You can ask for a list of disclosures of your health information over the past six years; one list a year is free
You can ask for a list (an "accounting") of the times Blue Shield has shared your health information in the six years before the date you ask. Blue Shield says it will tell you what it shared, the date, who it shared it with, and why. The list will include all disclosures except those about treatment, payment and health care operations and certain other disclosures, such as any you asked it to make. It provides one accounting a year for free and will charge a reasonable, cost-based fee if you ask for another one within 12 months.
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Get a list of those with whom we’ve shared information
You can ask for a list (“accounting”) of the times we’ve shared your health information for six years prior to the date you ask, and we will tell you what we shared, the date we shared it, who we shared it with, and why.
We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
Qualifications & exceptions
The list excludes disclosures for treatment, payment, and health care operations, and certain other disclosures such as any you asked Blue Shield to make.
One accounting a year is free; a reasonable, cost-based fee applies to another request within 12 months.
Not stated here
"Certain other disclosures" beyond the example given are not listed.
Sharing & Disclosure · User right or choice
You can tell Blue Shield not to share with family or others involved in your care or payment, or for fundraising
For certain health information you can tell Blue Shield your choices about what it shares and whether it shares it. If you have a clear preference in the situations described, Blue Shield says you should tell it what you want and it will follow your instructions. The notice says you have both the right and choice to tell it not to share your information with your family, close friends or others involved in your care or payment for your care, and in connection with fundraising efforts. A further item in the same list reads "As otherwise set forth in this Notice". If you cannot tell Blue Shield your preference, for example if you are unconscious, it may go ahead and share if it believes that is in your best interest.
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For certain health information, you can tell us your choices about what we share and whether we share it. If you have a clear preference for how we share your information in the situations described below, tell us what you want us to do, and we will follow your instructions.
For these purposes, you have both the right and choice to tell us not to share your information:
With your family, close friends, or others involved in your care or payment for your care
In connection with fundraising efforts
As otherwise set forth in this Notice
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.
Qualifications & exceptions
Applies to "certain health information" and the situations described in the list.
Exception: if you are not able to tell Blue Shield your preference, for example if you are unconscious, it may go ahead and share if it believes it is in your best interest.
Not stated here
The item "As otherwise set forth in this Notice" does not say which other sharing you can tell Blue Shield not to do.
Sharing & Disclosure · User right or choice
You can tell Blue Shield not to share with a Health Information Exchange such as Manifest Medex
Among the choices listed, you can tell Blue Shield not to share your information with a Health Information Exchange (HIE), such as Manifest Medex. The notice says HIEs help your health care providers and health plans securely review, analyze and share medical information about you, with the goals of improving the quality of your care, reducing medical errors and preventing unnecessary and duplicative treatment. It adds that you may also opt out of this sharing through the Manifest Medex opt-out page or by calling (800) 490-7617.
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For these purposes, you have both the right and choice to tell us not to share your information:
With a Health Information Exchange (“HIE”), such as Manifest Medex. HIEs help your health care providers and health plans securely review, analyze, and share medical information about you with the goals of improving the quality of your care, reducing medical errors, and preventing unnecessary and duplicative treatment. You may also opt out of this sharing of information by going to manifestmedex.org/opt-out/ or by calling (800) 490-7617.
Qualifications & exceptions
The listed opt-out routes are the Manifest Medex web page and phone number.
Not stated here
Manifest Medex is given as an example ("such as"); other exchanges, if any, and how to opt out of them are not listed.
Sharing & Disclosure · Permission or license
Blue Shield may share information when needed to lessen a serious and imminent threat to health or safety
Blue Shield says it may also share your information when needed to lessen a serious and imminent threat to health or safety. This appears alongside the statement that, if you cannot tell it your preference, it may share information it believes is in your best interest, but the threat sentence does not itself say it applies only when you cannot state a preference.
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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.
Qualifications & exceptions
Applies when sharing is "needed" to lessen a "serious and imminent" threat.
Not stated here
The notice does not say to whom information may be shared in this situation.
For marketing and for sale of your information, Blue Shield says it never shares without your written permission
In a list of cases where the notice says Blue Shield never shares your information unless you give written permission, two items are named: marketing purposes and sale of your information.
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For these cases, we never share your information unless you give us written permission:
Marketing purposes
Sale of your information
Qualifications & exceptions
The rule is stated as "never ... unless you give us written permission".
Not stated here
A later sentence about authorization ends with "except as expressly allowed by law"; whether that exception reaches marketing and sale is not stated.
Sharing & Disclosure · Permission or license
Blue Shield may use your health information and share it with professionals treating you
Blue Shield says it can use your health information and share it with professionals who are treating you. It gives the example of a doctor sending Blue Shield information about your diagnosis and treatment plan so it can arrange additional services.
