Policy/Memo 120

Number: Policy Memo 120
Date Issued: April 14, 2003
Policy File Ref: A1830
Subject: Individual Rights

ISSUE:

Confidential Communications of PHI

PURPOSE:

To issue instructions to EBD workforce members regarding an individual's right to submit requests for communications of their protected health information (PHI) by alternative method or at alternative locations. Health plans may comply with such a request if the request meets the health plan's reasonable prerequisites for such requests. Health plans are required to comply with the individual's request if the individual states that disclosure of all or part of the PHI could endanger the individual.

Policy:

Address Changes
For individuals who want to change the address on record with EBD and receive all future communications to that address, EBD will adhere to the policy that address changes will be made upon receipt of a signed, written request from the enrollee or the enrollee's legal representative.

Other Requests

• Maintain current address on record, but receive communications of all PHI by alternative methods (i.e. via telephone, e-mail) or at an alternative location

EBD shall comply with a reasonable request from an individual for communication of PHI by alternative methods or at an alternative location if the individual clearly states, in writing, that that disclosure of all or part of the PHI could endanger the individual.

Procedure:

Address Changes
In accordance with EBD Policy Memo #58r1, changes to the enrollment file, including address changes, will be made only upon receipt of a signed, written request of the enrollee or the enrollee's legal representative.

Other Requests
Staff should instruct individuals to submit a request in writing if they wish to receive communications of PHI by alternative methods or at an alternative location.

The letter must include the following information:

• Individual's name, current address, telephone number, and plan identification number (usually the individual's social security number);
• A clear explanation of how or where individual would like to receive information from the plan;
• What PHI the individual would like to receive at an alternative location or by alternative methods;
• Statement that disclosure of all or part of the information to which the request pertains could endanger the individual if delivered by standard methods or to standard location; and
• Statement as to whether the requesting individual is acting as the personal representative of other persons on whose behalf the request may be made, such as a mother making the request on behalf of herself and her custodial children. Such statement must specify the names of the individual(s) on whose behalf the requesting individual is acting.

All requests should be forwarded to the EBD Privacy Official for review.

Requests will be reviewed by the EBD Privacy Official to determine:

• reasonableness, including the reasonableness of how payment, if any, will be made and how the requested alternative method of contact is to be accomplished,
• the inclusion of an appropriate statement indicating the potential danger to the individual, and
• the alternative methods of communication.

The EBD Privacy Official will respond in writing to the individual notifying them of the decision to comply with or deny the request.

If the decision is to comply, the EBD Privacy Official will notify the appropriate staff by copy of the written response to the individual, of the manner in which the individual should receive communications of the PHI.

All requests and documentation regarding confidential communications shall be maintained for a period of six (6) years from their date of last effect.