HIPAA NOTICE OF PRIVACY PRACTICES
Effective Date of this Notice: August 5, 2016
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE
Primary Care Nursing Services, Inc. (Agency)
If you have any questions about this notice, please contact the person listed under “WHOM TO CONTACT” at the end of this Notice.
This notice describes our privacy practices and is intended to inform you of the ways we may use your information and the occasions on which we may disclose your information to others.
WHO MUST ABIDE BY THIS NOTICE
OUR RIGHT TO CHANGE THIS NOTICE
· We are required by law to make sure that medical information that identifies you is kept private and secure;
· We are required to give this notice of our legal duties and privacy practices with respect to protected health information to anyone who asks for it;
· We are required to follow the terms of the notice that is currently in effect.
· We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information
· We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
PERMITTED USE AND DISCLOSURE OF YOUR PROTECTED HEALTH
1. Treatment. We may use medical information about you to provide you with medical treatment or services. We may disclose medical information about you to our personnel who are involved in taking care of you. We also may disclose medical information about you to people outside of the Agency who may be involved in your medical care if we believe it is in your best interest, including family members, friends, pharmacists, suppliers of medical equipment or other health care professionals.
2. Payment. We may use and disclose medical information about you so that the treatment and services you receive may be billed to and payment may be collected from you, an insurance company or a third party. For example, we may need to give your treatment information to your health plan so they will pay us or reimburse you for the treatment.
3. Health Care Operations. We may use and disclose medical information about you for our own operations in order to make sure that all of our patients receive quality care. For example, we may use medical information to review our treatment and services and to evaluate the performance of our staff in caring for you. We may also combine medical information about many patients to decide what additional services we should offer, what services are not needed, and whether certain new treatments are effective. We may also disclosure information to other personnel for review and learning purposes. We may also combine the medical information we have with medical information from health care facilities to compare how we are doing and see where we can make improvements in the care and service we offer. We may remove information that identifies you from this set of medical information so others may use it to study health care and health care delivery without learning who the specific patients are.
4. Appointment Reminders. We may use and disclose medical information to contact you as a reminder that you have an appointment for a home visit.
5. Treatment Alternatives. We may use and disclose medical information to tell you about or recommend possible treatment options or alternatives that may be of interest to you.
6. Health-Related Benefits and Services. We may use and disclose medical information to tell you about health-related benefits or services that may be of interest to you.
7. Fundraising Activities. We may use medical information about you to contact you in an effort to raise money for the Agency and its operations. We may disclose medical information to a related Agency foundation. We only would release contact information, such as your name, address and phone number and the dates you received treatment or services. If you do not want to be contacted for fundraising efforts, you must notify the person identified under “WHOM TO CONTACT” at the end of this Notice.
8. Family and Friends. We may release medical information about you to a friend or family member who is involved in your medical care if we believe it is in your best interest. We may also give information to someone who helps pay for your care.
9. Required by Law. We will disclose medical information about you when required to do so by federal, state or local law. This includes reporting information to government agencies that have the legal responsibility to monitor the health care system.
10. To Avert a Serious Threat. We may use and disclose medical information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat.
11. Specialized Government Purposes. We may use or disclose protected health information of members of the armed forces as authorized by military command authorities. We may also release protected health information for national security, intelligence, and protection of the President.
12. Workers’ Compensation. We may release medical information about you for workers’ compensation benefit determination or similar programs.
13. Public Health Risks. We may disclose protected health information when required to do so for public health purposes, including reporting certain diseases, births, deaths, and reactions to certain medications. It also may include notifying people of recalls of products they may be using, notifying people who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition.
14. To Report Abuse. The Agency is permitted to notify government authorities if the Agency believes a patient is the victim of abuse, neglect or domestic violence. We will only make this disclosure when required or authorized by law or if you agree.
15. Government Oversight. We may disclose medical information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.
16. Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may disclose medical information about you in response to a court or administrative order. We may also disclose medical information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.
17. Law Enforcement. We may release medical information for law enforcement purposes. For example, we may provide information to help identify or locate a suspect, fugitive, material witness, or missing person, or in connection with a suspected criminal activity. We must also disclose your protected health information to a federal agency investigating our compliance with federal privacy laws and regulations.
