As of January 1, 2016, Investigator’s conducting research through the June E. Nylen Cancer Center do not hold any Significant Financial Interests determined to be Financial Conflicts of Interest. This website will be updated no less than an annual basis and within 60 days of identification of a new Financial Conflict of Interest. For additional information, please submit all requests in writing to:
June E. Nylen Cancer Center Research Department
ATTN: Director of Research
230 Nebraska St.
Sioux City, Iowa 51101
JUNE E. NYLEN CANCER CENTER NOTICE OF PRIVACY PRACTICES
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.
USE AND DISCLOSURE OF HEALTH INFORMATION
June E. Nylen Cancer Center may use your health information, information that constitutes protected health information as defined in the Privacy Rule of the Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996, for purposes of providing you treatment, obtaining payment for your care and conducting health care operations. June E. Nylen Cancer Center has established policies to guard against unnecessary disclosure of your health information.
THE FOLLOWING IS A SUMMARY OF THE CIRCUMSTANCES UNDER WHICH AND PURPOSES FOR WHICH YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED:
To Provide Treatment. June E. Nylen Cancer Center may use and disclose your health information to coordinate care within the Cancer Center and with others involved in your care, such as your attending physician, members of the Cancer Center staff and other health care professionals who have agreed to assist Cancer Center in coordinating care. For example, physicians involved in your care will need information about your symptoms in order to prescribe appropriate medications. June E. Nylen Cancer Center also may disclose your health care information to individuals outside of the Cancer Center involved in your care including family members, clergy, pharmacists, suppliers of medical equipment or other health care professionals/organizations.
To Obtain Payment. June E. Nylen Cancer Center may include your health information in invoices to collect payment from third parties for the care you receive from the Cancer Center. For example, the Cancer Center may be required by your health insurer to provide information regarding your health care status so that the insurer will reimburse you or the Cancer Center. The Cancer Center also may need to obtain prior approval from your insurer and may need to explain to the insurer your need for care and the services that will be provided to you. You have the right to restrict disclosure of your protected health information to your health plan if you have paid the Cancer Center out of pocket in full for services provided.
To Conduct Health Care Operations. June E. Nylen Cancer Center may use and disclose health information for its own operations in order to facilitate the function of the Cancer Center and as necessary to provide quality care to all of the Cancer Center’s patients. Health care operations includes such activities as:
– Quality assessment and improvement activities.
– Activities designed to improve health or reduce health care costs.
– Protocol development, case management and care coordination.
– Professional review and performance evaluation.
– Training programs including those in which students, trainees or practitioners in health care learn under supervision.
– Training of non-health care professionals.
– Accreditation, certification, licensing or credentialing activities.
– Review and auditing, including compliance reviews, medical reviews, legal services and compliance programs.
– Business planning and development including cost management and planning related analyses and formulary development.
– Business management and general administrative activities of the Cancer Center.
For example the Cancer Center may use your health information to evaluate its staff performance, combine your health information with other Cancer Center patients in evaluating how to more effectively serve all Cancer Center patients, disclose your health information to Cancer Center staff and contracted personnel for training purposes, use your health information to contact you as a reminder regarding a visit to you, or contact you as part of general fundraising and community information mailings (unless you tell us you do not want to be contacted).
For Fundraising Activities. June E. Nylen Cancer Center may use information about you including your name, address, phone number and the dates you received care in order to contact you or your family for charitable giving to the Cancer Center. If you do not want June E. Nylen Cancer Center to contact you or your family, notify the Cancer Center Quality and Compliance Manager at (712) 233-4144 and indicate that you do not wish to be contacted.
To Arrange Needed Community Resources. June E. Nylen Cancer Center may disclose your health information to arrange services for you from other community agencies that you have agreed to, such as Meals on Wheels or Aging Services, etc.
For Treatment Alternatives. June E. Nylen Cancer Center may use and disclose your health information to obtain information about treatment options or alternatives that may be of interest to you.
THE FOLLOWING IS A SUMMARY OF THE CIRCUMSTANCES UNDER WHICH AND PURPOSES FOR WHICH YOUR HEALTH INFORMATION MAY ALSO BE USED AND DISCLOSED.
