Privacy and protection

Fallon Health Weinberg protects your personal health information. It can only be used for official reasons.

About HIPAA

What is HIPAA?
HIPAA is the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA). While it is a broad and complicated law, it was essentially created to:

  • Protect patients' access to health care coverage when they change jobs
  • Enforce uniform standards for exchanging health information

In addition, it gave the Department of Health and Human Services the authority to mandate the use of certain standards and to specify the types of measures required to protect the privacy and security of personally identifiable health care information.

As a Fallon Health Weinberg-HMO SNP member, what do I need to know about HIPAA?

The HIPAA requirements are there to protect you, the consumer. With respect to health care, HIPAA is meant to simplify communications between health plans and providers—mostly through electronic means. However, you should be aware that HIPAA outlines strict guidelines to ensure the privacy and confidentiality of your PHI (protected health information, such as your name and medical information). These guidelines require that your PHI be used for purposes of treatment, payment and health plan operations, and not for purposes unrelated to health care.

Under HIPAA, Fallon Health Weinberg-HMO SNP must:

  • Provide a Notice of Privacy Practices to all members (the Notice is issued to all new members with their enrollment materials and is also available here: Notice of Privacy Practices).
  • Make sure that every person or company who works with us protects members' information as we do.
  • Carry out privacy training for all employees, whether they deal with member records or not.
  • Have consequences in place if member information is used or shared improperly.
  • Notify you if your personal or protected health information has been breached.

As a family member or caregiver, how does HIPAA impact my relationship with Fallon Health Weinberg-HMO SNP?

In order to provide a complete care package to our members, Fallon Health Weinberg-HMO SNP works closely with caregivers and family members. However, under HIPAA, Fallon Health Weinberg-HMO SNP must ensure that only the member and those with the proper authority are given access to the member’s personal health information.

Therefore, in addition to obtaining any forms of legal authorization for a participant (such as a health care proxy or durable power of attorney), Fallon Health Weinberg-HMO SNP requests that the member designate one or more persons to act as his or her personal representative(s). A personal representative is an individual that may be involved in the participant’s health care, but may not be otherwise expressly authorized to act on the participant’s behalf. Members may designate one or more personal representatives using Fallon Health Weinberg’s Personal Representative Authorization form (pdf).

If you have any questions about who may assist your loved one with their care, please contact Fallon Health Weinberg-HMO SNP at 1-855-561-7247 (TTY 711).

Web privacy policy

This policy explains how we protect your information on our website. Read our Web Privacy Policy

 

 

Fallon Health Weinberg is an HMO plan with a Medicare contract and a coordination of benefits agreement with the New York State Department of Health. Enrollment in Fallon Health Weinberg depends on contract renewal.

H2470_W_2017_7 Approved 10182016
The information on this page was last updated on 10/1/2017.

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Looking for a doctor? Need to see if your current doctor is in our network?

Search online

Download the Provider and Pharmacy Directory (H2470_W_2017_26_r1_NM, pdf)

Contact us

Information before enrolling:
1-855-561-7248 (TTY 711)
8 a.m.–8 p.m., Monday–Friday
(Oct. 1–Feb. 14, seven days a week)

Customer Service:
1-855-561-7247 (TTY 711)
8 a.m.–8 p.m., Monday–Friday
(Oct. 1–Feb. 14, seven days a week)

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Are you looking for a doctor, hospital, pharmacy, or other community service providers?

Find a doctor online ► or
Download the whole Fallon Health Weinberg-HMO SNP Provider and Pharmacy Directory (H2470_W_2017_26_r1_NM, pdf)

Member information

2017 Summary of Benefits (H2470_W_2017_6_r1 Accepted 10152016) ►

2017 Evidence of Coverage (H2470_W_2017_1 Accepted 09122016, pdf) ►

About the Medication Therapy Management Program

Covered medications

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