• New questions when you call

• New release form

The DC 37 Health and Security Plan is implementing new federal privacy protections (PDF format)* effective April 14.

The plan is adopting the guidelines to conform to the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The act requires health insurance plans and union welfare programs to restrict the disclosure of subscribers’ medical histories.

Changes in procedures
Eligible members and retirees should expect changes when processing claims or inquiring about benefits. For instance:

• The plan’s Inquiry Unit at (212) 815-1234 must ask callers to provide more comprehensive information to verify their identify before discussing personal information.
  
  
• Members will be asked to sign a release form when they ask union reps and local leaders to help with health-related inquiries and claims. You may obtain the release form by calling the Inquiry Unit or your union rep.
  
  
• Because the plan is updating its data base and claim procedures, it strongly encourages members to make sure their address and phone on file with the plan and the union are current.

Your right to information
Generally, HIPAA guarantees subscribers the right to look at and copy their protected health information on file at the DC 37 Health and Security Plan. The act also allows subscribers to restrict the release of their personal information.

• Subscribers may restrict disclosure to people who provide health care and payment for services.
  
  
• Subscribers may request confidential communications regarding their protected health information and the plan’s disclosure of information for routine non-claim processing as far back as six years before HIPAA’s effective date, April 14, 2003.

Release of information
HIPAA requires health insurance plans and union welfare programs that provide services — like the DC 37 plan’s vision, dental and prescription drug benefits — to restrict the disclosure of subscribers’ medical histories.

• Under HIPAA, plans generally may disclose personal medical information only when it is needed for treatment, payment and other health-care operations, such as medical reviews, audits and patient grievances. Any other disclosure requires the permission of the affected individual.
  
  
• Health-care providers that receive information about the treatment of individuals from the DC 37 Health and Security Plan must also meet HIPAA’s privacy standards. The law restricts plans from disclosing health-related information on individuals’ physical and mental conditions, record of health care and payment for services.
  
  
• In certain circumstances, the plan may be required to disclose protected medical information by federal, state or local law. It may, for instance, be required to make unauthorized disclosures for law enforcement, organ and tissue donation, public health activities, such as reporting births and controlling diseases, reporting abuse, neglect or domestic violence, judicial and administrative proceedings, national security and intelligence activities and Workers’ Compensation.

Complaints
Members and retirees who feel their privacy is violated may file a complaint. Complaints may be made by:

• calling the HIPAA privacy officer at (212) 815-1234
  
  
• writing: HIPAA Privacy Officer, DC 37, 125 Barclay St., Room 525, New York, NY 10007 or
  
  
• e-mailing to HIPAA-Privacy@DC37.net
  

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