April 14, 2003
HIPAA PRIVACY NOTICE
Cleveland State University Group Health Plans
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU,
MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO
THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Who Will Follow This Notice
This Notice describes the medical information practices of the Cleveland State University
Group Health Plans (the “Plan” or “Plans”) (e.g., Medical Mutual, Kaiser, Dental, Vision,
Medical Flexible Spending Account, and IMPACT Employee Assistance Plan).
Our Pledge Regarding Medical Information
We understand that medical information about you and your health is personal. We are
committed to protecting medical information about you.
The following is the Privacy Notice of Cleveland State University required under the
Health Insurance Portability and Accountability Act of 1996 and regulations promulgated
there under, commonly known as HIPAA. HIPAA requires Cleveland State University’s
Group Health Plans by law to maintain the privacy of your personal health information
and to provide you with notice of Cleveland State University’s legal duties and privacy
policies with respect to your personal health information. We are required by law to
abide by the terms of this Privacy Notice.
We create a record of the health care enrollment, payment, service issues, and claims
reimbursed under the Plans for Plan administration purposes. This Notice applies to the
medical records the Plans must maintain. Your personal doctor or health care provider
may have different policies or notices regarding the doctor’s use and disclosure of your
medical information created in the doctor’s office or clinic.
This Notice will tell you about the ways in which we may use and disclose the medical
information about you. It also describes our obligations and your rights regarding the use
and disclosure of medical information which we possess.
Cleveland State University HIPAA Notice for Group Health Plans – April 14,