Source: https://www.lmhospital.org/ynhhs/policies.aspx
Timestamp: 2020-05-29 06:16:08
Document Index: 452084030

Matched Legal Cases: ['§ 4', '§ 17', '§ 17', '§ 17', '§ 17', '§ 17', '§ 31', '§ 31', '§ 53', '§ 53', '§ 53', '§ 53', '§ 53', '§ 4', '§ 17', '§ 17', '§187', '§145', '§ 3729', '§ 3801', '§19', '§19', '§501']

The Office of Privacy and Corporate Compliance is committed to providing Yale New Haven Health System, and all of its individual delivery networks, with respect to its vision, mission and values, with clear and ethical compliance direction relating to all federal and state health care program requirements and regulations.
The YNHHS Compliance Program is designed to prevent and detect violations of applicable law, Code of Conduct and company policies. While it is expected that employees, contractors and agents will comply with applicable laws, Code of Conduct and policies, the System understands that the implementation of the Compliance Program cannot eliminate all risk of improper conduct. In the event that the System becomes aware of possible violations of law or Code of Conduct or policies, the Office of Privacy and Corporate Compliance will investigate the matter and, where appropriate, recommend disciplinary action and implement corrective measures to prevent future violations.
Compliance is not a “policing” action, but a way to ensure everyone is “doing the right thing”. To support this, YNHHS’ Corporate Compliance Department works with departments all across the health system to carry out primary functions such as:
Business structure and responsibility that includes a Compliance Officer and committee
Reporting mechanisms that include effective lines of communication
Response/prevention and enforcement through well publicized disciplinary guidelines
Responding to detected offenses and developing corrective actions
Comprehensive Fraud and Abuse Plans—procedures to voluntarily self-report potential fraud or misconduct
Once an issue is identified, the Compliance Department works with the applicable departments to investigate and resolve the issue. All issues are recorded and tracked for timely resolution.
We encourage you to call the Office of Corporate Compliance at 203-688-8416 or email us at compliance@ynhh.org to discuss any potential compliance concerns. In addition, the Compliance Hotline is available to everyone 24 hours a day, seven days a week by calling 888-688-7744 or visiting www.ynhhscomplianceprogramhotline.com.
You can make a report either anonymously or by using you name. All reports received by either the Office of Privacy & Corporate or Hotline are appropriately investigated.
YNHHS Code of Conduct
The YNHHS Code of Conduct is the foundation of our Compliance and Privacy Program. It outlines the duties and responsibilities of the Compliance Program and of those who are associated with and employed by Yale New Haven Health System and its affiliates.
Message from YNHHS President and CEO
Why We Have a Code of Conduct
Calling the Compliance Hotline
Message from YNHHS President and CEO Marna P. Borgstrom
Yale New Haven Health System is a leader in providing safe, high-quality, comprehensive patient care. We are committed to excellent service in day-to-day interactions with our patients and their families, visitors, other staff members and the communities we serve.
We rely on our education, training and experience, but it’s our values – integrity, patient-centered care, respect, accountability and compassion – that guide us as individuals and as an organization in the work we do.
In our work, often we face new and difficult situations involving issues like patient confidentiality, conflicts of interest or financial reporting. To be best positioned to address these challenges, we all need a thorough understanding of our policies, and the rules and regulations that govern our work and our actions and decisions.
The Yale New Haven Health System Code of Conduct reflects our commitment to ethical business behavior, provides guidelines for making informed decisions, and presents an overview of the policies to which we must all adhere.
If you are unsure about an issue or concerned about a possible violation, your organization’s corporate compliance officer will provide guidance. Or, you may call the Compliance Hotline at 1-888-688-7744 or go to the Corporate Compliance/Privacy website. Thank you for your continued commitment to providing safe, high-quality care to the patients we are privileged to serve.
YNHHS President and CEO
Our Code of Conduct reflects our collective commitment and responsibility to uphold our organization’s reputation, practice ethical business behavior, meet rigorous professional standards, and comply with the laws, regulations and policies that govern our work.
The Yale New Haven Health System (YNHHS) Code of Conduct applies to every individual affiliated with YNHHS, whether employee, volunteer, member of the medical staff or Auxiliary at YNHHS and its Bridgeport, Greenwich, Yale New Haven and Northeast Medical Group delivery networks.
The YNHHS Code of Conduct provides:
An overview of the commitments that govern our work
Tools for reporting concerns or suspected violations without fear
Guidance in making choices that may seem questionable or confusing
We as individuals have a shared commitment to meeting applicable laws and industry standards and applying them to our day-to-day interactions.
The YNHHS Code of Conduct articulates our commitment to our values and ethical business behavior while reminding us that our overriding responsibility is
to use sound judgment and personal integrity.
It is the responsibility of each of us to understand and comply with all applicable organization policies and procedures and be able to locate them and review them periodically.
The purpose of the Compliance and Privacy Program is to provide the system with clear ethical and compliance direction. In addition, the Compliance and Privacy Program is designed to prevent and detect violations of applicable law, Code of Conduct, and company policies.
Our Corporate Compliance Program is designed to enhance our understanding of acceptable behavior and appropriate decision-making.
It is everyone’s duty to promptly report any activity that appears to violate the Code of Conduct or any laws, regulations, or organizational policies.
All YNHHS policies (including compliance and privacy) can be found on the YNHHS intranet.
To access the Corporate Compliance Program page on the YNHHS intranet, go to Corp. Compliance/Privacy in the top navigation bar.
How to view compliance and privacy policies
To view specific Corporate Compliance policies, from the corporate compliance intranet page, click "Policies and Procedures" in the upper-left navigation box.
If you wish to obtain guidance on ethics or compliance issues, or if you are unsure about reporting a suspected violation, you may take any of the following actions:
Contact your direct supervisor.
Contact a higher level of management.
Contact Human Resources if the issue involves a human resources concern such as work conditions, discrimination or harassment, theft or abuse of propertyand personal security.
Contact the YNHHS Compliance Office 203-688-8416 or your delivery network Compliance Officer.
To make an anonymous report, call the Compliance Hotline at 1-888-688-7744 or visit the Corporate Compliance/Privacy website at www.ynhhscomplianceprogramhotline.com
If you feel uncomfortable about your activities or those of others around you and are hesitant about making a report in person, call the 24-hour Compliance Hotline at 1-888-688-7744 or make a report on the Corporate Compliance/ Privacy website at: www.ynhhscomplianceprogramhotline.com.
The hotline is outsourced to an independent company that has trained professional personnel available to speak with you. You are not required to identify yourself. The hotline is not set up for caller ID and cannot trace calls.
However, you may decide to identify yourself in order to provide information that may be helpful in an investigation.
Information you provide will remain confidential to the extent possible.
You will be given a case number and a call-back date. You may call back again on or after the call-back date to determine whether action has been taken, but the nature and outcome of an investigation are always confidential.
We will protect any employee who reports a concern in good faith. While you are accountable for your own wrong-doing, anyone who retaliates against you for reporting a concern in good faith will be subject to disciplinary action.
Report any retaliation or harassment immediately to your supervisor, another manager, the Compliance Office or the Compliance Hotline. Please see the YNHHS Non-Retaliation and Non-Retribution for Reporting policy for more information.
Why Call the Compliance Hotline
These are just a few of the concerns that might prompt you to call the hotline:
Improper billing or practices
Medical record documentation concerns
Inappropriate use of YNHHS computers or equipment
Any situation which places you, a patient, a co-worker or YNHHS at risk
No employee, member of the medical staff, volunteer, or member of the Board of Trustees may solicit or encourage a gift or gratuity from a patient or visitor. When gifts of a personal nature are offered by patients or visitors, they should be discouraged.
The patient or visitor should be politely thanked, but told that employees, medical staff, volunteers and trustees are not permitted to accept gifts or gratuities. YNHHS personnel may never accept cash or cash equivalents, such as gift certificates or gift cards.
Gifts & business courtesies from vendors guidelines
YNHHS personnel may not offer or receive gifts unless such gifts are of a nominal value and are in accordance with these guidelines. Refer to policy on intranet for details.
Under no circumstances may YNHHS personnel offer or receive a gift when the intent is to generate healthcare business. YNHHS personnel must disclose and, as appropriate, seek prior approval from their department manager when receiving or soliciting gifts as YNHHS personnel.
Protection of Patient Health Information (PHI)
Employees and medical staff should request, use or disclose only the minimum amount of information necessary from patients’ records, and only for patient treatment, payment or healthcare operations (TPO). Employees should use caution to never disclose PHI to any non-covered individual through any form of communication – verbal, written, electronic mail, social media, etc.
Employees who publish or post content on user-generated media on the internet (including, but not limited to, social media sites, blogs, wikis, chat rooms, message boards, etc.) should exercise good judgment, respect and discretion, and follow YNHHS’ policy on “Social Networking and Online Communications”.
Employees’ right to access Protected Health Information (PHI)
Employees may not use work access privileges to view the records of family members, friends, colleagues or others. Employees are granted access to electronic medical records (EMRs) for treatment, payment, or operations (TPO) purposes only.
