HIPPA
Privacy Practices
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. FOR PURPOSES
OF THIS NOTICE, THE USE OF “YOU” OR “YOUR” IS INTENTED TO RELATE BOTH TO YOU AND YOUR
CHILD OR OTHER MINOR PATIENT UNDER YOUR GUARDIANSHIP.
This Notice of Privacy Practices describes how we may use and disclose your protected health information to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. “Protected health information” is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services.
We are required to abide by the terms of this Notice of Privacy Practices. We may change the terms of our notice, at any time. The new notice will be effective for all protected health information that we maintain at that time. Upon your request, we will provide you with any revised Notice of Privacy Practices. You may request a revised version by accessing our website, or calling the office and requesting that a revised copy be sent to you in the mail or asking for one at the time of your next appointment.
1. Uses and Disclosures of Protected Health Information
Your protected health information may be used and disclosed by your physician, our office staff and others outside of our office who are involved in your care and treatment for the purpose of providing health care services to you. Your protected health information may also be used and disclosed to pay your health care bills and to support the operation of your physician’s practice.
Following are examples of the types of uses and disclosures of your protected health information that your physician’s office is permitted to make. These examples are not meant to be exhaustive, but to describe the types of uses and disclosures that may be made by our office.
Treatment: We will use and disclose your protected health information to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with another provider. For example, we would disclose your protected health information, as necessary, to a home health agency that provides care to you. We will also disclose protected health information to other physicians who may be treating you. For example, your protected health information may be provided to a physician to whom you have been referred to ensure that the physician has the necessary information to diagnose or treat you. In addition, we may disclose your protected health information from time-to-time to another physician or health care provider (e.g., a specialist or laboratory) who, at the request of your physician, becomes involved in your care by providing assistance with your health care diagnosis or treatment to your physician.
Payment: Your protected health information will be used and disclosed, as needed, to obtain payment for your health care services provided by us or by another provider. This may include certain activities that your health insurance plan may undertake before it approves or pays for the health care services we recommend for you such as: making a determination of eligibility or coverage for insurance benefits, reviewing services provided to you for medical necessity, and undertaking utilization review activities. For example, obtaining approval for a hospital stay may require that your relevant protected health information be disclosed to the health plan to obtain approval for the hospital admission.
Health Care Operations: We may use or disclose, as needed, your protected health information in order to support the business activities of your physician’s practice. These activities include, but are not limited to, quality assessment activities, employee review activities, training of medical students, licensing, fundraising activities, and conducting or arranging for other business activities.
We will share your protected health information with third party “business associates” that perform various activities (for example, billing or transcription services) for our practice. Whenever an arrangement between our office and a business associate involves the use or disclosure of your protected health information, we will have a written contract that contains terms that will protect the privacy of your protected health information.
We may use or disclose your protected health information, as necessary, to provide you with information about treatment alternatives or other health-related benefits and services that may be of interest to you. You may contact our Privacy Officer to request that these materials not be sent to you.
Other Permitted and Required Uses and Disclosures That May Be Made Without Your Authorization or Opportunity to Agree or Object.
We may use or disclose your protected health information in the following situations without your authorization or providing you the opportunity to agree or object. These situations include:
Required By Law: We may use or disclose your protected health information to the extent that the use or disclosure is required by law. The use or disclosure will be made in compliance with the law and will be limited to the relevant requirements of the law. You will be notified, if required by law, of any such uses or disclosures.
Public Health: We may disclose your protected health information for public health activities and purposes to a public health authority that is permitted by law to collect or receive the information. For example, a disclosure may be made for the purpose of preventing or controlling disease, injury or disability.
Communicable Diseases: We may disclose your protected health information, if authorized by law, to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading the disease or condition.
Health Oversight: We may disclose protected health information to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections. Oversight agencies seeking this information include government agencies that oversee the health care system, government benefit programs, other government regulatory programs and civil rights laws.
Abuse or Neglect: We may disclose your protected health information to a public health authority that is authorized by law to receive reports of child abuse or neglect. In addition, we may disclose your protected health information if we believe that you have been a victim of abuse, neglect or domestic violence to the governmental entity or agency authorized to receive such information. In this case, the disclosure will be made consistent with the requirements of applicable federal and state laws.