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Help manage the health care treatment you receive
We can use your health information and share it with professionals who are treating you.
Example: A doctor sends us information about your diagnosis and treatment plan so we can arrange additional services.
Sharing & Disclosure · Permission or license
Blue Shield may use and disclose your health information to pay for your health services
Blue Shield says it can use and disclose your health information as it pays for your health services. The example given is sharing information about you with your dental plan to coordinate payment for your dental work.
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Pay for your health services
We can use and disclose your health information as we pay for your health services.
Example: We share information about you with your dental plan to coordinate payment for your dental work.
Sharing & Disclosure · Permission or license
Blue Shield may disclose your health information to your health plan sponsor for plan administration
Blue Shield says it may disclose your health information to your health plan sponsor for plan administration. The example given is an employer that contracts with Blue Shield for a health plan receiving certain statistics that explain the premiums charged.
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Administer your plan
We may disclose your health information to your health plan sponsor for plan administration.
Example: Your company contracts with us to provide a health plan, and we provide your company with certain statistics to explain the premiums we charge.
Not stated here
The notice does not say which information the plan sponsor may receive beyond the example of certain statistics.
Sharing & Disclosure · Permission or license
Blue Shield says it is allowed and required to share information in other ways that serve the public good
Blue Shield says it is allowed and required to share your information in other ways, usually ways that contribute to the public good such as public health and research, without your written authorization. It says it must meet many conditions in the law before it can share your information for these purposes and points to a federal web page for more information.
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How else can we use or share your health information? We are allowed and required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research, without your written authorization. We must meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
Qualifications & exceptions
Blue Shield must meet many conditions in the law before sharing for these purposes.
"Usually" describes the purposes; the examples given are public health and research.
Not stated here
The conditions in the law are not listed; the linked federal page is not supplied.
Sharing & Disclosure · Permission or license
Blue Shield may share health information for public health and safety situations
Blue Shield says it may 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, assisting with disaster relief efforts, and preventing or reducing a serious threat to anyone’s health or safety.
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Help with public health and safety issues
We may 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
Assisting with disaster relief efforts
Preventing or reducing a serious threat to anyone’s health or safety
Qualifications & exceptions
The list is introduced by "such as" and is illustrative.
Sits within the public-good sharing for which many legal conditions must be met.
Not stated here
Who may receive the information in each situation is not stated.
Sharing & Disclosure · Permission or license
Blue Shield may share information with organ procurement groups and, as law allows, coroners and funeral directors
Blue Shield says it may share health information about you with organ procurement organizations. It may also share health information with a coroner, medical examiner or funeral director when an individual dies, but only according to, and as allowed by, law.
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Respond to organ and tissue donation requests and work with a medical examiner or funeral director
We may share health information about you with organ procurement organizations.
We may share health information with a coroner, medical examiner, or funeral director when an individual dies, but only according to, and as allowed by, law.
Qualifications & exceptions
The limit "only according to, and as allowed by, law" is stated for sharing with a coroner, medical examiner or funeral director.
Not stated here
The organ procurement item states no "as allowed by law" limit of its own.
Sharing & Disclosure · Permission or license
Blue Shield may share information for workers’ compensation, law enforcement and health oversight, as the law allows
Under a heading about workers’ compensation, law enforcement and other government requests, Blue Shield says it may use or share health information about you for workers’ compensation claims, for law enforcement purposes or with a law enforcement official, and with health oversight agencies for activities authorized by law. For law enforcement and health oversight it says this is only according to, and as allowed by, law. A further item in the same list, about special government functions, is carded with the next part of the notice.
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Address workers’ compensation, law enforcement, and other government requests
We may use or share health information about you:
For workers’ compensation claims
For law enforcement purposes or with a law enforcement official, but only according to, and as allowed by, law
With health oversight agencies for activities authorized by law, but only according to, and as allowed by, law
Qualifications & exceptions
The law enforcement and health oversight items are limited to disclosures "only according to, and as allowed by, law".
The workers’ compensation item states no such limit in its own words.
Not stated here
The notice does not describe what counts as a law enforcement request or which agencies are health oversight agencies.
Sharing & Disclosure · Permission or license
Blue Shield may share information for special government functions like national security, as the law allows
Continuing the list of disclosures for workers’ compensation, law enforcement and other government requests, Blue Shield says it may use or share health information about you for special government functions such as military, national security and presidential protective services, but only according to, and as allowed by, law. The notice says it must meet many conditions in the law before sharing information for these public-good purposes.
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For special government functions such as military, national security, and presidential protective services, but only according to, and as allowed by, law
We must meet many conditions in the law before we can share your information for these purposes.
Qualifications & exceptions
Only according to, and as allowed by, law.
Blue Shield must meet many conditions in the law before sharing for these purposes.
Not stated here
The conditions in the law are not listed.