Government exclusion from participation
YNHHS does not employ, contract with or otherwise utilize the services of any individual or organization that has been debarred or excluded from, or is otherwise ineligible to participate in, any federal healthcare program.
False claims & payment fraud prevention
All employees, contractors, agents and volunteers of YNHHS must immediately report to the delivery network Compliance & Privacy Officers or Chief Compliance & Privacy Officer any suspicion of fraud, waste or abuse in connection with the business of YNHHS. YNHHS engages in specific compliance efforts to detect and prevent fraud, waste and abuse.
Non-retaliation & non-retribution for reporting
YNHHS prohibits any acts of retribution, discrimination, harassment or retaliation against any employee who, in good faith, provides information or otherwise assists in an investigation or proceeding regarding any conduct which the employee reasonably believes to be in violation.
My mother-in-law is in the hospital and I’m a nurse working on another floor. Can I look up her lab results in Epic to see what is wrong and consult with her tonight? No. Family members, friends and co-workers are entitled to the same privacy as any other patient. You must obtain a release of information and request the records through Health Information Management (HIM) or MyChart proxy access.
May I post something that includes the YNHHS logo or has patient information on social media? If an employee chooses to be identified as related to the System, its hospitals or other entities, he/she must make it clear to the readers that the views expressed are the employee’s alone and that they do not necessarily reflect the views of the System. Employees must avoid making defamatory statements about the System or its employees, patients, clients, partners, affiliates and others, including competitors. Disclosing any protected or confidential information (e.g., patient/employee/business) on social media or online is prohibited.
What if a patient gives me a gift card to my favorite store? This would not be permitted. Thank the patient and direct him or her to your delivery network’s Development/Foundation office to make a charitable contribution.
I saw a co-worker photographing a celebrity in the hospital waiting room with his phone. I didn’t take the picture – do I need to report it? This is a breach of patient privacy and you are required to report it.
I noticed a few instances in which the physician’s office where I work was billing twice for services with a Medicare patient. Should I wait for someone to catch the error later? Billing and coding are high-risk areas and this may be considered a fraudulent claim. It should be reported immediately to your manager and/or the Compliance Department or Hotline.
Policy updated 2/27/2017
We work hard to ensure the privacy of patients and maintain the confidentiality their information and medical records. Like all accredited healthcare institutions, we follow a federal law called the Health Insurance Portability and Accountability Act (HIPAA), which is designed to protect the privacy and confidentiality of patient information. We insist that our staff observe patient confidentiality – respecting your right to privacy about your medical records and experience at our hospital.
Authorization for Access/Release of Information (English)
View or download a fillable PDF.
For Bridgeport, Greenwich and Yale New Haven Hospitals:
Authorization for Access/Release of Information
For Lawrence + Memorial Hospital:
For Westerly Hospital:
(Policies revised 7/19, 11/18, 11/19)
Authorization for Access/Release of Information (Spanish)
(Policy revised 7/19)
Yale New Haven Health & Yale University
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. If you have any questions, please contact our privacy office at the phone number at the bottom of this notice.
We understand that medical information about you is personal. We are committed to protecting medical information about you. We create a record of the care and services you receive to provide quality care and to comply with legal requirements. This notice applies to all of the records of your care generated by any of the separate facilities and providers described below. We are required by law to:
We may use and disclose medical information about you without your prior authorization for treatment, such as sending medical information about you to a specialist as part of a referral (this includes psychiatric or HIV information if needed for purposes of your diagnosis and treatment); to obtain payment for treatment, such as sending billing information to your insurance company or Medicare; and to support our healthcare operations, such as comparing patient data to improve treatment methods or for professional education purposes (Note: only limited psychiatric or HIV information may be disclosed for billing purposes without your authorization). If you are treated in a specialized substance abuse program, your special authorization is required for most disclosures other than emergencies.
Other examples of such uses and disclosures include contacting you for appointment reminders and telling you about or recommending possible treatment options, alternatives, health-related benefits or services that may be of interest to you. We may also contact you to support our fundraising efforts. It is always your choice to opt out of receiving fundraising communications from us.
Under certain circumstances, we may use and disclose health information about you for research purposes, subject to a special approval process. We may also allow potential researchers to review information that may help them prepare for research, so long as the health information they review does not leave our facility, and so long as they agree to specific privacy protection. For more information on research and how to opt out of research use of your records see www.yalestudies.org or 1-877-978-8343.
All departments and affiliated covered entities of Yale New Haven Health System, including; Bridgeport Hospital, Greenwich Hospital, Northeast Medical Group, Westerly Hospital, Lawrence + Memorial Hospital and Yale New Haven Hospital
You have the right to request a list accounting for any disclosures of your health information we have made, except for uses and disclosures for treatment, payment, and healthcare operations, circumstances in which you have specifically authorized such disclosure and certain other exceptions. as required by law.
You request that your information is not shared with an insurer for purposes of payment or other purposes unrelated to your treatment;
You pay all charges associated with the services you received out-of-pocket in full; and
We will inform you of our decision on your request. All written requests or appeals should be submitted to our Privacy Office listed below.
YNHHS Office of Privacy and Compliance
Toll Free: 1-888-688-7744
Yale University HIPAA Privacy Office
203-432-5919
Yale New Haven Health System Acknowledgement of Receipt of Notice Of Privacy Practices
Printed Name of Patient:
Patient's Medical Record Number:
Patient's Personal Representative & Relationship:
If Applicable, Reason for Patient Refusal to Sign:
Version effective 9/10/2019
Yale New Haven Health and Yale University
Este aviso describe cómo se puede utilizar y divulgar su información médica y de qué manera usted puede acceder a ella. Por favor lea este aviso con cuidado. Si tiene alguna pregunta, comuníquese con nuestra oficina de privacidad al número telefónico que aparece al final de este aviso.
Entendemos que su información médica es personal. Nos comprometemos a proteger su información médica. Para ofrecerle atención de calidad y cumplir con los requisitos legales, creamos un expediente de la atención y los servicios que recibe. Este aviso se aplica a todos estos expedientes médicos generados por cualquiera de nuestros centros y proveedores independientes mencionados a continuación. La ley nos exige:
Proteger la privacidad de su información médica;
Entregarle este aviso sobre nuestras obligaciones legales y prácticas de privacidad relacionadas con su información médica; y
Respetar las condiciones del aviso que se encuentre vigente.
De qué modo podemos usar y divulgar su información médica:
Podemos usar y divulgar información médica sobre usted sin su autorización previa por razones de tratamiento, como por ejemplo enviar su información médica a un especialista como parte de un remitido (incluyendo información psiquiátrica y sobre el VIH si fuera necesario para su diagnóstico y tratamiento); para obtener el pago de un tratamiento, por ejemplo enviar información de su estado de cuenta a la compañía de seguros o a Medicare; y para apoyar nuestros servicios de atención de salud, como por ejemplo comparar datos sobre los pacientes para mejorar los métodos de tratamiento o con fines educativos para profesionales (Nota: sólo se puede divulgar sin su autorización una cantidad limitada de información psiquiátrica o sobre el VIH con el fin de facturar los servicios médicos). Si usted recibe tratamiento en un programa especializado por abuso de substancias, se requerirá su autorización especial para la mayoría de las divulgaciones que no sean por una emergencia. Otros ejemplos de tales usos y divulgaciones incluyen comunicarse con usted para recordarle que tiene una cita y mencionarle o recomendarle posibles opciones de tratamiento, alternativas, beneficios o servicios relacionados con la salud que puedan serle de interés. También podríamos comunicarnos con usted para que apoye nuestros esfuerzos para recaudar fondos. En cualquier momento, usted puede optar por no recibir información sobre nuestras campañas para recaudar fondos.
Podemos usar o divulgar información médica sin su autorización previa por varias otras razones. Podemos divulgar sin autorización previa la información médica que tenemos sobre usted, siempre que se cumplan ciertos requisitos, por razones de salud pública, denuncias de abuso o negligencia, auditorías o inspecciones de vigilancia de la salud, evaluadores médicos, arreglos funerarios y donación de órganos, por razones de indemnizaciones laborales, emergencias, seguridad nacional y otras funciones gubernamentales especializadas y para miembros de las Fuerzas Armadas según lo exigen las autoridades de Comando Militar. También divulgamos información médica cuando la ley lo requiere, como por ejemplo en cumplimiento de una solicitud de la policía en circunstancias específicas, o en respuesta a órdenes judiciales o administrativas válidas u otros procesos legales.
Podemos usar y divulgar su información con fines de investigación científica, bajo ciertas circunstancias y siempre que se cumpla un proceso de autorización especial. También podríamos permitir que potenciales investigadores analicen la información que pueda ayudarlos a prepararse para una investigación, siempre que la información médica que analicen no salga de nuestras instalaciones, y siempre que acepten cumplir con mecanismos específicos de protección de la privacidad. Para obtener más información sobre las investigaciones científicas o sobre cómo evitar el uso de su expediente para investigaciones vea la página de internet www.yalestudies.org o llame al 1-877-978-8343.
