We recognize that the information we collect about you and your health is personal and private. Protecting your information is one of our most important responsibilities.
This Notice, which is required by law, is intended to inform you of your rights regarding your information and to give you notice outlining our responsibility and the ways your protected health information will be shared by the Ohio Department of Medicaid (ODM).
We collect and use your information to assist us in making decisions about whether you qualify for certain programs or services, to pay for health care services provided for you, and to evaluate the quality and effectiveness of services provided to you. We are permitted to use your protected health information without your consent or authorization in order to carry out payment, treatment or health care operations. The following are some common examples of how your information may be used:
We will not use or disclose your protected health information without your authorization for purposes other than those described above which include payment, treatment, healthcare operations or otherwise required by law. Other uses and disclosures will require your written authorization. Types and uses of disclosures requiring a written authorization include psychotherapy notes; uses or disclosures for marketing purposes not otherwise permitted, with limited exceptions for payment, treatment or health care operations.
You have the right to revoke your authorization by sending a written request to the individual listed on this Notice at any time. We are required to honor your request, except to the extent that we may have already acted upon your request relying on prior authorization.
You should be aware that ODM is not responsible for any further disclosure made by any party to whom you authorized release.
You have a number of rights under the Health Insurance Portability and Accountability Act (HIPAA) regarding your health information. Your rights, with noted exceptions, include the following:
You may exercise your rights to the above by contacting the ODM Privacy Office as listed on this notice.
If you believe that your privacy rights have been violated you may file a complaint with ODM or the Office for Civil Rights, U.S. Department of Health & Human Services.
Your benefits or status will not be impacted by filing a complaint. It is against the law for us to take any retaliatory or other negative action against you if you file a complaint.
Contact information:
Ohio Department of Medicaid Attn: Health Information Privacy Official PO Box 182709 Columbus, OH 43218-2709
Office for Civil Rights U.S. Department of Health and Human Services 233 N. Michigan Ave, Suite 240 Chicago, IL 60601 (312) 886-2359