Right to amend your PHI: You have the right to request an amendment of your PHI
in a designated record set if you believe the information the Health Plans have about you is incorrect or incomplete. You have this right as long as your PHI is maintained by the Health Plans in a designated record set.
The Health Plans may deny your request to amend if the PHI or the record that is
the subject of the request (1) was not created by the Health Plans, unless the person or entity that originally created the PHI is no longer available to make the amendment,
(2) is not a part of the designated record set, (3) would not be available to
you under your right to inspect and copy discussed above, or (4) is accurate and complete.
If the Health Plans deny any portion of your request to amend, the Health Plans
will give you a written denial decision discussing the basis for the denial and
give you the opportunity to submit a written statement of disagreement with the
Health Plans' decision. Any such written statement of disagreement that you
submit must contain an explanation of the basis for your disagreement. The
Health Plans have the right to prepare a rebuttal statement to your statement of
disagreement. Any such rebuttal will be provided to you and added along with the
denial decision and your statement of disagreement, to the information or record
which is the subject of the request.
You may request amendments of your PHI by completing the appropriate form available from the LAPRA Benefits Department.
Right to receive an accounting of disclosures of PHI: You have the right to request a list of certain disclosures of your PHI by the Health Plans.
Unless otherwise required by applicable law, the accounting will not include disclosures (1) to carry out treatment, payment and health care operations, (2) to you, (3) incident to a use or disclosure permitted or required by law, (4) pursuant to an authorization provided by you, (5) for
certain directories or to people involved in your care or other notification purposes as permitted by law, (6) for national security or intelligence purposes, (7) to correctional institutions or law enforcement officials, (8) that are part of a limited data set,
or (9) that occurred prior to April 14, 2003, or more than six years before your request. Your first request for an accounting within a 12-month period will be free. We may charge you for costs associated with providing you additional accountings. We will notify you in advance of any costs, and you may choose to withdraw or modify your request before you incur any expenses.
You may make a request for an accounting by submitting the appropriate request form available from the LAPRA Benefits Department.
Right to Receive Notice: The Health Plans must notify you
following the acquisition, access, use or disclosure of your unsecured PHI in a manner that is impermissible under the HIPAA privacy rules,
unless there is a low probability that such PHI was compromised (or notification
is not otherwise required under HIPAA).
Right to file a complaint: If you believe your
privacy rights under this Notice have been violated, you should let us know immediately.
You may file a formal complaint with our Privacy Officer and/or with the United States Department of Health and Human Services at the addresses below. You should attach any evidence or documents that support your belief that your privacy rights have been violated. We take your complaints very seriously. LAPRA prohibits retaliation against any person for filing such a complaint.
Complaints should be sent to:
Privacy Officer
Los Angeles Police Relief Association, Inc.
600 N. Grand Avenue
Los Angeles, California 90012
Phone: (213) 674-3701
(888) 252-7721
Fax: (213) 674- 3715
Region IX, Office for Civil Rights
U.S. Department of Health and Human Services
90 7th Street, Suite 4-100
San Francisco, CA 94103
Phone: (800) 368-1019
FAX: (415) 437-8329
TDD: (800) 537-7697
www.hhs.gov/ocr/privacy/hipaa/complaints/index.html
Changes to this Notice: We reserve the right to change the Health Plans’ privacy practices as described in this Notice. Any change may affect the use and disclosure of your PHI already maintained by the LAPRA Health Plans, as well as any of your PHI that the Health Plans may receive or create in the future. If there is a material change to the terms of this Notice,
we will inform you of such change as provided by HIPAA and provide you with
information about how to get a copy of the revised Notice. To the extent the
Health Plans maintain a website, the Health Plans will post a copy of the
current Notice on such website.
How to obtain a copy of this Notice: You can obtain a copy of the current Notice by contacting the Privacy Officer at the address
at the top of this Notice.
No change to Health Plans benefits: This Notice explains your
privacy rights as a current or former participant in LAPRA Health Plans. The
Health Plans are bound by the terms of this Notice as they relate to the privacy
of your protected health information. However, this Notice does not change any
other rights or obligations you may have under the Health Plans. You should
refer to the Health Plans documents for additional information regarding your
Health Plans benefits.