HCA notice of privacy practices

This notice describes how the Washington State Health Care Authority (HCA, we, or us) uses or discloses medical information about you and how you can get access to this information. Please review it carefully.

On this page

HCA is required by law to maintain the privacy of your information and to provide this notice to all Health Care Authority clients. It does not affect your eligibility for services or coverage. [Available in 15 languages]

Why am I getting this notice?

HCA is committed to protecting your health information. The law requires us to provide this notice to all members so you know how we may use or disclose your information. This notice does not affect your eligibility for services or coverage. If you have any questions about this notice, please email the HCA Privacy Office, call 1-844-284-2149 or write to HCA Privacy Officer, Health Care Authority, P.O. Box 42704, Olympia, WA 98504-2704.

Summary

Your rights Your choices Our uses and disclosures

You have the right to:

  • Get a copy of your health and claims records.
  • Correct your health and claims records.
  • Request confidential communication.
  • Ask us to limit the information we share.
  • Get a list (with some exceptions)of those with whom we’ve shared your information.
  • Get a copy of this privacy notice.
  • Choose someone to act for you.
  • File a complaint if you believe your privacy rights have been violated.

You can tell us your choices about certain health information we use or share.

For example, how we:

  • Answer coverage questions from your family and friends.
  • Provide disaster relief.

We do not market our services or sell your information.

We may use and share your information for these reasons:

  • Help manage the health care treatment you receive.
  • Run our organization.
  • Pay for your health services. Administer your health plan.
  • Help with public health and safety issues.
  • Do research.
  • Comply with the law.
  • Respond to organ and tissue donation requests and work with a medical examiner or funeral director.
  • Address workers’ compensation, law enforcement, and other government requests.
  • Respond to lawsuits and legal actions.
  • Identify quality improvement opportunities.

Details

Your rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you. If you would like to exercise your rights or have other questions regarding your health information that HCA holds, please email the HCA Privacy Office, call 1-844-284-2149 or write to HCA Privacy Officer, Health Care Authority, P.O. Box 42704, Olympia, WA 98504-2704.

Get a copy of your health and claims records

You may review the personal information HCA has about you by asking, in writing, for access to it or a copy of it. We may charge a fee for copies. In many situations, we will provide the copies in electronic format upon request.

Except for the exclusions listed below, here are the records you may review and copy:

  • Enrollment, payment, claims adjudication, and case or medical management records maintained by or for HCA.
  • Other records HCA uses to make decisions about you.

The information you may review and copy does not include:

  • Psychotherapy notes.
  • Information compiled in reasonable anticipation of, or for use in, a civil, criminal, or administrative action or proceeding.
  • Information that HCA cannot legally disclose to you.
  • Information received from someone other than a health care provider under a promise of confidentiality if the access requested would be reasonably likely to reveal the source of the information.
  • Information that a licensed health care professional or HCA determines should not be disclosed to you because it might harm you or someone else.

Ask us to correct health and claims records

  • You may ask us to amend your personal information if you believe it is incorrect or incomplete. You must make the request in writing, identify which information you want changed, and explain why it should be changed.
  • HCA is not necessarily required to make the changes you request. For example, HCA is not required to change information that it did not create or information that is correct. If HCA does not make the change you request, it will tell you why. If HCA does make the changes, it will make a reasonable effort to inform others to whom it gave the information or others you tell HCA received the information.

Request confidential communications

  • You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
  • We will consider all reasonable requests, and must say “yes” if you tell us you would be in danger if we do not.

Request restrictions (limited disclosures)

  • You can ask us not to use or share certain health information for treatment, payment, or our operations.
  • We are not required to agree to your request, and we may say “no” if it would affect your care.

Get a list of those with whom we’ve shared information

You may ask for a list of entities to whom HCA has disclosed your information. The list will not include all disclosures. For example, the list will not include:

  • Disclosures for treatment, payment, and health care operations.
  • Disclosures to you or with your authorization.
  • Disclosures made more than six years before your request.

HCA will respond to you within 60 days of your request. If you ask for more than one accounting in any 12-month period, HCA may charge you a reasonable fee.

Get a copy of this privacy notice

  • You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

Choose someone to act for you

  • If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
  • We will make sure the person has this authority and can act for you before we take any action.

File a complaint if you feel your rights are violated

If you believe your privacy rights have been violated or you have questions:

Your choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

  • Share information with your family, close friends, or others involved in payment for your care.
  • Share information in a disaster relief situation.

Example: If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

Our uses and disclosures

How do we typically use or share your health information? We typically use or share your health information in the following ways.

Help manage the health care treatment you receive

  • This includes care provided to you and the coordination or management of your care. For example, HCA might disclose information to alert your health care provider to possible problems in your care.

Run our organization

  • We can use and disclose your information to run our organization and contact you when necessary.
  • We are not allowed to use genetic information to decide whether we will give you coverage and the price of that coverage. This does not apply to long term care plans.

Example: We use health information about you to develop better services for you.

Pay for your health services

  • We can use and disclose your health information as we pay for your covered health services.

Example: We might share information about you with your doctor to coordinate payment for your surgery.

  • If you ask for an administrative hearing to review a denial, we usually have to disclose information in the hearing process.

How else can we use or share your health information?

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes.

For more information, visit the Department of Health and Human Services HIPAA webpage.

Help with public health and safety issues

We can share health information about you for certain situations such as:

  • Preventing disease.
  • Helping with product recalls.
  • Reporting adverse reactions to medications.
  • Reporting suspected abuse, neglect, or domestic violence.
  • Preventing or reducing a serious threat to anyone’s health or safety.

Do research

  • We can use or share your information for health research.

Comply with the law

  • We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.

Respond to organ and tissue donation requests and work with a medical examiner or funeral director

  • We can share health information about you with organ procurement organizations.
  • We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

Address workers’ compensation, law enforcement, and other government requests

We can use or share health information about you:

  • For workers’ compensation claims.
  • For law enforcement purposes or with a law enforcement official.
  • With health oversight agencies for activities authorized by law.
  • For special government functions such as military, national security, and presidential protective services.

Respond to lawsuits and legal actions

  • We can share health information about you in response to a court or administrative order, or in response to a subpoena.

Are there specially protected types of information?

Yes, some types of information have greater protection under Washington State or federal laws. The above disclosure practices do not necessarily apply to specially protected types of information, which include:

  • Confidential HIV-related information protected by Washington State laws.
  • Alcohol and substance use disorder treatment information protected under both Washington State and federal laws.
  • Mental health treatment information protected under both Washington State and federal laws.

Our responsibilities

  • We are required by law to maintain the privacy and security of your protected health information.
  • We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
  • We must follow the duties and privacy practices described in this notice and give you a copy of it if you ask.
  • We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

For more information, visit the Department of Health and Human Services Notice of Privacy Practices webpage.

Changes to the terms of this notice

We can change the terms of this notice, and the changes will apply to all information we have about you. We will give you the new notice, or tell you about it and how to get a copy. The revised notice will be available on our website, and we will email or mail a copy to you on request.