Si lo ingresan al hospital, incluiremos en el directorio de pacientes su nombre, ubicación en el hospital, su estado de salud general (bueno, regular, etcétera) y su afiliación religiosa y podremos divulgar dicha información, excepto su afiliación religiosa a cualquiera que pregunte sobre usted por su nombre, a menos que nos solicite lo contrario. Su afiliación religiosa sólo puede ser divulgada a miembros del clero, aunque no pregunten por su nombre.
Podemos divulgar su información médica a un amigo o pariente que usted haya designado o en determinadas circunstancias, a menos que usted solicite una restricción. También podemos divulgar información a las autoridades que brindan asistencia en caso de desastre para poder notificar a su familia sobre su ubicación y estado de salud.
En cualquier otra situación que no esté contemplada en este aviso, incluyendo el uso o divulgación de las notas de las consultas de psicoterapia, solicitaremos su autorización por escrito antes de usar o divulgar información médica sobre su persona. Si usted elige autorizar el uso o la divulgación, puede revocarla más adelante notificándonos su decisión por escrito.
¿Quiénes deben seguir las normas de este aviso?
Las instalaciones de Yale New Haven Health System (YNHHS) (El Sistema de Servicios de Salud de Yale New Haven) y Yale University School of Medicine (YSM) (la Facultad de Medicina de la Universidad de Yale) brindan atención médica a nuestros pacientes, en colaboración con otros profesionales y otras organizaciones de atención de la salud. La información que contiene este aviso sobre las prácticas de privacidad será acatada por:
Cualquier profesional de la salud que lo atienda en cualquiera de nuestros centros.
Todos los departamentos y entidades afiliadas cubiertas del Yale New Haven Health System, incluyendo el Bridgeport Hospital, el Greenwich Hospital, el Westerly Hospital, el Lawrence + Memorial Hospital, Northeast Medical Group y el Yale New Haven Hospital.
La Facultad de Medicina de la Universidad de Yale
El personal clínico de la Facultad de Enfermería de Yale, así como sus instituciones afiliadas.
Todos los empleados, el personal médico, afiliados, personal en entrenamiento, estudiantes o voluntarios de las entidades mencionadas anteriormente.
Aunque cada uno de nuestros centros y afiliados funciona de manera independiente, pueden compartir la información sobre su salud a fin de coordinar su atención médica, tratamiento, pago, y asuntos de salud.
Derecho a que se le notifique si ha habido fuga de información:
Le notificaremos si ha ocurrido alguna fuga de su información confidencial.
Derecho a obtener y rectificar su historial:
En la mayoría de los casos, usted tiene derecho a ver u obtener una copia de la información médica que usamos para tomar decisiones sobre su cuidado. Todas las solicitudes de copias del expediente médico o las solicitudes para tener acceso al mismo se deben de presentar con anticipación y por escrito. Si se le concede su solicitud, programaremos la hora y el lugar convenientes para que pueda revisar su expediente. Si solicita copias, podríamos cobrarle una tarifa por el costo del copiado, envío u otros suministros relacionados. Si denegamos su solicitud de revisar u obtener una copia, puede presentar una solicitud por escrito para que se reconsidere dicha decisión.
Si usted opina que la información que aparece en su historial es incorrecta o que falta información importante, tiene derecho a que rectifiquemos su historial presentando una petición por escrito expresando la razón por la cual ha solicitado la enmienda. Podríamos denegar su solicitud de corrección si la información no está a nuestro cargo; o si determinamos que su registro es correcto. Si nuestra decisión es no enmendar su historial, puede presentar por escrito una declaración de desacuerdo.
Derecho a recibir un informe:
Usted tiene derecho a solicitar un informe de las divulgaciones que hayamos hecho de su información de salud, excepto cuando se usó o divulgó para tratamiento, pago, servicios de atención de salud, aquellas circunstancias para las cuales haya autorizado dicha divulgación y otras excepciones según lo exige la ley.
Para solicitar esta lista de divulgaciones, indique el período relevante, que debe estar comprendido dentro de los últimos seis años. Usted debe presentar la solicitud por escrito al Departamento de Archivos Médicos (Medical Records) o al Departamento de Facturación (Billing Department), según sea apropiado.
Derecho a solicitar restricciones:
Usted puede solicitar por escrito que no usemos o divulguemos su información médica para tratamiento, pago o servicios de cuidado de la salud, o a personas involucradas en su cuidado, excepto cuando usted lo autorice específicamente, cuando lo exija la ley o en una emergencia. Consideraremos su solicitud y trataremos de ajustarnos a la misma, cuando sea posible, pero no estamos obligados por ley a aceptarla, a menos de que se cumplan todas las condiciones que aparecen a continuación:
Que solicite que no se divulgue su información al seguro para propósitos de pago u otros propósitos no relacionados con su tratamiento;
Que usted pague por su cuenta la totalidad de los cargos relacionados con los servicios que recibió; y
Que la ley no exija que divulguemos su información a la compañía de seguros.
Le informaremos nuestra decisión sobre su solicitud. Todas las solicitudes y apelaciones escritas deben ser presentadas ante la Oficina de Privacidad indicada más adelante.
Solicitudes de comunicaciones confidenciales:
Usted tiene derecho a solicitar que su información médica le sea comunicada de forma confidencial como por ejemplo el envío de correspondencia a una dirección distinta a la de su hogar, notificándonos por escrito cuál es el modo específico o qué dirección debemos utilizar para comunicarnos con usted.
Derecho a solicitar una copia impresa de este aviso:
Usted puede recibir una copia impresa de este aviso si así lo solicita, aunque haya aceptado recibir este aviso por vía electrónica.
Podemos cambiar nuestras políticas en cualquier momento. Los cambios serán aplicables tanto a la información médica que ya tengamos como a la nueva información que obtengamos después de ocurrido el cambio. Antes de realizar un cambio importante en nuestras políticas, cambiaremos nuestro aviso y lo colocaremos en las salas de espera, salas de examen médico y en nuestro sitio de Internet: yalenewhavenhealth.org. Usted puede recibir una copia del aviso vigente en cualquier momento. La fecha de vigencia aparece al final del mismo. Habrá copias del aviso vigente disponibles cada vez que usted visite nuestro centro para tratamiento. Se le pedirá que reconozca por escrito que recibió de este aviso.
Si a usted le preocupa que se hayan violado sus derechos de privacidad, o si está en desacuerdo con una decisión que hayamos tomado respecto al acceso a su historial, puede comunicarse con nuestra Oficina de Privacidad (indicada más adelante).
Si no queda satisfecho con nuestra respuesta, puede enviar una queja escrita al Departamento de Salud y Servicios Humanos de los Estados Unidos, Oficina de Derechos Civiles [U.S. Department of Health and Human Services Office of Civil Rights]. Nuestra Oficina de Privacidad puede proporcionarle la dirección. Bajo ninguna circunstancia será sancionado o sufrirá represalias por presentar una queja.
YNHHS Office of Privacy & Compliance
(Departamento de Cumplimiento de Normas y Privacidad)
Número telefónico gratuito: 1-888-688-7744
(Departamento de Asesoría Jurídica,
Cumplimiento de Normas y Confidencialidad (HIPPA) de la Universidad de Yale)
Yale New Haven Health System Recibí el Aviso sobre las prácticas de privacidad
Nombre del paciente en letra de imprenta:
No de récord médico del paciente:
Fecha de nacimiento del paciente:
Dirección del paciente:
Representante personal del paciente y vínculo:
Si corresponde, motivo por el que el paciente rehusó firmar:
Online Privacy and Terms of Use
The information and content on Yale New Haven Health’s (“YNHHS”) websites, applications and social media platforms are provided for your convenience and general educational information only, and are not intended as medical advice nor to replace the relationship that you have with your healthcare professionals. If you have a question related to your medical care, please communicate with your provider through MyChart, which is secured for that purpose.
Yale New Haven Health is committed to protecting your privacy and the confidentiality of your medical information. This policy applies to ynhhs.org, bridgeporthospital.org, greenwichhospital.org, lmhospital.org, westerlyhospital.org, ynhh.org, northeastmedicalgroup.org and other online properties and social media platforms under YNHHS’ control.
Please review our Patient Rights if you are looking for information about your Patient Rights or the Notice of Privacy Practices.
Information collection and use: To communicate effectively with visitors to YNHHS digital properties, we may ask you for personally-identifiable information that can include, by way of illustration, name, email address or phone number. YNHHS will never share personally-identifiable information you voluntarily provide to us, except in situations where we must provide information for legal purposes or investigations.
Use of “Cookies”: Unless you take steps to browse the Internet anonymously, or opt-out, YNHHS, like most institutions and organizations on the Internet, tracks web browsing patterns to inform how our websites are being used. Generic information is collected through the use of “cookies,” which are text files placed on your computer, to evaluate usage patterns so that we can improve both content and distribution. You may refuse the use of cookies by selecting the appropriate settings on your browser; however, doing so may prevent you from using the full functionality of all of our websites.
