hipaa rights and procedures . privacy notice . this notice describes how medical information about you may be used and disclosed and how you can get access to this information.
Please refer to the applicable plan summary for information about the eligibility for, and benefits provided under, each of the above-listed plans.
HIPAA RIGHTS AND PROCEDURES PRIVACY NOTICE 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. If you are a participant or beneficiary in one or more of the following plans, you are entitled to certain rights and protections under the Health Insurance Portability and Accountability Act of 1996 (HIPAA): · ChoicePlus Benefits Plan · Medical Plan for Retirees and LTD Participants · Special Medical Care Plan · Medical Case Management Plan · Drug and Alcohol Rehabilitation Service Program (DARS) Please refer to the applicable plan summary for information about the eligibility for, and benefits provided under, each of the above-listed plans. However, generally speaking: DARS and the Medical Case Management Plan cover all employees; the ChoicePlus Benefits Plan covers certain active nonagreement employees; the Medical Plan for Retirees and LTD Participants covers certain former employees who have retired or are on long-term disability; and the Special Medical Care Plan covers trainees for certain agreement positions and certain former agreement employees who separated under a voluntary separation program. When we use the term "we" and "our" in this Notice, we are referring to a Plan listed above. "You" and "yours" refer to an individual participant or beneficiary in a Plan. Notice of Privacy Practices We are required to provide you with a notice regarding each Plan's policies and procedures related to your Protected Health Information by providing you with this Privacy Notice. We are required to abide by the terms of the Privacy Notice, as it may be updated from time to time. Each Plan reserves the right to change the terms of the Privacy Notice and to make the new Privacy Notice provisions effective for all Protected Health Information maintained by that Plan. We will provide you with a new notice if we make a material change to this Privacy Notice, or information about the change and how to obtain the revised notice will be provided in the group health plans' next annual mailing. Use and Disclosure of Protected Health Information Pursuant to the provisions of HIPAA, we are required to take certain steps to protect the privacy of individually identifiable health information, also referred to as Protected Health Information. Under applicable law, we are permitted to make certain types of uses and disclosures of your Protected Health Information, without your authorization, for treatment, payment, and health care purposes. · For treatment purposes, use and disclosure may take place in the course of providing, coordinating, or managing health care and its related services by one or more of your providers, such as when the Plan consults with a physician or facility regarding your condition. · For payment purposes, use and disclosure may take place to determine responsibility for coverage and benefits, such as when the Plan undertakes activities to determine or fulfill responsibility related to payment or reimbursement for health care provided to you. The Plan may also use your Protected Health Information for other payment-related purposes, such as to assist in making eligibility and coverage determinations, or for utilization review activities. · For health care operations purposes, use and disclosure may take place in a number of ways involving plan administration, including for coordination of benefits, quality assessment and improvement, vendor review, underwriting activities, to assist in the evaluation of Plan performance, for a disease management or wellness program to improve your health, for audit services, fraud and abuse detection programs, or to explore alternatives for improving Plan costs. Your information could be used, for example, to assist in the evaluation of one or more vendors who support the Plan or to evaluate the performance of the Plan. The Plan also may contact you to provide reminders or information about treatment alternatives or other health-related benefits and services under the Plan. The Plan also may disclose your Protected Health Information to the Company (as the Plan Sponsor) in connection with these activities. The Company has designated a limited number of employees who are the only ones permitted to access and use your Protected Health Information for plan operations and administration. When appropriate, the Plan may share the following Protected Health Information with the Company: · Enrollment/disenrollment data information on whether you participate in the Plan or whether you have enrolled or disenrolled from a Plan option. · Summary Health Information summaries of claims from which names and other identifying information have been removed. The Company will not use or disclose Protected Health Information other than as permitted or required by the group health plan components of the Plans or pursuant to HIPAA. DARS. If you are an employee receiving benefits under DARS, you must execute a HIPAA authorization providing certain Health Services, other necessary Company representatives and third parties involved in the return to service process, access to your Protected Health Information for (i) a determination concerning your compliance with all treatment recommendations for addiction to alcohol and/or controlled substances, if any, and your ability to return to service with the Company, (ii) periodic drug and alcohol testing, and (iii) certain other employment-related determinations. The DARS Program may not condition treatment, payment, enrollment, or eligibility for DARS Program benefits on whether you sign this authorization, and you have the right to refuse to sign the authorization. If you do not execute the authorization, you may