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Maryland Department of Health and Your Health Information
Notice of Privacy Practices

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND
HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW CAREFULLY.

Safeguarding Your Protected Health Information
The Maryland Department of Health (MDH) is committed to protecting your health information. In order to provide treatment or to pay for your healthcare, MDH will ask for certain health information and that health information will be put into your record. The record usually contains your symptoms, examination and test results, diagnoses, and treatment. That information, referred to as your health or medical record, and legally regulated as health information may be used for a variety of purposes. MDH is required to follow the privacy practices described in this Notice, although MDH reserves the right to change our privacy practices and the terms of this Notice at any time. You may request a copy of the new notice from any MDH agency. It is also posted at http://health.maryland.gov/hipaa/Pages/privacy.aspx.

How MDH May Use and Disclose Your Protected Health Information
MDH employees will only use your health information when doing their jobs. For uses beyond what MDH normally
does, MDH must have your written authorization unless the law permits or requires it. The following are some examples of our possible uses and disclosures of your health information.

Uses and Disclosures Relating to Treatment, Payment, or Health Care Operations:
For treatment: MDH may use or share your health information to approve, deny treatment and to determine if
your medical treatment is appropriate. For example, MDH health care providers may need to review your
treatment plan with your healthcare provider for medical necessity or for coordination of care.
To obtain payment: MDH may use and share your health information in order to bill and collect payment for
your health care services and to determine your eligibility to participate in our services. For example, your health
care provider may send claims for payment of medical services provided to you.
For health care operations: MDH may use and share your health information to evaluate the quality of
services provided, or to our state or federal auditors.

Other Uses and Disclosures of health information required or allowed by law:
Information purposes: Unless you provide us with alternative instructions, MDH may send appointment
reminders and other materials about the program to your home.
Required by law: MDH may disclose health information when a law requires us to do so.
Public health activities: MDH may disclose health information when MDH is required to collect or report
information about disease or injury, or to report vital statistics to other divisions in the department and other public
health authorities.
Health oversight activities: MDH may disclose your health information to other divisions in the department and
other agencies for oversight activities required by law. Examples of these oversight activities are audits,
inspections, investigations, and licensure.
Coroners, Medical Examiners, Funeral Directors and Organ Donations: MDH may disclose health
information relating to a death to coroners, medical examiners or funeral directors, and to authorized
organizations relating to organ, eye, or tissue donations or transplants.
Research purposes: In certain circumstances, and under supervision of our Institutional Review Board or other
designated privacy board, MDH may disclose health information to assist medical research.
Avert threat to health or safety: In order to avoid a serious threat to health or safety, MDH may disclose health
information as necessary to law enforcement or other persons who can reasonably prevent or lessen the threat of
harm.
Abuse and Neglect: MDH will disclose your health information to appropriate authorities if we reasonably
believe that you are a possible victim of abuse, neglect, domestic violence, or some other crime. MDH may
disclose your health information to the extent necessary to avert a serious threat to your health or safety or the
health or safety of others.
Specific government functions: MDH may disclose health information of military personnel and veterans in
certain situations, to correctional facilities in certain situations, to government benefit programs relating to
eligibility and enrollment, and for national security reasons, such as protection of the President.
Families, friends or others involved in your care: MDH may share your health information with people as it
is directly related to their involvement in your care or payment of your care. MDH may also share health
information with people to notify them about your location, general condition, or death.
Worker’s Compensation: MDH may disclose health information to worker’s compensation programs that
provide benefits for work-related injuries or illnesses without regard to fault.
Patient Directories: The health plan under which you are enrolled does not maintain a directory for disclosure to
callers or visitors who ask for you by name. You will not be identified to an unknown caller or visitor without
authorization.
Lawsuits, Disputes and Claims: If you are involved in a lawsuit, a dispute, or a claim, MDH may disclose your
health information in response to a court or administrative order, subpoena, discovery request, investigation of a
claim filed on your behalf, or other lawful process.
Law Enforcement: MDH may disclose your health information to a law enforcement official for purposes that
are required by law or in response to a subpoena.

You have a Right to:
Request restrictions: You have a right to request a restriction or limitation on the health information MDH uses
or discloses about you. MDH will accommodate your request if possible, but is not legally required to agree to
the requested restriction. If MDH agrees to a restriction, MDH will follow it except in emergency situations.
Request Confidential Communications: You have the right to ask that MDH send you information at an
alternative address or by alternative means. MDH must agree to your request as long as it is reasonably easy
for us to do so.
Inspect and copy: You have a right to see your health information upon your written request. If you want copies
of your health information, you may be charged a fee for copying, depending on your circumstances. You have a
right to choose what portions of your information you want copied and to have prior information on the cost of
copying.
Request amendment: You may request in writing that MDH correct or add to your health record. MDH may
deny the request if MDH determines that the health information is: (1) correct and complete; (2) not created by
us and/or not part of our records; or (3) not permitted to be disclosed. If MDH approves the request for
amendment, MDH will change the health information and inform you, and will tell others that need to know about
the change in the health information.
Accounting of disclosures: You have a right to request a list of the disclosures made of your health information
after April 14, 2003. Exceptions are health information that has been used for treatment, payment, and
operations. In addition, MDH does not have to list disclosures made to you, based on your written authorization,
provided for national security, to law enforcement officials or correctional facilities. There will be no charge for up
to one such list each year.
Notice: You have the right to receive a paper copy of this Notice and/or an electronic copy by email upon request.

For More Information
This document is available in other languages and alternate formats that meet the guidelines for the Americans with
Disabilities Act. If you have questions and would like more information, you may contact:  the Calvert County Health
Department (410) 535-5400.

Report a Problem about our Privacy Practices
If you believe your privacy rights have been violated, you may file a complaint.

• You can file a complaint with the Department of Health and Mental Hygiene, Division of Corporate Compliance at 1-866-770-7175.
  
• You can file a complaint with the Secretary of the U.S. Department of Health and Human Services, Office of Civil Rights. You may call the Department of Health and Mental Hygiene for the contact information.

MDH will take no retaliatory action against you if you make such complaints.
Effective Date: This notice is effective on April 14, 2003.