Some sections of YNHHS-owned websites use Google Analytics, a web analytics service provided by Google, Inc. Google Analytics uses cookies to help us analyze how users use our sites. The information generated by the cookie about your use of the website includes your IP address. This information will be transmitted to and stored by Google on its servers. Google will use this information for the purpose of evaluating your use of the website, compiling reports on website activity, and providing other services relating to Internet usage. Google may also transfer this information to third parties where required to do so by law, or where such third parties process the information on Google’s behalf. Google will not associate your IP address with any other data held by Google. By using this website, you consent to the processing of data about you by Google in the manner and for the purposes set out above.
Data Security: YNHHS makes every reasonable effort to ensure that all of the transactions that occur on our websites are secure. We store all data with Secure Socket Layer (SSL) encryption to protect information you may submit on our site. SSL is the industry standard protocol. All off-line information is securely stored and is accessible only by authorized staff. That being said, YNHHS cannot ensure or warrant the security of any information you transmit to us, and you do so at your own risk. We have taken reasonable steps to ensure the integrity and confidentiality of personally identifiable information that you may provide. You should understand, however, that electronic transmissions via the internet are not necessarily secure from interception, and so we cannot absolutely guarantee the security or confidentiality of such transmissions.
User Name and Password: In the event you access any service requiring a User Name and Password, you are solely responsible for keeping such User Name and Password strictly confidential.
Forms: YNHHS’ websites contain secure forms through which users may request information or supply feedback to us. This information may be shared with a patient relations representative, employee or medical expert who is most able to address your inquiry. Once the information is sent to our websites, it is kept in secure databases accessible only by authorized YNHHS users. In some cases, telephone numbers, email addresses or return addresses are required so that we can supply requested information to you. Submissions may be reviewed infrequently, and so no material of an urgent nature should be submitted. There is no guarantee or expectation of a personal response to any individual submission, regardless of the subject matter.
Surveys: Occasionally, YNHHS may survey visitors to our websites. The information from these surveys is used in aggregate form to help us understand the needs of our visitors so that we can make improvements. The information may be shared with third parties with whom we have a business relationship. Those third parties have agreed to keep all data from surveys confidential. We generally do not ask for information in surveys that would personally identify you. If we do request contact information for follow-up, you may decline to provide it.
Email: YNHHS provides users with the opportunity to receive email communications. If you subscribe to a newsletter produced by YNHHS and distributed via email, we will keep your email address in a private distribution list. You can unsubscribe from our newsletters at any time.
Email communications that you send to YNHHS via the email links on our websites may be shared with a patient relations representative, employee or medical expert who is most able to address your inquiry. We make every effort to respond in a timely fashion once communications are received. Once we have responded to your communication, it is discarded or archived, depending on the nature of the inquiry.
The email functionality on our websites does not provide a completely secure and confidential means of communication. It is possible that your email communication may be accessed or viewed by another internet user while in transit. If you wish to keep your communication private, do not use email. Please do not email patient health information, as that information is confidential and should only be discussed with your physician. If you have a question related to your medical care, please communicate with your provider through MyChart, which is secured for that purpose.
"Phishing" is a scam designed to steal your personal information. If you receive an email that looks like it is from YNHHS asking you for your personal information, do not respond. We will never request your password, user name, credit card information or other personal information through email.
Voice Applications: For voice applications such as those enabled by Amazon and Google, YNHHS collects a unique identifier from your Amazon and Google account. This information is used to enhance user experience and is not personally identifiable to you. We collect no additional information from your account.
Google and Amazon collect and store both the spoken utterance from the customer, and the skill's response, to improve and troubleshoot the voice experience.
You may delete this data in both applications:
See Amazon's privacy policy and terms of use for more information.
See Google’s privacy policy and terms of use for more information.
Please read these Terms of Use (the “Terms”) carefully before accessing or participating in any website or other online platform or service available on or through ynhhs.org, bridgeporthospital.org, greenwichhospital.org, lmhospital.org, westerlyhospital.org, ynhh.org, northeastmedicalgroup.org or other Yale New Haven Health sites (the “Site” or “Sites”). The Terms are an enforceable agreement between Yale New Haven Health System (“YNHHS”) and you, the user of the Sites. By using and accessing the Sites, you acknowledge that you have read the Terms and agree to be bound by and comply with them. If you do not agree to be bound by and comply with the Terms, you are not authorized to use the Sites. YNHHS reserves the right to modify the Terms at any time in its sole discretion, and will publish notice of any such modifications on this site. Any modified Terms are effective immediately upon posting. By continuing to access any Site after YNHHS posts notification of modified Terms, you agree to be bound by and comply with them. If you do not agree to the Terms, please do not enter the Sites. If you are not yet eighteen years of age, a parent or guardian may agree to be bound by the Terms on your behalf.
Nothing in the Terms overrides the application of other rules and policies of YNHHS or other agreements between you and YNHHS.
If you are experiencing a medical emergency, you should not rely on any information on the Site and should seek appropriate emergency medical assistance, such as calling “911”. You should always talk to your healthcare professionals for diagnosis and treatment, including information regarding which drugs or treatment may be appropriate for you. Statements made by any persons on these Sites are not intended to substitute for discussion or evaluation with your healthcare professional or provide any guarantee as to outcomes. Nothing on these Sites represents or warrants that any particular drug or treatment is safe, appropriate or effective for you. Health information changes quickly. Therefore, you should always confirm information with your healthcare professionals.
The Sites are intended for a United States audience. If you live outside the United States, you may see information on the Sites about products or therapies that are not authorized in your country.
You agree not to use the Sites or any other YNHHS computing resources to engage in any of the following conduct. Such conduct is unacceptable and may result in the termination of your use of the Sites.
Copying, scraping, downloading, exporting, storing or otherwise capturing any data obtained via the Sites without proper written authorization by YNHHS;
Misrepresenting your identity, or, sharing or otherwise transferring user account information to any person other than the registered user authorized by YNHHS to use such account;
Where authorized, you may submit any text, images, data, information, content or other materials (collectively, “Materials”) to the Sites. In doing so, such Materials will be considered non-personal and non-confidential (except for personal information as described in the Privacy Policies), and you hereby grant to YNHHS a royalty-free, perpetual, irrevocable, non-exclusive, sublicensable, assignable, worldwide right and license to link to, use, reproduce, transmit, modify, adapt, practice, publish, display, perform, distribute, translate, and create derivative or collective works from, any such Materials, in whole or in part, throughout the world in any media, including all intellectual property rights therein, unless otherwise agreed in writing with YNHHS. You acknowledge and agree that any Materials submitted by users of any Site represent the opinions of the specific author and are not statements of advice, opinion or information of YNHHS. Any such Materials is no substitute for your own research and should not be relied upon for any purpose.
By submitting Materials to any Site, you certify ownership authority to grant such rights to YNHHS and acknowledge that the burden of determining whether any such Materials are protected by copyright rests solely with you.
Further, you are solely responsible for Materials submitted by you, and YNHHS assumes no responsibility or liability for Materials submitted by you or any other visitor to the Sites. We may, but are not obligated to, restrict or remove any and all Materials that we determine in our sole discretion violates the Terms or is otherwise harmful to us, other Site visitors or any third party. We reserve the right to remove Materials you submit at any time, but you understand that we may preserve and access a backup-copy, and we may disclose such Materials if required to do so by law or in a good faith belief that such access, preservation or disclosure is required by law or in the best interests of YNHHS.
Any Materials you submit will be routed through the Internet and you understand and acknowledge that you have no expectation of privacy with regard to any such Materials. Never assume that you are anonymous and cannot be identified by your submissions. You hereby grant YNHHS and any of its sublicensees the right to use the name that you submit in connection with the Materials, if they choose. You represent and warrant that you own or otherwise control all of the rights to the Materials submitted by you; that such Materials are accurate; that use of such Materials does not violate the Terms, and will not cause injury to any person or entity; and that you will indemnify YNHHS and its officers, trustees, employees, representatives and agents for all third-party claims resulting from Materials you submit.
You may not create links to any Site from any website with content that is fraudulent, threatening, harassing, libelous, defamatory, discriminatory, obscene, or similarly objectionable or harmful, or in a manner that would constitute or encourage a criminal offense, violate the rights of any party (directly or indirectly), or otherwise give rise to liability, violate any law or falsely imply YNHHS’ sponsorship, endorsement or approval of your or another party’s site or activities. Additionally, YNHHS, in its sole discretion, has the right to require that you remove links to any Site.
As a courtesy, the Sites may contain links to websites controlled by third parties. YNHHS is not responsible for these third-party sites or their content, activities or privacy practices. The inclusion of links on the Sites does not imply YNHHS’ endorsement of the linked web sites, their content, or any associated organization or activity. YNHHS makes no representation or warranty whatsoever about the nature of the linked sites. You should read the privacy policies and terms of use that govern your use of other sites before accessing and using their services.
