HMSA’s Notice Of Privacy Practices
Privacy of Your Confidential Member Information
This notice describes how information about HMSA members may be used and disclosed and how
you can get access to this information. Please review it carefully.
If you suspect improper use or access to HMSA information, please notify HMSA
immediately. Contact HMSA’s Compliance and Incident Hotline at 1 (800) 749-HMSA (4672)
or via email at incidents@hmsa.com.
As your health plan, we care about the privacy of your confidential member information.
Federal law also requires all health plans to maintain this privacy. This notice
describes our privacy practices, our legal duties, and your rights regarding confidential
member information. This notice took effect on April 14, 2003, and will stay in
effect until it is updated or changed. We will not make any changes to our privacy
practices without letting you know in advance. It may be necessary to revise or
update them over time, but we will let you know before the changes go into effect.
Your Confidential Member Information
Each member generates confidential information. For example, when you visit a doctor,
a record of your visit is made. This record may have details about your symptoms,
injury or illness, exam, treatment, test results, and more. Claims sent to HMSA
may have some of these details. Information about you and the services that you
received is called your confidential member information.
In today’s health care system, this information is used in a number of ways.
For example, it may be used to plan or coordinate your care. As such, it may be
shared among your health care providers. Or it may be used to process claims, pay
for your health care services, or review services.
Your Rights
The law gives you certain rights that pertain to your confidential member information.
As an HMSA member, you have the right to:
- Request and receive a copy of this privacy notice at any time.
- View or request a copy of your confidential member information. (A copying fee will
be applied.)
- Ask for added limits on permitted uses of your confidential member information.
There may be reasons we cannot agree to this request. If we agree to your request,
we will keep our agreement except to make records available to a provider when necessary
for your treatment in a medical emergency or disaster.
- Request and receive a list of third parties we disclose your information to for
certain, permitted reasons described in this notice.
- Ask that your confidential member information be sent by reasonable means other
than mail or be sent to a different address to avoid putting your life in danger.
- Request to change or add to your confidential member information. We may deny your
request if we did not create the information or for certain other reasons. If we
deny your request, we will explain why in writing. If you do not agree with our
denial, you may send us a written statement of disagreement that will be added to
your record.
Our Duties
The law clearly spells out the duties of health plans. HMSA must:
- Protect the privacy of your confidential member information.
- Give you a notice of our privacy practices.
- Follow the terms of this privacy notice.
- Fulfill your request to send information by other means or to another address to
avoid putting your life in danger. Your request must be reasonable and must state
the other address or the means you wish us to use. The alternate address or means
must allow us to pay claims and collect dues under your health plan.
- Use and share only the information needed to do our jobs.
- Make sure our business partners agree to protect your information the same way that
we do.
We will not use or share your confidential member information except as required
by law or described in this notice. Also, we will not ask you to waive your privacy
rights to enroll in an HMSA plan or to receive services.
How Confidential Member Information is Used
In today’s health care system, there are three key areas where we need to
use your confidential member information. We may use it for treatment, payment, and
other health care operations. We may also contract with other parties to do the
work for us, as long as they promise to protect your information the same way we
do. Each area is described below.
Treatment: This includes services needed to provide, coordinate,
or manage your health care. As your health plan, we may need to share confidential
member information with your doctor or other health care providers for treatment
reasons.
Payment: We need to pay claims from doctors, hospitals, and other
providers for the care you receive. This key area includes our efforts to collect
dues, see if you are eligible for care, determine the level of coverage, work with
other plans to determine benefits, and pay claims.
Health Care Operations: We want all HMSA members to receive quality
health care services. This may include our quality review and improvement activities,
case management, care coordination, reviewing provider credentials, setting dues,
resolving complaints and appeals, managing our business, and other operations. We
may also use your information to send you communications to describe a health-related
product or service. This may include information on our participating providers,
new health-related products or services available only to HMSA members, or to recommend
other treatments, health care providers, or settings of care that may be of interest
to you.
Other Uses of the Information
There may be a time when the use of your confidential member information is needed
because it benefits you, serves the public interest, or is required by law. In these
cases, we will use and share only the confidential member information needed or
as required by law. Please read all of these other uses carefully.
