

For Law Enforcement Purposes:

As required by law pursuant to a search warrant lawfully issued to a governmental law enforcement agency

As required by law for reporting of certain types of wounds or other physical injuries pursuant to the court order, warrant, subpoena, summons or similar process​

For the purpose of identifying or locating a suspect, fugitive, material witness or missing person

Under certain limited circumstances, when you are the victim of a crime

To a law enforcement official if Partnership has a suspicion that your death was the result of criminal conduct including criminal conduct at Partnership

In an emergency in order to report a crime

To Coroners and Medical Examiners: Partnership may disclose your health information to coroners and medical examiners for purposes of determining your cause of death or for other duties, as authorized by law.

To Funeral Directors: Partnership may disclose your health information to funeral directors consistent with applicable law and, if necessary, to carry out their duties with respect to your funeral arrangements. If necessary to carry out their duties, Partnership may disclose your health information prior to, and in reasonable anticipation of, your death.

For Organ, Eye or Tissue Donation: Partnership may use or disclose your health information to organ procurement organizations or other entities engaged in the procurement, banking or transplantation of organs, eyes or tissue for the purpose of facilitating the donation and transplantation, if you so desire.

In the Event of a Serious Threat to Health or Safety: Partnership may, consistent with applicable law and ethical standards of conduct, disclose your health information if Partnership, in good faith, believes that such disclosure is necessary to prevent or lessen a serious and imminent threat to your health or safety or to the health and safety of the public.

For Specified Government Functions: Partnership may make disclosure to authorized federal officials in national security activities or for the provision of protective services to officials.

For Workers Compensation: Partnership may release your health information for worker’s compensation or similar programs.

To a Correctional Institution or to a Law Enforcement Official: If you are an inmate of a correctional institution or under the custody of a law enforcement official, Partnership may release health information about you to the institution or official. To other agencies administering government health benefit programs, as authorized or required by law.

For Immunization Purposes: To a school, about a member who is a student or prospective student of the school, but only if: (1) the information that is disclosed is limited to proof of immunization; (2) the school is required by the state or other law to have such proof of immunization prior to admitting the member; and (3) there is documented agreement by the member or the member’s guardian.

For Disaster Relief Purposes: Partnership may make disclosure to a public or private entity authorized by law or by its charter to assist in disaster relief efforts.

For Research Purposes: Partnership may use or disclose protected health information for research purposes.​

Can others involved in my care receive information about me?

Yes, Partnership may release health information to a friend or family member who is involved in your care, or who is paying for your care, to the extent we judge it necessary for their participation unless you specifically ask us not to and we agree to that request. This includes responding to telephone enquiries about eligibility and claim status.

OTHER THAN WHAT IS STATED ABOVE, PARTNERSHIP WILL NOT DISCLOSE YOUR HEALTH INFORMATION OTHER THAN WITH YOUR WRITTEN AUTHORIZATION. IF YOU OR YOUR REPRESENTATIVE AUTHORIZES PARTNERSHIP TO USE OR DISCLOSE YOUR HEALTH INFORMATION, YOU MAY REVOKE THAT AUTHORIZATION IN WRITING AT ANY TIME.​

Are there instances when my health information is not released?

We will not permit other uses and disclosures of your health information without your written permission, or authorization which you may revoke at any time in the manner described in our authorization form.  Please note that it is possible that information that Partnership has properly disclosed pursuant to this Notice will be redisclosed by the recipient and, if so, it is no longer protected by the policies in this Notice. Except as described above (How does Partnership HealthPlan of California use and disclose my health information), disclosures of psychotherapy notes, marketing and the sale of your information require your written authorization and a statement that you may revoke the authorization at any time in writing. 

Furthermore, your health information cannot be used or disclosed to conduct any criminal, civil, or administrative investigation or impose any liability on you or anyone else, or identify you or anyone else in connection with either of those purposes, for seeking, obtaining, providing, or facilitating reproductive health care, provided that the reproductive health care is lawful under Federal law and the law of the state in which the reproductive health care is provided. For example, if you live in one state and travel to California to receive lawful reproductive health care, such as an abortion, we are not allowed to and will not share that information if someone tries to investigate you for obtaining that care. However, if Partnership receives a lawful attestation from the person requesting it, we may disclose your protected health information potentially related to reproductive health care (such as an abortion) for the following purposes: 

Health oversight activities

Judicial or administrative proceedings 

Law enforcement

Coroner or medical examinations

Pursuant to the requirements of CMIA, we will not cooperate with any inquiry or investigation by or provide medical information to, any individual, agency, or department from another state or, to the extent permitted by federal law, to a federal law enforcement agency that would disclose identifiable abortion or abortion-related services that are lawful under the laws of California, unless the individual provides written authorization or disclosure is required by law. 