All trademarks, service marks and logos or copyrights displayed and used on these Sites are the property of their respective owners. Nothing on the Sites should be construed as granting any right or license to use any Trademark without the written permission of its owner. You may download and reprint a single copy of the materials from the Sites ONLY for your own personal, noncommercial use, provided you include all applicable notices and disclaimers. Any other use of the materials is strictly prohibited without the prior written permission of YNHHS and the permission of the applicable rights holder(s).
The Sites and services, information and content available on or through any of them are provided “as is” and “as available.” YNHHS does not warrant that the Sites or any such services, information or content will be uninterrupted or error-free. There may be delays, omissions, interruptions and inaccuracies in such services, information and content. YNHHS makes no representations or warranties about the accuracy, completeness, timeliness, reliability or non-infringement thereof, including user content, or of any services, information or content available through links to other websites. YNHHS reserves the right to correct any errors or omissions in the Sites. If you rely on any services, information and/or content available on or through the Sites, you do so entirely at your own risk.
You specifically acknowledge that YNHHS is not liable for the defamatory, offensive or illegal conduct of other users or third parties, and that the risk of injury from this type of conduct rests entirely with you. Your sole remedy for dissatisfaction with any Site or any services, information and/or content available on or through any Site is to stop using the Site and/or those services, information and content.
To the maximum extent permitted under law, YNHHS disclaims all express or implied warranties with respect to the Sites and any services, information and content that are available on or through them, including without limitation, any warranty of merchantability, fitness for a particular purpose (even if that purpose has been disclosed) and non-infringement.
Although YNHHS intends to take reasonable steps to prevent the introduction of viruses, worms, “Trojan horses” or other malicious code to the Sites, YNHHS does not guarantee or warrant that the Sites, or any services, information and content that may be available on or through the Sites, are free from such destructive features. YNHHS is not liable for any damages or harm attributable to such features. It is up to you to take any and all precautions to ensure that the services, information and content you access and use from any Site or any hyperlinked website is free of such items of a destructive nature.
YNHHS and its officers, trustees, employees, representatives and agents are not liable for any claim of any nature whatsoever based on loss or injury because of errors, omissions, interruptions or inaccuracies in the Sites or any services, information or content available on or through the Sites, including loss or injury that results from your breach of any provision of the Terms.
Under no circumstances will YNHHS or its officers, trustees, employees, representatives or agents be liable for any direct, indirect, incidental, consequential, special, punitive, or exemplary damages (including, but not limited to, procurement of substituted services or materials; loss of use, data, revenues or profits; or business interruption) arising in any way out of or in connection with your use of any Site or any services, information or content available on or through the Sites or the Terms, however caused and regardless of the theory of liability, whether in tort (including negligence of any kind), contract, statutory, or any other legal or equitable theory, even if advised of the possibility of such damages.
The Terms are the complete agreement between you and YNHHS regarding the subject matter hereof, and any and all prior or contemporaneous written or oral agreements existing between you and YNHHS regarding such subject matter are expressly canceled. We may terminate this agreement at any time for any reason. If you breach any of the Terms, your license to access and use the Sites, including all services, information and content available on or through the Sites, terminates immediately. Upon such termination, you must stop using the Sites, including all services, information and content available on or through the Sites, and return or destroy all copies, including electronic copies, thereof in your possession or control. Any heading, caption, or paragraph title contained in the Terms is inserted only as a matter of convenience and in no way defines or explains any paragraph or provision contained within the Terms. If any provision of the Terms is found to be invalid by any court having competent jurisdiction, the invalidity of such provision shall not affect the validity of the remaining provisions thereof, which shall remain in full force and effect. No waiver of any of the Terms shall be deemed a further or continuing waiver of such term or condition or any other term or condition. You may not transfer or assign any rights or obligations under this agreement. In the event of termination hereunder, you shall have a continuing obligation thereafter to comply with any provision of the Terms that by its sense and context is intended to survive termination.
YNHHS necessarily reserves the right to change this policy from time to time, without advance notice. We will promptly post any changes to our privacy policy and terms of use on all sites owned by YNHHS.
If you are concerned about your patient privacy rights, please contact the Office of Corporate Compliance at 888.688.7744 or compliance@ynhh.org.
If you have an issue relating to a Yale New Haven Health website, email us at webteam@ynhh.org, and we will forward your concern to the appropriate unit for response or resolution.
These Terms of Use were last updated on Oct. 26, 2018
Detecting and Preventing Fraud, Waste, Abuse and Misconduct
Although no precise measure of health care fraud exists, those intent on abusing the system can cost taxpayers billions of dollars while putting beneficiaries' health and welfare at risk. Medicare fraud and abuse increases the strain on the Medicare Trust Fund. The impact of these losses and risks magnify as Medicare continues to serve a growing number of people. - CMS Medicare Learning Network
It is the policy of the Yale New Haven Health System to provide healthcare services in a manner that complies with all applicable federal and state laws. Such compliance is critical to the Health System's commitment to operating pursuant to the highest business, professional and ethical standards. In compliance with the Federal Deficit Reduction Act of 2005, YNHHS maintains a vigorous Compliance and Privacy Program and has implemented a system-wide policy regarding the detection and prevention of fraud, waste, abuse and misconduct.
We encourage you to call the Office of Corporate Compliance at 203-688-8416 or email us at compliance@ynhh.org to discuss any potential compliance concerns. In addition, the Compliance Hotline is available to everyone 24 hours a day, seven days a week by calling 888-688-7744 or by visiting www.ynhhscomplianceprogramhotline.com
You can make a report either anonymously or by using your name. All reports received by either the Office of Privacy amp; Corporate Compliance or the Hotline are appropriately investigated.
False Claims and Fraud Protection Policy
The purpose of this policy is to inform employees, contractors, volunteers and agents of Yale New Haven Health System of the Federal False Claims Act (referenced in this policy as "FCA") the Federal Program Fraud Civil Remedies Act, the Connecticut False Claims Act (“CFCA”), and all other State False Claims Acts; to provide general information regarding YNHHS’s efforts to combat fraud, waste, and abuse; and to describe the remedies and fines for violations that can result from certain types of fraudulent activities.
In addition, this policy conforms to The Deficit Reduction Act (DRA) “Employee Education Provision” intended to bolster Medicaid fraud and abuse enforcement with the following:
Establish fraud and abuse policies and an effective and comprehensive education plan; Included in annual Health Stream training “Corporate Compliance: A Proactive Stance Course.”
Provide detailed explanation of administrative remedies pertaining to civil or criminal penalties for false claims.
Provide specific discussion to the rights of employees regarding whistleblower protection under such laws.
Ensure the entity has a non-retaliation policy available to all employees.
This policy applies to YNHHS, and each of its affiliated entities, its affiliated hospitals (Bridgeport Hospital, Greenwich Hospital, Yale New Haven Hospital, Lawrence + Memorial Hospital, Westerly Hospital, and any other hospital that affiliates with YNHHS), its affiliated providers (including but not limited to Northeast Medical Group and Visiting Nurse Association of Southeastern Connecticut), and each of their subsidiary entities.
All employees, contractors, agents, and volunteers of YNHHS must not create any false or misleading documents or financial or electronic records for any purpose. No one may instruct you to so.
All employees, contractors, agents, and volunteers of YNHHS must immediately report any suspicion of fraud, waste, or abuse in connection with the business of YNHHS to the Office of Privacy and Corporate Compliance. YNHHS engages in specific compliance efforts to detect and prevent fraud, waste, and abuse, such as the Corporate Compliance Program. It is the policy of YNHHS that an employee, contractor, or agent of YNHHS who knowingly and intentionally submits a false claim will be reported to the necessary authorities by the Office of Privacy and Corporate Compliance.
Specific reporting requirements are noted in Attachment A:
Wellcare Suspected Fraud Waste Abuse (FWA) Reporting form
If you would like more information on the Corporate Compliance Program and specific compliance policies or on how to report any concerns, please contact the Office of Privacy and Corporate Compliance (203-688-8416). Compliance Policies may also be accessed via the YNHHS Intranet at https://ynhh.ellucid.com/manuals/binder/1892/1.
Detailed Information of the Federal False Claims Act [31 U.S.C. 3729-3733}
The Federal False Claims Act (FCA) imposes civil penalties on people and companies who knowingly submit a false claim or statement to a federally-funded program or otherwise conspire to defraud the government in order to receive payment. Failure to report and return overpayments from Medicare and Medicaid within certain timeframes might also constitute a violation of the FCA. The FCA also protects people who make efforts to stop the suspected fraud.
The FCA is not confined to healthcare claims, but extends to any payment requested of the federal government or the federal government’s contractor, grantee, or other party, if the payment is to be spent or used on the government’s behalf or to advance a government program or interest and the government provides any portion of the payment or will reimburse the contractor, grantee, or other party. The FCA applies to billing and claims sent from YNHHS to any government payor program, including Medicare and Medicaid.