When Legally Required. June E. Nylen Cancer Center 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. June E. Nylen Cancer Center may disclose your health information for public activities and purposes in order to:
– Prevent or control disease, injury or disability, report disease, injury, vital events such as birth or death and the conduct of public health surveillance, investigations and interventions.
– Report adverse events, product defects, to track products or enable product recalls, repairs and replacements and to conduct post-marketing surveillance and compliance with requirements of the Food and Drug Administration.
– Notify a person who has been exposed to a communicable disease or who may be at risk of contracting or spreading a disease.
To Report Abuse, Neglect Or Domestic Violence. June E. Nylen Cancer Center is required to notify government authorities if the Cancer Center believes a patient is the victim of abuse, neglect or domestic violence. The Cancer Center will make this disclosure only when specifically required or authorized by law or when the patient requests the disclosure.
To Conduct Health Oversight Activities. June E. Nylen Cancer Center may disclose your health information to a health oversight organization for activities including audits, civil administrative or criminal investigations, inspections, licensure or disciplinary action. However, the Cancer Center, may not disclose your health information if you are the subject of an investigation and your health information is not directly related to your receipt of health care or public benefits.
In Connection With Judicial And Administrative Proceedings. June E. Nylen Cancer Center 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 the Cancer Center makes reasonable efforts to either notify you about the request or to obtain an order protecting your health information.
For Law Enforcement Purposes. As permitted or required by State law, June E. Nylen Cancer Center may disclose your health information to a law enforcement official for certain law enforcement purposes as follows:
– As required by law for reporting of certain types of wounds or other physical injuries pursuant to the court order, warrant, subpoena or 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 the Cancer Center has a suspicion that your death was the result of criminal conduct.
– In an emergency in order to report a crime.
To Coroners And Medical Examiners. June E. Nylen Cancer Center 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.
For Organ, Eye Or Tissue Donation. June E. Nylen Cancer Center 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.
For Research Purposes. June E. Nylen Cancer Center may, under very select circumstances, use and disclose your health information for research. Before the Cancer Center discloses any of your health information for such research purposes, the project will be subject to an extensive approval process.
In the Event of A Serious Threat To Health Or Safety. June E. Nylen Cancer Center may, consistent with applicable law and ethical standards of conduct, disclose your health information if the Cancer Center, 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. In certain circumstances, the Federal regulations authorize June E. Nylen Cancer Center to use or disclose your health information to facilitate specified government functions relating to military and veterans, national security and intelligence activities, protective services for the President and others, medical suitability determinations and inmates and law enforcement custody.
For Worker’s Compensation. June E. Nylen Cancer Center may release your health information for worker’s compensation or similar programs.
AUTHORIZATION TO USE OR DISCLOSE HEALTH INFORMATION
Other than what is stated above, June E. Nylen Cancer Center will not disclose your health information other than with your written authorization. A written authorization is required for most uses and disclosures of psychotherapy notes, uses and disclosures of protected health information for marketing purposes and disclosures that constitute a sale of protected health information. If you or your representative authorizes June E. Nylen Cancer Center to use or disclose your health information, you may revoke that authorization in writing at any time.
YOUR RIGHTS WITH RESPECT TO YOUR HEALTH INFORMATION
You have the following rights regarding your health information that June E. Nylen Cancer Center maintains:
Right to request restrictions. You may request restrictions on certain uses and disclosures of your health information. You have the right to request a limit on the Cancer Center’s disclosure of your health information to someone who is involved in your care or the payment of your care. However, the Cancer Center is not required to agree to your request. If you wish to make a request for restrictions, please contact the Quality and Compliance Manager at (712) 233-4144.
Right to receive confidential communications. You have the right to request that the Cancer Center communicate with you in a certain way. For example, you may ask that the Cancer Center only conduct communications pertaining to your health information with you privately with no other family members present. If you wish to receive confidential communications, please contact the Quality and Compliance Manager at (712) 233-4144. The Cancer Center will not request that you provide any reasons for your request and will attempt to honor your reasonable requests for confidential communications.