Food and Drug Administration: We may disclose your protected health information to a person or company required by the Food and Drug Administration for the purpose of quality, safety, or effectiveness of FDA-regulated products or activities including, to report adverse events, product defects or problems, biologic product deviations, to track products; to enable product recalls; to make repairs or replacements, or to conduct post marketing surveillance, as required.
Legal Proceedings: We may disclose protected health information in the course of any judicial or administrative proceeding, in response to an order of a court or administrative tribunal (to the extent such disclosure is expressly authorized), or in certain conditions in response to a subpoena, discovery request or other lawful process.
Law Enforcement: We may also disclose protected health information, so long as applicable legal requirements are met, for law enforcement purposes. These law enforcement purposes include (1) legal processes and otherwise required by law, (2) limited information requests for identification and location purposes, (3) pertaining to victims of a crime, (4) suspicion that death has occurred as a result of criminal conduct, (5) in the event that a crime occurs on the premises of our practice, and (6) medical emergency (not on our practice’s premises) and it is likely that a crime has occurred.
Coroners, Funeral Directors, and Organ Donation: We may disclose protected health information to a coroner or medical examiner for identification purposes, determining cause of death or for the coroner or medical examiner to perform other duties authorized by law. We may also disclose protected health information to a funeral director, as authorized by law, in order to permit the funeral director to carry out their duties. We may disclose such information in reasonable anticipation of death. Protected health information may be used and disclosed for cadaveric organ, eye or tissue donation purposes.
Research: We may disclose your protected health information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your protected health information.
Criminal Activity: Consistent with applicable federal and state laws, we may disclose your protected health information, if we believe that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public. We may also disclose protected health information if it is necessary for law enforcement authorities to identify or apprehend an individual.
Military Activity and National Security: When the appropriate conditions apply, we may use or disclose protected health information of individuals who are Armed Forces personnel (1) for activities deemed necessary by appropriate military command authorities; (2) for the purpose of a determination by the Department of Veterans Affairs of your eligibility for benefits, or (3) to foreign military authority if you are a member of that foreign military services. We may also disclose your protected health information to authorized federal officials for conducting national security and intelligence activities, including for the provision of protective services to the President or others legally authorized.
Workers’ Compensation: We may disclose your protected health information as authorized to comply with workers’ compensation laws and other similar legally-established programs.
Inmates: We may use or disclose your protected health information if you are an inmate of a correctional facility and your physician created or received your protected health information in the course of providing care to you.
Uses and Disclosures of Protected Health Information Based upon Your
Written Authorization: Other uses and disclosures of your protected health information will be made only with your written authorization, unless otherwise permitted or required by law as described below. You may revoke this authorization in writing at any time. If you revoke your authorization, we will no longer use or disclose your protected health information for the reasons covered by your written authorization. Please understand that we are unable to take back any disclosures already made with your authorization.
Other Permitted and Required Uses and Disclosures That Require Providing You the Opportunity to Agree or Object:
We may use and disclose your protected health information in the following instances. You have the opportunity to agree or object to the use or disclosure of all or part of your protected health information. If you are not present or able to agree or object to the use or disclosure of the protected health information, then your physician may, using professional judgment, determine whether the disclosure is in your best interest.
Facility Directories: Unless you object, we will use and disclose in our facility directory your name, the location at which you are receiving care, your general condition (such as fair or stable), and your religious affiliation. All of this information, except religious affiliation, will be disclosed to people that ask for you by name. Your religious affiliation will be only given to a member of the clergy, such as a priest or rabbi.
Others Involved in Your Health Care or Payment for your Care: Unless you object, we may disclose to a member of your family, a relative, a close friend or any other person you identify, your protected health information that directly relates to that person’s involvement in your health care. If you are unable to agree or object to such a disclosure, we may disclose such information as necessary if we determine that it is in your best interest based on our professional judgment. We may use or disclose protected health information to notify or assist in notifying a family member, personal representative or any other person that is responsible for your care of your location, general condition or death. Finally, we may use or disclose your protected health information to an authorized public or private entity to assist in disaster relief efforts and to coordinate uses and disclosures to family or other individuals involved in your health care.
2. Your Rights
Following is a statement of your rights with respect to your protected health information and a brief description of how you may exercise these rights.