It is the policy of YNHHS that an employee, contractor, or agent of YNHHS who knowingly and intentionally submits a false claim will be reported to the necessary authorities. Anyone or any company that submits a false claim or statement to the government may be fined under the FCA between $10,957 and $21,916 for each such claim submitted, regardless of the size of the false claim, and the person or company could be required to pay an additional fine of three times the value of any charges. Where a person who violated the FCA reports the violation to the government under certain conditions, the FCA provides that the person shall be liable for not less than double damages.
Part of the FCA's purpose is to create an environment where employees and others feel safe reporting concerns about fraud. Any person, who lawfully attempts to stop any FCA violations or reports information about false claims or suspected false claims that are submitted by others, may not be retaliated against, demoted, suspended, threatened, or harassed for such actions. The FCA also protects individuals who assist in an investigation, provide testimony, or participate in the government's handling of a false claim. Individuals have the right to FCA whistle blower protection from retaliation in any form as to the result of their whistle blowing. These protections include reinstatement without loss of seniority if fired, recovery of two times lost wages plus interest and recovery of attorney fees and other reasonable costs in connection with pursuing retaliation claim. Confidentiality will be maintained to the extent possible.
The FCA’s provisions are generally enforced by the U.S. Department of Justice. The FCA provides that an individual may initiate a formal claim under certain circumstances. If any funds are recovered, a portion of the funds may be paid to the person who initiated the formal claim, at the discretion of a federal court. This amount, if awarded, generally is between 15% and 30% of the total damage amount.
If a person wishes to file a claim regarding fraud or suspected fraud related to a healthcare payment directly with the government, he or she must first present a formal complaint, along with all material evidence relating to the alleged fraud, to the authorities at the U.S. Department of Justice. The authorities have 60 days to investigate, during which time the complaint is kept confidential. Upon completion of the investigation, the government will decide either to pursue the case on its own or decline to proceed with the case. If the federal government declines the case, the individual may still proceed with the case on his or her own, but without the government's assistance, and at his or her own expense.
A private legal action under the FCA must be brought within six years from the date that the false claim was submitted to the government. (A government-initiated claim may be brought up to ten years after the false claim, depending on the circumstances.)
Detailed Information of the Federal Program Fraud Civil Remedies Act
Persons or companies that commit fraud on the federal government, by false claim or statement, can be assessed monetary penalties in addition to the penalties of the False Claims Act because of a law called the Program Fraud Civil Remedies Act (referenced in this policy as "PFCRA"). Specifically, PFCRA penalties of $5,000 per false claim or statement apply if a person or company submits a claim to the federal government that: the person or company knows or has reason to know is false, fictitious, or fraudulent; includes or is supported by written statements containing false, fictitious, or fraudulent information; includes or is supported by written statements that omit a material fact, which causes the statements to be false, fictitious, or fraudulent and the person submitting the statement has a duty to include the omitted fact; or is for payment of property or services that are not provided as claimed.
The $5,000 penalty also applies if a person or company provides written back-up or materials relating to the claim in which the person or company asserts a material fact that is false, fictitious, or fraudulent; or omits a fact that the individual had a duty to include, the omission causes the statement to be false, fictitious, or fraudulent, and the statement contains a certification of accuracy.
In 2009, the Connecticut General Assembly enacted the Connecticut False Claims Act (“CFCA”). The CFCA is very similar to the FCA and prohibits any individual or entity from knowingly presenting or causing to be presented a false or fraudulent claim for payment or approval under the medical assistance programs administered by the Connecticut Department of Social Services or knowingly making or causing to be made a false statement in order to get such a claim approved, or knowingly concealing, avoiding, or decreasing any obligation to pay or transmit money or property to the state. Any individual or entity that violates this prohibition can be subjected to civil monetary penalties of $5,000 to $10,000 per violation as well as up to three times the damages sustained by the state as a result of the false claim.
The CFCA provisions are generally enforced by the Connecticut Attorney General. However, like the FCA, under certain circumstances, the CFCA permits private individuals to initiate civil actions and protects these individuals from workplace retaliation. If any funds are recovered, a portion of the funds may be paid to the person who initiated the formal claim, at the discretion of a court. This amount, if awarded, general is between 15% and 30% of the total damage amount. A legal action under the CFCA cannot be initiated more than six years after the date the violation occurs or more than three years after the date when a state official knew or should have reasonably known the violation, but in no event more than ten years after the date that the violation occurs.
In addition, there are also other Connecticut laws that prohibit fraudulent billing. It is a crime in Connecticut to fraudulently bill Medicaid or general assistance programs. All employees, contractors, and agents of YNHHS must immediately report suspicion of any criminal activity, including criminal fraud, to the System Compliance Operations Officer.
Anyone who provides services to a state Medicaid beneficiary and seeks or accepts payment for unnecessary or improper services is subject to possible imprisonment and/or criminal fines under state law. Depending upon the extent of the fraudulent services involved, such offenses carry potentially significant penalties, with a maximum of 20 years in prison and a maximum fine of $15,000.
Anyone who provides services to a recipient of Connecticut's general assistance program and seeks or accepts payment for unnecessary or improper services is also subject to civil and criminal penalties. Depending upon the amount of the fraudulent services involved, such offenses carry a minimum one-year prison sentence and a maximum of 20 years, as well as a maximum fine of $15,000. Any person who defrauds Connecticut's general assistance program is also excluded from participating in the program for a minimum of one year.
Connecticut law protects employees who report suspected violations of state or federal law, including reports of criminal fraud. An employer may not discharge, discipline, or otherwise penalize an employee for reporting a violation of the law, or suspected violation, as long as the employee does not know the information being reported is false.
Additional other state laws inclusive of New York, New Jersey, Massachusetts and Rhode Island will be reviewed as required for compliance purposes.
YNHHS is dedicated to creating an environment where employees and others feel safe reporting concerns about fraud. YNHHS shall not unlawfully retaliate against individuals who: lawfully attempt to stop fraudulent billing practices or violations of the FCA, CFCA, or any other federal or state law or regulation regarding false or fraudulent claims; report information about false claims or suspected false claims that are submitted by YNHHS; or assist in any investigation, provides testimony, or participate in the government’s handling of a false claim investigation.
Relevant Connecticut Laws and Regulations
Connecticut General Statutes § 4-61dd (Whistle blowing)
Connecticut General Statutes § 17b-25a (Toll Free Vendor Fraud Telephone Hotline)
Connecticut General Statutes § 17b-99 (Vendor Fraud)
Connecticut General Statutes § 17b-102 (Financial Incentive for Reporting Vendor Fraud)
Connecticut General Statutes § 17b-127 (General Assistance Fraud)
Connecticut General Statutes § 17b-301a et seq. (Connecticut False Claims Act)
Connecticut General Statutes § 31-51m (Protection of Employee Who Discloses Employer's
Illegal Activities or Unethical Practices)
Connecticut General Statutes § 31-51q (Liability of Employer for Discipline or Discharge of
Employee on Account of Employee's Exercise of Certain Constitutional Rights) Connecticut
General Statutes § 53-440 et seq. (Health Insurance Fraud) Connecticut General Statutes § 53a118 et seq. (Larceny)
Connecticut General Statutes § 53a-155 (Tampering with or Fabricating Physical Evidence)
Connecticut General Statutes § 53a-157b (False Statement Intending to Mislead Public
Connecticut General Statutes § 53a-290 et seq. (Vendor Fraud)
Regulations of Connecticut State Agencies § 4-61dd-1 et seq. (Rules of Practice for
Contested Case Proceedings under the Whistleblower Protection Act)
Regulations of Connecticut State Agencies § 17-83k-1 et seq. (Administrative Sanctions)
Regulations of Connecticut State Agencies § 17b-102-01 et seq. (Financial Incentive for
Reporting Vendor Fraud and Requirements for Payment for Reporting Vendor Fraud)
Relevant New York State Laws and Regulations
New York State Finance Law §§187-194
New York State Social Services Law, Title 1 §145b (False Statements)
Relevant Massachusetts Laws and Regulations
MassHealth Regulation 130 CMR 450.205(F) (1)
MassHealth Regulation 130 CMR 450.223(C) (7)
Federal Law Cross References
Section 6032 of the Deficit Reduction Act of 2005
31 U.S.C. §§ 3729-3733 (Federal False Claims Act)
31 U.S.C. §§ 3801-3812 (Administrative Remedies for False Claims and Statements)
Effective date 1/1/2007 | Revised policy approved 6/19/2018
Yale New Haven Health System Supply Chain Management staff is focused on working with vendors to deliver high-quality supplies, services and equipment, at the lowest total cost. Click here to learn more about our vendor policy.
To provide guidelines that give Vendor Representatives an opportunity to conduct business in a manner that does not interfere with the normal operations of Yale New Haven Health Services Corporation and its affiliates (“YNHHS”), to enhance patient care quality and safety, respect for the confidentiality of information and to ensure a cost effective procurement system that complies with YNHHS contractual and ethical policies and standards while fostering an environment of fair competition with vendor access and control.
It is the policy of YNHHS that the conducting of business with vendor representatives be initiated and managed through the locally based facility’s Supply Chain Management personnel and YNHHS Corporate Supply Chain Management Department, with special emphasis on all HIPAA requirements to safeguard the privacy and confidentiality of patient health information.
