AMO Plans issues privacy statement outlining new federal requirements to all AMO Medical Plan participants

AMO Plans issues privacy statement outlining new federal requirements to all AMO Medical Plan participants

      The American Maritime Officers Medical Plan recently sent the following letter to AMO members and participants in the plan.
      As you may know, federal law now requires that health plans, such as the American Maritime Officers (AMO) Medical Plan (the "Medical Plan"), take steps to protect the privacy of individually identifiable health information. In general, this means the Medical Plan cannot, without written authorization, use or disclose health information that identifies the individual to whom that information relates, except for purposes of treatment of that individual, payment of medical expenses, operation of the health plan or for other specified purposes.
      The law, which is effective April 14, 2003, requires that the Medical Plan provide participants with a privacy statement that sets forth the legal obligations of the Medical Plan, the specific ways the Medical Plan can use and disclose participants' health information and the process for participants to file a complaint related to the Medical Plan's treatment of their health information. The rules apply to the AMO Medical Center in Dania Beach, Fla.. Please note that the Medical Plan and Medical Center reserve the right to amend this statement, in which case you will receive a copy of the amended statement.
      The U.S. Department of Health and Human Services has issued detailed and complex regulations implementing the new law that will affect some dealings with the Medical Plan concerning health benefits of participants and their families. For example, if you wish to have someone receive information from the Medical Plan concerning the status of your claim, you will need to complete an authorization form authorizing the Medical Plan to provide information to that individual. The following questions and answers provide some highlights of the new privacy rules.

1. What do the privacy regulations require?
      In general, the regulations require the Medical Plan to secure all Protected Health Information ("PHI") so that it is not readily accessible or available to those who do not need access to it. The Medical Plan may discuss PHI with the individual directly, but the Medical Plan will no longer be able to discuss or disclose any other individual's health care information with third parties, such as your spouse or an AMO official, unless you specifically authorize the Medical Plan to do so. Thus, if your spouse or union representative calls the Medical Plan with a question about you or your family's benefits from the Medical Plan, the Medical Plan is prohibited by law from disclosing any information to them in the absence of a written authorization, even though they may already know all the details directly from you (parents, however, may obtain information concerning their minor children).

2. What is Protected Health Information or PHI?
      Protected Health Information or "PHI" is any information created, received, or stored by the Medical Plan that relates to an individual's past, present or future physical or mental health condition, health care, or payment for health care and that identifies the individual or is detailed and specific enough that the identity of the individual can reasonably be determined. For example, PHI includes the individual's name, address, phone number, social security number, marital status, eligibility for benefits, medical diagnosis, types or dates of treatment or service. Therefore, an individual's benefit information, claims records and benefit appeals would include PHI and the use and disclosure of this information would have to be restricted.

3. How do I authorize someone else to have access to my PHI?
      You may authorize the Medical Plan to disclose PHI to your spouse, your union representative, or another third party by completing an authorization form. You may revoke your authorization at any time by submitting to the Medical Plan a cancellation of authorization form. (Please note that, if you are married, you must each complete an authorization form to allow the Medical Plan to disclose to one spouse PHI about the other. Also if you have a dependent child age 18 or over, he or she must also complete an authorization form to allow the Medical Plan to disclose PHI to you or your spouse). In addition, there is a special rule in the regulation that deals with "implied authorization." If the individual is present and he or she does not object when the AMO Medical Plan staff asks for consent to disclose PHI to a third party, then no written authorization is required. Generally, this rule applies to disclosures when the other person is a family member, other relative or close personal friend.
      Authorization forms and cancellation of authorization forms were sent out with the initial mailing. Additional authorization and cancellation of authorization forms may be obtained from the Medical Plan. If you have any questions, please call the Medical Plan office at 1-800-345-6515 ext. 12.

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