You have the right to inspect and copy your protected health information. This means you may inspect and obtain a copy of protected health information about you for so long as we maintain the protected health information. You may obtain your medical record that contains medical and billing records and any other records that your physician and the practice uses for making decisions about you. As permitted by federal or state law, we may charge you a reasonable copy fee for a copy of your records.
Under federal law, however, you may not inspect or copy the following records: psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding; and laboratory results that are subject to law that prohibits access to protected health information. Depending on the circumstances, a decision to deny access may be reviewable. In some circumstances, you may have a right to have this decision reviewed. Please contact our Privacy Officer if you have questions about access to your medical record.
You have the right to request a restriction of your protected health information. This means you may ask us not to use or disclose any part of your protected health information for the purposes of treatment, payment or health care operations. You may also request that any part of your protected health information not be disclosed to family members or friends who may be involved in your care or for notification purposes as described in this Notice of Privacy Practices. Your request must state the specific restriction requested and to whom you want the restriction to apply.
Your physician is not required to agree to a restriction that you may request. If your physician does agree to the requested restriction, we may not use or disclose your protected health information in violation of that restriction unless it is needed to provide emergency treatment. With this in mind, please discuss any restriction you wish to request with your physician.
You have the right to request to receive confidential communications from us by alternative means or at an alternative location. We will accommodate reasonable requests. We may also condition this accommodation by asking you for information as to how payment will be handled or specification of an alternative address or other method of contact. We will not request an explanation from you as to the basis for the request. Please make this request in writing to our Privacy Officer.
You may have the right to have your physician amend your protected health information. This means you may request an amendment of protected health information about you in a designated record set for so long as we maintain this information. In certain cases, we may deny your request for an amendment. If we deny your request for amendment, you have the right to file a statement of disagreement with us and we may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal. Please contact our Privacy Officer if you have questions about amending your medical record.
You have the right to receive an accounting of certain disclosures we have made, if any, of your protected health information. This right applies to disclosures for purposes other than treatment, payment or health care operations as described in this Notice of Privacy Practices. It excludes disclosures we may have made to you if you authorized us to make the disclosure, for a facility directory, to family members or friends involved in your care, or for notification purposes, for national security or intelligence, to law enforcement (as provided in the privacy rule) or correctional facilities, as part of a limited data set disclosure.
You have the right to receive specific information regarding these disclosures that occur after April 14, 2003. The right to receive this information is subject to certain exceptions, restrictions and limitations.
You have the right to obtain a paper copy of this notice from us, upon request, even if you have agreed to accept this notice electronically.
3. Complaints
You may complain to us or to the Secretary of Health and Human Services if you believe your privacy rights have been violated by us. You may file a complaint with us by notifying our Privacy Officer of your complaint. We will not retaliate against you for filing a complaint.
You may contact your doctor if you have any other questions about privacy practices.
Home Care Pediatrics
Notice of Privacy Practices
This notice describes how medical information about your child may be used and disclosed and how you can get access to this information. Please review it carefully.
Protected health information (PHI)
PHI refers to any patient information relating to treatment, diagnosis or payment that identifies a person.
PHI Uses and disclosures
Uses and disclosures of your child’s PHI may be permitted, required or authorized. Home Care Pediatrics uses PHI when employees within the organization share, examine or analyze a patient's medical information.
Home Care Pediatrics discloses PHI upon release, transfer or granting of access of PHI to other external persons or facilities.
Except for the following circumstances, Home Care Pediatrics will not release your child’s PHI without your written authorization:
Payment
Your child’s PHI will be used and/or disclosed, as needed, to help obtain payment for your child’s services. These uses are often required to obtain payment from third parties such as your child’s insurance company.
Many services require prior authorization from the insurance company, and your child’s PHI may be disclosed to obtain insurance authorization for such services before they are rendered.
Health Care Operations
Your child’s PHI may be used and/or disclosed, as needed, to aid in the everyday administration of Home Care Pediatrics.
In order to provide your child with quality care, Home Care Pediatrics may use your child’s PHI for quality control reviews, internal investigations, performance reviews, patient safety activities, training of new employees, and for other health-related activities as defined by 45 CFR 164.50. Home Care Pediatrics may also use and/or disclose your child’s PHI to provide information to you.
Treatment
Home Care Pediatrics will use and/or disclose your child’s PHI to provide medical services, coordinate medical care, and/or help manage your child’s health care and other medical services. Home Care Pediatrics may also disclose PHI to external persons or facilities that will be involved in your child’s medical care. We may also provide your physician or a subsequent healthcare provider with copies of various reports that should assist him or her in treating your child once your child is discharged from this facility.