B. Standard Procedures
1. All Vendor representatives wishing to conduct business at YNNHS facilities must do so through the Supply Chain Management Department, Pharmaceutical Department, Food Services Department or Facilities/Construction Department. Vendors who have been authorized as YNHHS business partners by one of these departments and Supply Chain Management, may conduct business, by appointment, with the respective departments, and in accordance with the policy set forth below. Representatives who attempt to conduct business directly with hospital departments or staff without prior authorization of Supply Chain Management and an appointment will be immediately redirected to the Supply Chain Management Department by the affected department and be considered in breach of this policy.
2. Vendor Representatives are individuals who market products and services to YNHHS facilities. All Vendor representatives must be fully registered and signed in to the “Vendor Mate” vendor management system upon each visit to the hospital. Representatives are not allowed to conduct business at YNHHS without full registration in the Vendor Mate System. When fully registered and upon signing into the system upon each visit, the Vendor representative will then be allowed to print a vendor badge with photo ID, that must be worn visibly on a part of the clothing located above the waist. Those representatives who are witnessed not wearing a badge will be questioned by hospital personnel, advised of the policy and immediately referred to the facility’s Procurement Coordinator or other Supply Chain Management personnel.
3. Vendor representatives are required to adhere to YNHHS policies including but not limited to: HIPAA Policies, The Gifts and Gratuity Policy (CC:R-20), Gifts and Business Courtesies from Vendor Policy (CC:R-35) and the YNHHS Code of Conduct. Pharmaceutical representatives are required to adhere to the YNHHS Pharmaceutical Vendor Policy (Exhibit 1).
4. Vendor representatives will not be allowed to conduct business on YNNHS property after 5:00 pm. unless prior arrangements have been made for such activities such as product fairs/demonstrations, in-service programs, or service / repair work.
5. New products that are introduced will need prior approval / determination of pricing and YNHHS contractual adherence through the Supply Chain Management personnel. The Supply Chain Management Department in collaboration with the requesting department will direct new product introduction through the appropriate hospital and/or Health System committee structure/approval process. Trials for new product will require prior authorization through the completion and approval of the “New Product Request” form. The request and the form must be generated from a Hospital or Health System employee or a physician and may not be completed by a vendor representative. At a minimum, the request form will be signed by the user department as well as a member of the Supply Chain Management department for the respective facility or the Health System. New items introduced that would potentially be used by several departments (such as commodity type products) will require review by each facility’s Product Evaluation Committee before a trial is granted.
C. Violation of Vendor Policy
In the event that a member of the YNHHS staff observes a Vendor or Vendor Representative in violation of policy, the staff member should immediately notify the Supply Chain Management Department. YNHHS reserves the right to investigate any violations and based upon the severity of the violation shall determine disciplinary action and communicate such actions to the system hospitals as needed.
Verbal and/or written warning to the vendor representative and his/her supervisor.
Restriction of all activity and service calls at any YNHHS location for 3 months, 6 months, or 1 year depending on infraction.
Violations committed by any one representative of a given company may result in disciplinary action against any or all representatives of that company.
Repeated Violations by any Vendor or Representative may result in the banning of future visitations by Vendor or a particular Representative for a one year period or indefinitely if warranted.
Guidelines for Pharmaceutical Company Representatives
Definition: Pharmaceutical Company Representative
A Pharmaceutical Company Representative (PCR) shall be defined as a representative of a pharmaceutical company who enters Yale New Haven Health System (YNHHS) to promote the use of products/services which are evaluated and/or purchased by the Department of Pharmacy Services.
Refer to hospital–specific PCR policy for a more detailed guideline.
General Code of Conduct for Pharmaceutical Company Representatives
Any PCR who wishes to access YNHHS facilities and be eligible for business with YNHHS must register in our vendor credentialing and compliance monitoring system (Vendormate).
Upon Vendormate registration, PCR must read and acknowledge acceptance of the YNHHS PCR guidelines as well as any site specific procedures annually.
All PCRs visiting YNHHS must sign in and out at one of the Vendormate Kiosk locations.
PCRs shall display Vendormate-generated identification badges at all times.
The PCR must make an appointment with the secretary or designee of the hospital employee with whom they wish to speak PRIOR to conducting business with that individual.
PCRs may not be present in patient care areas at any time. Approved appointments must be held in a location that does not require travel through a patient care area.
PCRs may not use inter-hospital phones, paging system or inter-hospital mail systems.
P&T and its sub-committee members shall not be specifically targeted by PCRs regarding product information or Committee business items.
Disbursement of Drug Information
PCRs shall first inform the Department of Pharmacy Services of new drugs they wish to discuss at YNHHS.
— Information changes pertaining to medications on formulary (i.e. indications, dosage, routes of administration, formulations, etc.) shall be provided to the Department of Pharmacy Services prior to discussion with other YNHHS personnel.
All pharmaceutical detailing shall be within the context of P&T approved criteria for restricted drugs, as it relates to the specific hospital.
— PCRs shall limit discussions of restricted drugs with those authorized to prescriber as noted in the P&T approved criteria and designated pharmacy staff.
At no time shall PCRs detail non-formulary drugs or indications not included in the YNHHS criteria or specific hospital criteria without approval from the Director of Pharmacy Services or his/her designee.
— Non-formulary categories include the following: drugs not yet reviewed by the P&T Committee, drugs reviewed and denied addition, and off-criteria indications of restricted formulary drugs.
All information and materials distributed at YNHHS must be approved by the Director of Pharmacy Services or his/her designee prior to distribution.
Product package inserts and peer-reviewed journal articles that are not company labeled may be distributed only when attached to the YNHHS Criteria for Use to highlight differences between FDA approved indications and YNHHS approved indications.
PCRs are not permitted to attend or provide educational in-services at YNHHS unless prior approval is obtained by the Director of Pharmacy Services or his/her designee.
PCRs may not post and YNHHS will not advertise industry-sponsored events that are not CME/CE accredited or fail to comply with the Yale School of Medicine Conflict of Interest Policy, Accreditation Council for Continuing Medical Education (ACCME), or Accreditation Council for Pharmacy Education (ACPE) standards.
Violations of PCR guidelines shall be reported to the respective Director of Pharmacy Services.
Based on the severity of the violation, the Director of Pharmacy Services or his/her designee shall determine disciplinary action and communicate to the system hospitals as needed.
The Director of Pharmacy Services shall impose one or more of the following restrictions on an PCR found to be in violation of the guidelines:
— Verbal and/or written warning to the PCR and his/her supervisor.
— Restriction of all activity and service calls at any YNHHS location for 3 months, 6 months, or 1 year depending on infraction.
— Letters to the PCR, his/her supervisor, and to the Vendor Director of the pharmaceutical company stating that the PCR is no longer permitted on the hospital and/or YNHHS premises for a specified time frame.
SC I - 001 Vendor Visitation
To provide guidelines that give Vendor Representatives an opportunity to conduct business in a manner that does not interfere with the normal operations of Yale New Haven Health Services Corporation and its affiliates (ï¿½YNHHSï¿½), to enhance patient care quality and safety, respect for the confidentiality of information and to ensure a cost effective procurement system that complies with YNHHS contractual and ethical policies and standards while fostering an environment of fair competition with vendor access and control.
Policy updated 11/6/2018
To ensure that outstanding balances on patient accounts are pursued fairly and consistently by the Hospital and its agents in a manner consistent with its charitable mission.
"Collection agent" means any person, either employed by or under contract to, the Hospital, who is engaged in the business of collecting payment from consumers for medical services provided by the Hospital, and includes, but is not limited to, attorneys performing debt collection activities.
"FAP" means the Hospital's Financial Assistance Policy.
"FAP-eligible individual" means an individual eligible for financial assistance under the hospital's FAP, without regard to whether the individual has applied for assistance under the FAP.
"Hospital bed fund" or "free bed fund" means a special donation received by the Hospital to subsidize, in whole or in part, the cost of medical care, including inpatient or outpatient care, incurred by patients at the hospital, whose financial circumstances render them unable to pay their hospital bills.
"Patient" means those persons who receive care at the Hospital and the person who is financially responsible for the care of the patient.
"Uninsured patient" means any person who is liable for one or more hospital charges whose income is at or below two hundred fifty percent (250%) of the poverty income guidelines who: (1) has applied and been denied eligibility for any medical or health care coverage provided under the state-administered general assistance program or the Medicaid program due to failure to satisfy income or other eligibility requirements, and (2) is not eligible for coverage for hospital services under the Medicare or CHAMPUS programs, or under any Medicaid or health insurance program of any other nation, state, territory or commonwealth, or under any other governmental or privately sponsored health or accident insurance or benefit program including, but not limited to, workers' compensation and awards, settlements or judgments arising from claims, suits or proceedings involving motor vehicle accidents or alleged negligence.