Sharing & Disclosure · Permission or license
Blue Shield may share information if state or federal law requires it, including with the federal health department
Blue Shield says it may share information about you if state or federal laws require it, including with the Department of Health and Human Services if that agency wants to see that Blue Shield is complying with federal privacy law. The notice says it must meet many conditions in the law before sharing information for these public-good purposes.
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Comply with the law
We may 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.
We must meet many conditions in the law before we can share your information for these purposes.
Qualifications & exceptions
Blue Shield must meet many conditions in the law before sharing for these purposes.
Not stated here
The notice does not list which laws require disclosure.
Sharing & Disclosure · Permission or license
Blue Shield may share information in response to a court or administrative order or a subpoena, as the law allows
Blue Shield says it may share health information about you in response to a court or administrative order, or in response to a subpoena, but only according to, and as allowed by, law. The notice says it must meet many conditions in the law before sharing information for these public-good purposes. Separate passages on reproductive health care and substance use disorder records set separate limits for those kinds of information.
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Respond to lawsuits and legal actions
We may share health information about you in response to a court or administrative order, or in response to a subpoena, but only according to, and as allowed by, law.
We must meet many conditions in the law before we can share your information for these purposes.
Qualifications & exceptions
Only according to, and as allowed by, law.
Reproductive health care and substance use disorder records are covered by separate rules later in the notice.
Not stated here
The notice does not say whether you are told when information is shared in response to a subpoena or order.
Sharing & Disclosure · Restriction or exception
Lawful abortion-related information will not go to other-state or federal inquiries without your authorization
Blue Shield says any of your health information relating to lawful abortion-related services will not be released in response to a subpoena, request or court order, nor in cooperation with an inquiry or investigation by an individual or government entity in another state or a federal law enforcement agency, without your written authorization, except as expressly permitted or required by law.
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Any of your health information relating to lawful abortion-related services will not be released in response to a subpoena, request, or court order, nor in cooperation with an inquiry or investigation by an individual or government entity in another state or a federal law enforcement agency, without your written authorization, except as expressly permitted or required by law.
Qualifications & exceptions
The exception is "as expressly permitted or required by law".
Not stated here
The notice does not say how this relates to the lawful attestation exception described in the example; the example lists disclosures for health oversight, judicial or administrative proceedings, law enforcement and coroner or medical examinations.
Abortion-related information will not be made available through electronic records or an HIE to people in another state
Blue Shield says any of your health information relating to you seeking, obtaining, providing, supporting or aiding in the performance of a lawful abortion will not be disclosed, shared or made available in an electronic health records system or through a Health Information Exchange to any individual in another state, without your written authorization, except as expressly permitted or required by law.
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Any of your health information relating to you seeking, obtaining, providing, supporting, or aiding in the performance of a lawful abortion will not be disclosed, shared, or made available in an electronic health records system or through an HIE to any individual in another state, without your written authorization, except as expressly permitted or required by law.
Qualifications & exceptions
The exception is "as expressly permitted or required by law".
With a lawful attestation, Blue Shield may disclose information possibly related to reproductive care for four purposes
Using an example of a person who lives in one state and travels to California for lawful reproductive health care such as an abortion, Blue Shield says it is not allowed to and will not share that information if someone tries to investigate the person for obtaining that care. It adds that if it receives a lawful attestation from the person requesting it, it may disclose PHI potentially related to reproductive health care, such as an abortion, for health oversight activities, judicial or administrative proceedings, law enforcement, or coroner or medical examinations.
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Example: If you live in one state and travel to California to receive lawful reproductive health care, such as an abortion, we are not allowed to and will not share that information if someone tries to investigate you for obtaining that care. However, if we receive a lawful attestation from the person requesting it, we may disclose your PHI potentially related to reproductive health care (such as an abortion) for the following purposes:
Health oversight activities
Judicial or administrative proceedings
Law enforcement
Coroner or medical examinations
Qualifications & exceptions
The exception depends on receiving a "lawful attestation" from the requester.
Not stated here
The notice does not define a lawful attestation or say what it must state.
The four listed purposes follow the word "following" in the example; the notice does not say whether other purposes are possible.
Information Blue Shield properly discloses may be redisclosed by the recipient, then falls outside this notice
Blue Shield says it is possible that information it has properly disclosed under the notice will be redisclosed by the recipient and, if so, it is no longer protected by the policies in the notice.
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Please note that it is possible that information that we have properly disclosed pursuant to this Notice will be redisclosed by the recipient and, if so, it is no longer protected by the policies in this Notice.
Qualifications & exceptions
Applies to information disclosed "properly ... pursuant to this Notice".
Not stated here
The sentence says the notice’s own policies no longer protect redisclosed information; it does not say whether other laws or the recipient’s own rules apply.