NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED
AND HOW YOU MAY ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Effective: February 17, 2015.
The Utah Department of Health, Division of Medicaid and Health Financing (DMHF) is committed to
protecting your medical information. DMHF is required by law to maintain the privacy of your medical
information, provide this notice to you, and abide by the terms of this notice.
HOW WE USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION
DMHF may use your health information for conducting our business. Examples:
Treatment – We may use your health information to appropriately determine approvals or denials of your
medical treatment. For example, if you are a Medicaid, Children’s Health Insurance Program (CHIP), or a
Utah’s Premium Partnership for Health Insurance (UPP) recipient we may review the treatment plan provided
by your health care provider to determine if it is medically necessary.
Payment – We may use your health information to determine your eligibility in the Medicaid, CHIP, or UPP
program and make payment to your health care provider. For example, we may review claims for payment
by DMHF for medical services you received from your provider.
Health Care Operations – We may use your health information to evaluate the performance of a health
plan or a health care provider. For example, DMHF contracts with consultants who review the records of
hospitals and other organizations to determine the quality of care you received.
Informational Purposes – We may use your health information to give you helpful information such as
health plan choices, program benet updates, and free medical exams.
YOUR INDIVIDUAL RIGHTS
You have the right to:
• Request in writing restrictions on how we use and share your health information. We will consider all
requests for restrictions carefully but are not required to agree to any restriction.
• Request that we use a specic telephone number or address to communicate with you.
• Inspect and get a copy of your health information (including an electronic copy if we maintain the
record electronically). Fees may apply. Under limited circumstances, we may deny you access to a
portion of your health information and you may request a review of the denial.*
• Request in writing corrections or additions to your health information.*
• Change your participation in the cHIE. Contact cHIE by phone (801-466-7705), fax
• Request an accounting of certain disclosures of your health information made by us. The accounting
does not include disclosures made for treatment, payment, and health care operations and some
disclosures required by law. Your request must state the period of time desired for the accounting,
which must be within the six years prior to your request. The rst accounting is free but a fee will
apply if more than one request is made in a 12-month period.*
• Request a paper copy of this notice even if you agree to receive it electronically.
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