This policy applies to each licensed hospital affiliated with Yale New Haven Health System (YNHHS), including Bridgeport Hospital, Greenwich Hospital, Westerly Hospital, Lawrence + Memorial Hospital, Yale New Haven Hospital and any other hospital that may affiliate with YNHHS from time to time, Northeast Medical Group and its subsidiaries, Yale New Haven Care Continuum (d/b/a Grimes), and any other providers of health care services owned by or under common control with YNHHS.
It is the Hospital's policy to treat all patients equitably with respect and compassion, from the bedside to the billing office. The Hospital will pursue patient accounts, directly and through its collection agents, fairly and consistently taking into consideration demonstrated financial need. As part of its collection process, the Hospital will make reasonable efforts to determine if an individual is eligible for financial assistance under its FAP. In the event of nonpayment, where based on information in its possession a person is not FAP-eligible individual, the Hospital (and any collection agency or other party to which it has referred debt) may engage in extraordinary collection actions as defined on Attachment I.
General & Limitation on Billing
In accordance with Connecticut law, before a bill is sent to a patient the Hospital will:
determine (based on information in its possession) (i) if the patient is an uninsured patient as defined herein; and (ii) eligibility for free bed funds; and
notify the patient in writing of this insurance determination and the reasons for the determination.
If a patient is determined to be an uninsured patient as defined herein, the patient will be eligible for free care under the Hospital's FAP.
Following a determination of eligibility for financial assistance under the Hospital's FAP, the Hospital will charge all FAP-eligible individuals: (a) for emergency or other medically necessary care, the costs of such care (which the Hospital ensures is no more than amounts generally billed (AGB) to persons who have insurance covering emergency or other medically necessary care), and (b) no more than gross charges for all other care.
Each bill and all collection notice from the Hospital, or any collection agent acting on behalf of the Hospital, must include the YNHHS Summary of Financial Assistance Programs. In addition, at Greenwich Hospital the Availability of Hospital Funds notice must be disseminated in accordance with the Greenwich Hospital Bed Fund Agreement.
Throughout the billing and collections cycle, the Hospital will provide financial counseling to patients about their Hospital bills and respond promptly to patient's questions about their bills and to requests for financial assistance.
Reasonable efforts – Accounts Receivable ("A/R") Collections The Hospital will follow its A/R billing cycle in accordance with internal operational processes and practices. As part of such processes and practices, the Hospital will, at a minimum, notify patients about its FAP from the date care is provided and throughout the A/R billing cycle (or during such period as is required by law, whichever is longer) by posting signs throughout the Hospital, distributing a plain language summary of its FAP in all billing statements, and discussing the FAP with eligible patients.
The Hospital will seek to maintain written contractual relationships with one or more collection agents and attorneys for collection of past due accounts that will require compliance with the standards and scope of collection practices set out in this Policy.
At the end of the Hospital's internal (pre-collection) billing cycle, outstanding balances may be referred to an approved outside collection agent under the following guidelines:
Hospital has billed all third-party payers that may, based on hospital's records, be responsible for paying the claim;
Hospital has provided patient information on how to arrange for a payment plan if the patient cannot afford to pay the entire bill at once and patient has not qualified for, arranged for, or complied with a payment plan;
Hospital has notified patient that it has free bed funds and other free or discounted care for which the patient may be eligible;
(a) No financial assistance application has been completed that establishes the patient's eligibility for hospital bed funds or other financial assistance nor is an application in process, or (b) patient has applied and qualified for partial financial assistance, but has not paid his/her responsible part then the ineligible portion of the account may be referred for collection;
A representative of the Hospital's Finance Department or a Turnover Expeditor concludes, based on the results of an internal review and in accordance with the Hospital's eligibility criteria for its financial assistance programs, that the patient has the financial ability to pay for all or a portion of his or her bill; and
The referral is reviewed and approved by the Credit & Collections staff under the direction of the Manager, Credit & Collections and using criteria & procedures permitted by the Director of Patient Accounts, the VP, Corporate Business Services and/or the Sr. VP, Finance.
If at any point in the debt collection process, the Hospital, including any employee or agent of the Hospital, or a collection agent acting on behalf of the Hospital, receives information that a patient is eligible for hospital bed funds, free or reduced price hospital services, or any other program which would result in the elimination of liability for the debt or reduction in the amount of such liability, the Hospital or collection agent will promptly discontinue collection efforts and, if a collection agent, refer the account back to the Hospital for determination of eligibility. The collection effort will not resume until such determination is made.
The Hospital will annually file a debt collection report with the Office of Health Care Access as required by Connecticut law.
Conn. Gen. Statutes §19a-673 and §19a-673(a) – (d) Internal Revenue Code §501(r)(6) Fair Debt Collection Practices Act Connecticut Not-For-Profit Acute Care Hospital Voluntary Guidelines for Debt Collection AHA – Statement of Principles and Guidelines - Hospital Billing & Collection Practices
Standards & scope of collection practices
Prior approval of extraordinary collection action and reasonable efforts to determine if FAP-eligible individual. The Hospital (and any collection agency or other party to which it has referred debt) shall not engage in any extraordinary collection action ("ECA") before making reasonable efforts to determine if a patient is an FAP-eligible individual, and further must obtain written approval from the Manager of Credit/Collections, prior to the initiation of any ECA, including as set forth below.
ECA Defined:
Commencement of a legal action concerning a referred account
Property Liens & Foreclosures.
Liens on personal residences are permitted only if:
The patient has had an opportunity to apply for free bed funds and has either failed to respond, refused, or been found ineligible for such funds;
The patient has not applied or qualified for other financial assistance under the Hospital's Financial Assistance Policy, including sliding scale discounts to assist in the payment of his/her debt, or has qualified, in part, but has not paid his/her responsible part;
The patient has not attempted to make or agreed to a payment arrangement, or is not complying with payment arrangements that have been agreed to by the Hospital and patient;
The aggregate of account balances is over $1000 and the property(ies) to be made subject to the lien are at least $125,000 in assessed value; and
The lien will not result in a foreclosure on a personal residence. Except in unusual circumstances (e.g. where there is evidence of an ability to pay, multiple homes or properties, or the existence of significant assets), the Hospital will not pursue foreclosures for property liens.
Garnishments of wages are permitted only if:
The patient is not an uninsured patient;
The criteria in (i) – (iii) above under Property Liens are met;
A court determines that the patient's wages are sufficient for garnishment and enters a judgment against the patient; and
The Hospital has notified the patient in writing of the foregoing.
Wage garnishments, if approved, will only apply to account balances over $500. Additionally, any State Marshall fee for administering the wage garnishment will be absorbed by the Hospital as a cost of collection. No interest will accrue on wage garnishments.
Bank Executions.
All bank executions, in addition to pre-approval, require special review by the Hospital for verification that the execution will not cause undue financial hardship on the patient. If this cannot be determined, no bank execution will be ordered.
Writs of Capias.
The Hospital will not pursue and will not initiate a writ of capias (i.e., a petition to have a debtor arrested as a result of a debt collection activity). The Hospital may ask for examinations of patients but the Hospital itself will specifically indicate that the Hospital does not request any writ of capias.
Interest and Court Costs.
Interest will be allowed to accrue on accounts after legal court judgment is received. Interest will accrue at the current statutory rate. The Hospital will not allow interest to accrue greater than 50% of the account balance. If the principal is paid in full, the Hospital will waive payment of interest. Court costs will be assumed by the Hospital as a cost of collections and not charged to the patient.
No accounts or account activity will be directly reported to Credit Bureaus or rating agencies. Credit Bureaus may obtain information from court records.
Policy effective 09/20/2013
Financial Assistance Plan Language Summary and Application (revised 2/12/2019)
Financial Assistance Policy (revised 7/15/2018)
All patients and visitors at Yale New Haven Health and its member organizations have the right to receive information in a language they understand, free of charge. YNHHS complies with the Department of Health and Human Services' Section 1557 rule of the Affordable Care Act — which sets guidelines about language assistance for people with limited English proficiency or those who are deaf or hard-of-hearing — and takes reasonable steps to provide meaningful access to people with limited English proficiency who may require assistance within the health system.
(Policy updated 12/2016)
Northeast Medical Group: 203-502-6527
Lawrence + Memorial Hospital: 860-442-0711, ext. 5032
Westerly Hospital: 860-442-0711, ext. 5032
Greenwich Hospital: Patient and Guest Relations, Greenwich Hospital, 5 Perryridge Road, Greenwich, CT 06830; 203-863-4746; Fax 203-863-4546; GHpatientrelations@ynhh.org.
Westerly Hospital: Patient Relations, Westerly Hospital, 25 Wells Street, Westerly, RI 02891; 860-442-0711, ext. 5032; patientrelations@westerlyhospital.org.
Lawrence + Memorial Hospital: Patient Relations, Lawrence + Memorial Hospital, 365 Montauk Ave., New London, CT 06320; patientrelations@lmhosp.org.
Northeast Medical Group: Patient Relations, 99 Hawley Street, Stratford, CT 06614; 203-502-6527; Fax 203-502-6556; NEMGPatientExperience@ynhh.org.
Policy updated 12/2016