continue participation in the DARS Program, but you will not be eligible at any time for return to service with the Company. Medical Case Management Plan. If you are an employee receiving benefits under the Medical Case Management Plan, a HIPAA authorization providing certain Health Services and other representatives access to your protected health information is required for a determination concerning your ability to return to work. The Medical Case Management Plan will not condition treatment, payment, enrollment, or eligibility for benefits on whether you sign this authorization, and you have the right to refuse to sign the authorization. If you do not execute the authorization, however, you will not be eligible at any time for re-employment. We may use or disclose Protected Health Information without your authorization under conditions specified in federal regulations, including: · as required by law, provided the use or disclosure complies with and is limited to the relevant requirements of such law; · to persons involved with your care, such as family member, if you are incapacitated, in an emergency, or when permitted by law; · for public health activities; · disclosures to an appropriate government authority regarding victims of abuse, neglect or domestic violence; · to a health oversight agency for oversight activities authorized by law; · in connection with judicial and administrative proceedings and other lawful processes, such as in response to a court or administrative order, or in response to a subpoena; · to a law enforcement official pursuant to a subpoena and other law enforcement processes; · to a coroner, medical examiner or funeral director; · to cadaveric organ, eye or tissue donation programs; · for research purposes, as long as certain privacy-related standards are satisfied; · to avert a serious threat to health or safety; · for specialized government functions (e.g., military and veterans activities, national security and intelligence, federal protective services, medical suitability determinations, correctional institutions and other law enforcement custodial situations); · for workers' compensation or other similar programs established by law that provide benefits for work-related injuries or illness without regard to fault; and · as required by the U.S. Department of Transportation regulations concerning substance abuse professional (SAP) reports to an employer. We may use your medical information to contact you with information about related benefits and services or about treatment alternatives that may be of interest to you. We may disclose your medical information to a business associate to assist us in these activities. If none of the above reasons apply, uses and disclosures will be made only with your written authorization, and you may revoke your authorization in writing at any time. Specific uses and disclosures that require your written authorization include: · uses and disclosures of your Protected Health Information for marketing purposes; · uses and disclosures that constitute a sale of your Protected Health information; and · other uses and disclosures not described in this Privacy Notice After we receive authorization from you to release your Protected Health Information, we cannot guarantee that the person to whom the information is provided will not disclose your information. You may revoke your written authorization unless we have already acted based on your authorization. You may ask us to restrict uses and disclosures of your Protected Health Information to carry out treatment, payment, or health care operations, or to restrict uses and disclosures to family members, relatives, friends, or other persons you identify who are involved in your care or payment for your care. However, we are not required to agree to your request. You may exercise this right by contacting the individual or office identified at the end of this section. They will provide you with additional information. Your Rights Under HIPAA You have the right to request the following with respect to your Protected Health Information: (i) inspection and copying of certain information; (ii) amendment or correction of certain information; (iii) an accounting of certain disclosures of your Protected Health Information by the Plan (you are not entitled to an accounting of disclosures made for payment, treatment or health care operations, or disclosures made pursuant to your written authorization or in connection with other disclosures for which federal law does not require the plan to provide an accounting); and (iv) the right to receive a paper copy of the privacy notice upon request. You have the right to request in writing that you receive your Protected Health Information by alternative means or at an alternative location if you reasonably believe that disclosure could pose a danger to you. You have the right to be notified following a breach of your unsecured Protected Health Information. If you believe that your privacy rights have been violated, you may file a complaint with us in writing at the location described below under "Contacting The Privacy Officer," or you may file a complaint with U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hippa/complaints/. You will not be retaliated against for filing a complaint. Contacting the Privacy Officer You may exercise the rights described in this section by contacting the Privacy Officer identified below. They will provide you with additional information. The contact is: Director of Benefits Administration Norfolk Southern Corporation Three Commercial Place Norfolk, Virginia 23510-2191 Phone: 800-267-3313 For Vision Benefits under the ChoicePlus Benefits Plan, the contact is: Privacy Office EyeMed Vision Care, LLC 4000 Luxottica Place Mason, Ohio 45040 Phone: 513-765-4321 Email: privacyoffice@luxotticaretail.com Web site: www.eyemedvisioncare.com Effective Date of Notice: November 14, 2019.Tyler, John Adobe PDF Library 19.21.79