For Underwriting: We may receive your confidential member information
to create, renew, or replace a contract of health insurance or health benefits. We
will not use or further disclose this information for any other reasons except as
required by law. If the contract of health insurance or health benefits is placed
with us, then we will use and share your confidential member information only as
described in this notice.
With Your Written Permission: You may give us written permission
to use your information or share it with someone you name for any purpose. You may
withdraw your permission in writing at any time. We will honor your request unless
the timing is such that the information has already been shared.
During an Emergency or Disaster: During a medical emergency or
disaster, if it is believed that disclosure of the information would be in your
best interest, then we may disclose it. This would be done to make sure you have
access to the services you need or to process payment for those services.
To Plan Sponsors: We may disclose your confidential member information
– and the information of others enrolled in your group health plan – to your plan
sponsor or its authorized representative. Employers are often plan sponsors, and
this disclosure helps them administer your group health plan. Plan sponsors may
use your confidential member information only as permitted or required by law.
To Report to Authorities: We may need to share confidential member
information if we suspect abuse, neglect or domestic violence. As required by law,
we may need to make such a report to the authorities.
For Research Purposes: We may use or share information with researchers
when their work has been approved by an institutional review board that has gone
over the research project and set rules to make sure that your confidential member
information is kept private.
To Comply with the Privacy Law: We may use or share information
as required by the privacy law. For example, to see if we are complying with the
law, the U.S. Department of Health and Human Services may review our practices and
ask us for some confidential member information.
For Workers’ Compensation: We may disclose information to
comply with laws on workers’ compensation or other similar programs.
For Public Health: We may share your confidential member information
with public health or legal authorities who work to prevent or control disease,
injury, or disability in the community. For example, we may share information about
problems related to food, drugs, supplements, and product defects with the U.S. Food
and Drug Administration (FDA).
For Health Oversight: We may share information with authorities
for activities to prevent fraud and abuse, audits, investigations, inspections,
licenses, and other government activities to monitor health care.
For Judicial and Administrative Proceedings: We may share your
information in response to a court or administrative order, subpoena, or other lawful
process, under certain circumstances.
For Law Enforcement Purposes: Under limited circumstances, such
as a court order, warrant, or grand jury subpoena, we may disclose your information
to law enforcement officials.
For Military or National Security Purposes: Under certain conditions,
we may share the confidential member information of armed forces staff with military
authorities. We may also share your information with federal officials for intelligence,
counterintelligence, and other national security activities.
For More Information or to Report a Problem
If you have questions or would like more information on HMSA’s privacy practices,
you may contact us using the information at the end of this notice.
If you believe your privacy rights have been violated, you may file a complaint
with us using the contact information at the end of this notice. You may also send
a written complaint to the U.S. Department of Health and Human Services. If you
choose to file a complaint, you have our assurance we will not retaliate in any
way.
Thank you for taking the time to review HMSA’s Notice of Privacy Pratices. As your health
plan, we work hard to protect your confidential member information. We know the
privacy of this information is important to you, and we take our duties very seriously.
Send HMSA correspondence to:
HMSA Privacy Office
Attention: Privacy Official, Room 800
P.O. Box 860
Honolulu, HI 96808-0860
Honolulu, Oahu
- Group/Individual Plans (808) 948-6111
- Federal/State/County Plans 808) 948-6499
- HMO Plans (808) 948-6372
- Blue Cross Blue Shield
- Federal Employee Program (808) 948-6281
- QUEST (808) 948-6486
- Senior Plan/65C Plus (808) 948-6000
- Text Telephone (TTY) (808) 948-6222
Hilo, Hawaii (808) 935-5441
Kona, Hawaii (808) 329-5291
Lihue, Kauai (808) 245-3393
Kahului, Maui (808) 871-6295
Send U.S. Department of Health and Human Services correspondence to:
U.S. Department of Health and Human Services
200 Independence Ave., S.W.
Washington, D.C. 20201
(202) 619-0257
Toll free: 1 (877) 696-6775
