Your health information will be used by MegaAid only to:
If you give consent, all employees, agents, and staff of MegaAid may access ALL of your electronic health information. This includes information created before and after the date of this Consent Form. Your health records may include a history of illnesses or injuries you have had (like diabetes or a broken bone), test results (like Xrays or blood tests), and lists of medicines you have taken. This information may relate to sensitive health conditions, including but not limited to: • Alcohol or drug use problems • Mental health conditions • Birth control and abortion (family planning) • HIV/AIDS • Genetic (inherited) diseases or tests • Sexually transmitted diseases.
Information about you comes from places that have provided you with medical care or health insurance (“Information Sources”). These may include hospitals, physicians, pharmacies, clinical laboratories, health insurers, the Medicaid program, and other health organizations.
Only these people may access information about you: designated MegaAid employees and staff who are involved in your medical care, and designated staff involved in compliance, quality improvement, or care management activities permitted by this Consent Form as described above in paragraph one.
There are penalties for inappropriate access to or use of your electronic health information. If at any time you suspect that someone who should not have seen or gotten access to information about you has done so, contact MegaAid Compliance Department at email@example.com, or call the NYS Department of Health at 877-690-2211.
Any electronic health information about you may be re-disclosed by MegaAid only to the extent permitted by state and federal laws and regulations. This is also true for health information about you that exists in a paper form. As stated in #2 above, if you give consent, ALL of your health information, including sensitive health information, will be available to MegaAid staff and employees. Some state and federal laws provide special protections for some kinds of sensitive health information, including related to: (i) your assessment, treatment or examination of a health condition by certain providers; (ii) HIV/AIDS; (iii) mental illness; (iv) mental retardation and developmental disabilities; (v) substance abuse; and (vi) predisposition genetic testing. Their special requirements must be followed whenever people receive these kinds of sensitive health information. MegaAid employees and staff who access this information through these health information exchanges, must comply with these requirements.
This Consent Form will remain in effect until the day you withdraw your consent or until such time MegaAid ceases operation, or until 50 years after your death, whichever is later.
You can withdraw your consent at any time by contacting MegaAid at 212.920.4500 and informing us that you withdraw your consent. If you withdraw your consent, you will lose access to the patient portal.
You are entitled to get a copy of this Consent Form after you sign it.
If you deny consent for MegaAid employees and staff to access your information through the patient portal, your healthcare providers may not be able to access critical health information about you, obtained during a prior encounter, in a timely manner. You will also not be able to access or utilize the patient portal.