Right to inspect and copy your health information. You have the right to inspect and copy your health information, including billing records as long as the Cancer Center maintains it except when it is prohibited or protected by law. An electronic copy of protected health information is available for records that are maintained electronically. You may request that the Cancer Center provide a copy of your protected health information directly to an individual designated by you. A request to inspect and copy records containing your protected health information must be made in writing. Information regarding requests for records may be made to the Quality and Compliance Manager at (712 233-4144. The Cancer Center will verify the identity and authority of the individual making the request. The Cancer Center may charge a reasonable fee for copying and assembling costs associated with your request. The Cancer Center will provide access to your records within 30 days of your request with the option of a one-time 30 day extension.
Right to amend health care information. You or your representative has the right to request that June E. Nylen Cancer Center amend your records, if you believe that your health information is incorrect or incomplete. That request may be made as long as the information is maintained by the Cancer Center. A request for an amendment of records must be made in writing to: Quality and Compliance Manager, 4300 Hamilton Blvd., Sioux City, IA. 51104. The Cancer Center may deny the request if it is not in writing or does not include a reason for the amendment. The request also may be denied if your health information records were not created by June E. Nylen Cancer Center, if the records you are requesting are not part of the Cancer Center‘s records, if the health information you wish to amend is not part of the health information you or your representative are permitted to inspect and copy, or if, in the opinion of the Cancer Center, the records containing your health information are accurate and complete.
Right to an accounting. You or your representative has the right to request an accounting of disclosures of your health information except for the following disclosures: 1) to carry out treatment, payment or health care operations, 2) to you or by you in writing, 3) to persons involved in your care, 4) for national security or intelligence purposes, 5) to correctional institutions or law enforcement officials or 6) that occurred prior to April 14, 2003. The request for an accounting must be made in writing to: Quality and Compliance Manager, 4300 Hamilton Blvd., Sioux City, IA. 51104. You must include the time period of the accounting, which may not be longer than six years. The Cancer Center will respond to your request within 60 days from its receipt. The Cancer Center will provide the first accounting you request during any 12-month period without charge. Subsequent accounting requests may be subject to a reasonable cost-based fee.
Right to be notified following a data breach. You or your representative will be notified if a data breach occurs you will be informed of all actions that have been or will be taken in regard to the breach.
Right to pay out of pocket for Cancer Center services. You or your representative has the right to pay out of pocket for your Cancer Center services and require that the Cancer Center not submit a claim to insurance for the services.
Right to a paper copy of this notice. You or your representative has a right to a separate paper copy of this Notice at any time even if you or your representative has received this Notice previously. To obtain a separate paper copy, please contact: Quality and Compliance Manager at (712 233-4144). The patient or a patient’s representative may also obtain a copy of the current version of the Cancer Center’s Notice of Privacy Practices at its website, http://www.nylencancercenter.com.
DUTIES OF CANCER CENTER
June E. Nylen Cancer Center is required by law to maintain the privacy of your health information and to provide to you and your representative this Notice of its duties and privacy practices. The Cancer Center is required to abide by the terms of this Notice as may be amended from time to time. The Cancer Center reserves the right to change the terms of its Notice and to make the new Notice provisions effective for all health information that it maintains. If the Cancer Center changes its Notice, the Cancer Center will provide a copy of the revised Notice to you or your appointed representative. You or your personal representative has the right to express concerns to the Cancer Center and to the Secretary of Department of Health and Human Services (DHHS) if you or your representative believes that your privacy rights have been violated. Any concerns to the Cancer Center should be made in writing to: Quality and Compliance Manager, 4300 Hamilton Blvd., Sioux City, IA. 51104. The Cancer Center encourages you to express any concerns you may have regarding the privacy of your information. You will not be retaliated against in any way for filing a concern.
June E. Nylen Cancer Center has designated the Quality and Compliance Manager as its contact person for all issues regarding patient privacy and your rights under the Federal privacy standards. You may contact this person at 4300 Hamilton Blvd., Sioux City, IA. 51104. Phone: (712) 233-4144.
This Notice is effective September 23, 2013.
IF YOU HAVE ANY QUESTIONS REGARDING THIS NOTICE, PLEASE CONTACT:
Quality and Compliance Manager
4300 Hamilton Blvd.
Sioux City, IA 51104
Phone: (712) 233-4144