We will not knowingly disclose, transmit, transfer, share, or grant access to medical information in an electronic health records system or through a health information exchange identifiable abortion or abortion-related services that is lawful under the laws of California to any individual from another state, unless the individual provides written authorization or disclosure is required by law. 

YOUR INDIVIDUAL RIGHTS
What rights do I have as a Partnership member?

As a Partnership member you have the following rights with respect to your health information:

To ask us to restrict certain uses and disclosures of your health information for the purpose of carrying out treatment, payment, or health care operations, or if the disclosure is to a family member, relative, or close personal friend and is related to the person’s involvement with your health care or payment for your health care or for notification purposes. Partnership is not required to agree to any restrictions requested by its members unless the disclosure is for the purpose of carrying out payment or health care operations and the request is solely for a health care item or service for which you, or another person other than Partnership, has paid for the service(s) out of pocket.

To receive confidential communications from Partnership at a particular phone number, P.O. Box, or some other address that you specify to us.

To see and copy any of your health records that Partnership maintains on you, including billing records, we must receive your request in writing. We will respond to your request within 30 days. Partnership may charge a fee to cover the cost of copying, assembling and mailing your records, as applicable. You may also request Partnership to transmit the information directly to another person if your written request is signed by you and clearly identifies both the designated person and where to send the information. In some situations, Partnership may ask if you would agree to receive a summary or an explanation of the requested information and to any fees that might be imposed to create it. Under certain circumstances, Partnership may deny your request. If your request is denied, we will tell you the reason why in writing. You have the right to appeal a denial.

If you feel the information in our records is wrong, you have the right to request us to amend the records. Partnership may deny your request in certain circumstances. If your request is denied, you have the right to submit a statement for inclusion in the record.

You have the right to receive a list of our non-routine disclosures that we have made of your health information, up to six years prior from the date of your request. Non-routine disclosures do not include, for example, disclosures to carry out treatment, payment, health care operations, disclosures made with your authorization; disclosures made for the purposes of health care treatment, determining payment for health services, or conducting the health plan operations of Partnership; disclosures made to you; and certain other disclosures. You are entitled to one disclosure list in any 12-month period at no charge. If you request any additional lists less than 12 months later, Partnership may charge you a fee.

If you received this notice electronically, you have the right to request a paper copy from us at any time.​

How do I exercise these rights?

You can exercise any of your rights by sending a written request to our Privacy Official at the address below. To facilitate processing of your request, we encourage you to use our request form called Health Information Restriction Request, which you can obtain from our Internet website at PartnershipHP.org or by calling us at the telephone number below. You can also obtain a complete statement of your rights, including our procedures for responding to requests to exercise your rights, by calling or writing to the Privacy Official at the address below.​

Health Information Restriction Request Form

Protection and Release of Member Health Information

Authorization to Release Medical Information

Members will use this form when they want Partnership to release certain information for a certain purpose for a set period of time.
Click the language to download: English | Spanish | Tagalog | Russian

Assignment of Authorized Representative

Members will use this form when they want a friend, family member, or other person to help with making health care decisions.
Click the language to download: English | Spanish | Tagalog | Russian

Designated Personal Representative Form

This form is use when, by operation of law, another person has the legal authority to make health care decisions for a member.
Click the language to download: English | Spanish | Tagalog | Russian

How do I file a complaint if my privacy rights are violated?

As a Partnership member, you or your personal representative have the right to file a complaint with our Privacy Official if you believe your privacy rights have been violated. You or your representative must provide us with specific written information to support your complaint; see contact information below. You may also file a complaint with the Secretary of Health and Human Services on their website or use the contact information listed below:


Partnership encourages you to contact us with any concerns you have regarding the privacy of your information. Partnership will not retaliate against you in any way for filing a complaint. Filing a complaint will not adversely affect the quality health care services you receive as a Partnership member. 

Contact Us:
Partnership HealthPlan of California
Attn: Privacy Officer
4665 Business Center Drive 
Fairfield, CA 94534

Telephone Number: (800) 863-4155 or TTY/TDD (800) 735-2929 or call 711

Or visit http://www.partnershiphp.org/Members/Medi-Cal/Pages/Notice-of-Privacy-Practices---HIPAA.aspx

Partnership's Complaint Hotline is (800) 601-2146 and is operated 24 hours a day, 7 days a week 
 

California Department of Health Care Services:
DHCS Privacy Officer 
1501 Capitol Avenue, MS 4721
PO BOX 997413 
Sacramento, CA 95899-7413
 
Phone: (916) 445-4646; TTY/TDD: (877) 735-2929
Email: Privacyofficer@dhcs.ca.gov


You can file a complaint with the United States Department of Health and Human Services at:

Centralized Case Management Operations  
U.S. Department of Health and Human Services 
200 Independence Avenue, S.W.​
Room 509F HHH Bldg.
Washington, D.C. 20201
 

Phone: (877) 696-6775
Or visit http://www.hhs.gov/hipaa/filing-a-complaint/complaint-process/index.html