Privacy & Confidentiality

State and federal laws require MPHC to protect confidential member and provider information from unauthorized disclosure.

Many of these requirements also apply to the information we receive from providers. Participating providers are required to comply with all laws and regulations applicable to MPHC Health Plans, including but not limited to the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Providers are also required to permit MPHC to review and duplicate member data and records related to services provided to carry out medical management and quality management programs.

This notice describes how member medical information may be used and disclosed and how members can get access to this information.

In order to effectively provide and administer health plan services and benefits to our members, MPHC must collect, use, and disclose certain protected health information. This is only done, however, in accordance with MPHC privacy policies. MPHC is committed to ensuring the privacy and confidentiality of our Members' Protected Health Information (PHI) and to fully supporting the HIPAA provisions.

PHI is information about a member or his/her dependents, including demographic information, that can reasonably be used to identify the member and that relates to the member’s past, present, or future physical or mental health or condition, the provision of health care service to the member or our payment for that care.

We are required by law to maintain the privacy of member PHI and to provide members with this notice about our legal duties and privacy practices with respect to PHI. We must follow the privacy practices described in this notice while it is in effect.