Continuation of Treatment
Home Care Pediatrics may use and/or disclose your child’s PHI to ensure continuation of care by checking on your child’s progress or notifying you of received test results.
Treatment Options
Home Care Pediatrics may use and/or disclose your child’s PHI to inform you of various treatment options or programs that may be of benefit to your child’s care.
Business Associates
Certain aspects and components of our services may be performed through contracts with outside persons or organizations, such as auditing, billing, legal services, etc.
At times, it may be necessary for us to provide your child’s PHI to one or more of these outside persons or organizations who assist us with our Health Care Operations.
These uses or disclosures will only occur after performing due diligence to ensure that the business associate is meeting all statutory and contractual requirements.
Other permitted / required uses and disclosures
Home Care Pediatrics may use and/or disclose your child’s PHI in the following situations without your authorization:
The Department of Health, to report communicable diseases, traumatic injuries, or birth defects, or for vital statistics, such as a baby’s birth.
State authorities, to report child abuse.
The appropriate governmental agency, if an injury or unexpected death occurs.
Law enforcement, for certain types of crime-related injuries
Certain governmental inspectors
A medical device’s manufacturer, as required by the FDA.
Court officers, as required by law, in response to a court order or a valid subpoena.
Governmental authorities, to prevent serious threats to the public’s health or safety.
Governmental agencies and other affected parties, to report a breach of health-information privacy.
A worker’s compensation program, if a person is injured at work and claims benefits under that program.
As otherwise required by federal, state, or local law
Home Care Pediatrics may use and/or disclose your child’s PHI with your authorization in certain situations. You have the opportunity to authorize or object to the use and/or disclosure of all, or part, of your child’s PHI in the following situations:
Emergencies
If an emergent situation exists where it is impossible to obtain your consent for PHI uses and/or disclosures, Home Care Pediatrics will make every effort to obtain consent once the emergent situation is resolved.
Deceased Individuals
Home Care Pediatrics may disclose a decedent's PHI related to the recent illness and care to family members and others who were involved in the care or payment for the decedent prior to death, unless doing so is inconsistent with any prior express preference of the individual that is known to the covered entity.
Your Authorizations
Other uses or disclosures of your child’s PHI will be made only with your written authorization, unless otherwise permitted or required by law. For example, in most cases, we will obtain your authorization before we disclose psychotherapy notes related to your child. We will never sell your child’s PHI unless you have authorized us to do so.
If you authorize Home Care Pediatrics to use or disclose PHI about your child, you may revoke that permission in writing at any time and we will no longer use or disclose PHI about your child for the reasons covered by your authorization.
Please understand that we are unable to take back any uses or disclosures we have already made with your permission and that we are required to retain our records of the medical treatment or other services we have provided to you.
Your Health Information Rights
You may:
Inspect and obtain a copy of your child’s medical or billing records (including an electronic copy if we maintain the records electronically), as allowed by law, usually within 30 days of your written request.
Request and receive a paper copy of our current Notice of Privacy Practices.
Require us to communicate with you using an alternate address or phone number.
Require that we not send information about a healthcare service or related item to your child’s health plan.
Request in writing that restrictions be placed on how your child’s health information is used or shared for treatment or other purposes.
Request an accounting of when your child’s identifiable health information is shared outside of Home Care Pediatrics for a purpose other than treatment or payment.
Receive notice if we or our business associates have breached the confidentiality of your child’s health information, which will include information regarding the actions Home Care Pediatrics has undertaken to minimize any impact such breach may or could have on your child and/or your child’s information.
Report a privacy concern and be assured that we will investigate your concern thoroughly, support you appropriately, and not retaliate against you in any way. You may also send a written complaint directly to the Department of Health and Human Services (HHS) by using its Health Information Privacy Complaint Package. If you have questions regarding how to file a complaint with HHS you may contact the agency via email at OCRM@hhs.gov or visit the HHS website at www.hhs.gov.
Request in writing that your child’s health information be amended if you think there is an error.
Changes To This Notice
We reserve the right to change this notice and the revised or changed notice will be effective for information we already have about your child as well as any information we receive in the future. The current notice will be posted on our website.