18. Coroners and Medical Examiners. We may release medical information to a coroner, medical examiner, and/or funeral directors for purposes of identifying a deceased person, to determine the cause of death, or as authorized by law.
19. Organ Donation. The Agency may use or disclose your health information for cadaveric organ, eye or tissue donation.
MORE STRINGENT LAW
1. Request Restrictions. You have the right to request restrictions on certain uses and disclosures of your protected health information. You have the right to request a limit on the Agency’s disclosure to someone who is involved in your treatment, payment or health care operations. However, we are not required to agree to your request and we may say “no” if it would affect your care If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information. Your request must describe in detail the restrictions you are requesting. You have the right to instruct us as to whether to share your protected health information in a disaster relief situation. If you are not able to tell us your preference, we may go ahead and share your information if we believe it is in your best interest.
2. Request Confidential Communications. You have the right to reasonably request that we communicate with you in a certain way. For example, you can ask that we only contact you at work or by mail. We will agree to any reasonable request. You must make your request in writing signed by you. Your request must specify how or where you wish to be contacted and your request should be sent to us at the address under “WHOM TO CONTACT” at the end of this notice.
3. Inspect and Copy. You have the right to inspect and copy or to obtain an electronic copy of your protected health information, including medical and billing records but not psychotherapy notes. A request to inspect and copy should be in writing signed by you or your representative and submitted to us at the address under “WHOM TO CONTACT” at the end of this notice. We may charge a reasonable fee for the costs of copying, mailing or other supplies associated with your request. We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to protected health information, we will give you the reason in writing and explain how you may appeal the decision.
4. Amend Protected Health Information. If you feel that protected health information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept us. A request to amend should be in writing signed by you or your representative, give us the reason why you believe the information is not correct or complete, and submitted to us at the address under “WHOM TO CONTACT” at the end of this notice. We may deny your request for an amendment for various reasons, but will tell you why in writing. For example, if it was not created by us, is not part of the records we use to make decisions about your care, is not part of the information which you would be permitted to inspect and copy, or is accurate and complete.
5. Accounting of Disclosures. You have the right to request an “accounting of disclosures.” This is a list of the disclosures we made of your protected health information about you and the reasons for such disclosures. We will include all disclosures except for those about treatment, payment and health care operations and certain other disclosures (such as any you asked us to make). The first list you request within a 12 month period will be free. For additional lists, we may charge you for the reasonable costs of providing the list. A request for an accounting of disclosures must be in writing, signed by you or your representative, specify the time period for the accounting which must start on or after April 14, 2003 and not be longer than 6 six years, and be submitted to us at the address of the Privacy Officer as listed below.
6. Paper Copy of This Notice. You or your representative have the right to a paper copy of this notice. If you have received this notice electronically, you may request a paper copy of this notice by contacting the person listed under “WHOM TO CONTACT” at the end of this notice.
7. Choose Someone to Act for You. If you have given someone medical power of attorney of if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will confirm the person has this authority and can act for you before we take any action.
8. Authorization. We may use or disclose your protected health information for any purpose listed in this notice without your written authorization. Other uses and disclosures of medical information not covered by this notice or the laws that apply to us will be made only with your written permission. . For example, we will get your authorization:
· for marketing purposes,
· for purposes related to the sale of your protected health information,
· for most sharing of psychotherapy notes, and
· for other reasons as required by law.
If you authorize us to use or disclose your protected health information, you may revoke your authorization, in writing, at any time. For information about how to authorize us to use or disclose your protected health information, or about how to revoke an authorization, contact the person listed under “WHOM TO CONTACT” at the end of this notice. Once your revoke your authorization, we will no longer use or disclose your protected health information for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you or as required by law.
9. Complaints. If you believe your privacy rights have been violated, you may file a complaint with the person listed under “WHOM TO CONTACT” at the end of this notice. You may also file a complaint with the Secretary of the U.S. Department of Health and Human Services. All complaints must be submitted in writing, describe the situation giving rise to the complaint and be filed within 180 days of the date you know or should have known of the event giving rise to the complaint. You will not be retaliated against in any way for filing a complaint.
WHOM TO CONTACT
Contact the person listed below:
· For more information about this notice, or
· For more information about our privacy policies, or
· If you want to exercise any of your rights, as listed in this notice, or
· If you want to request a copy of our current notice of privacy practices.
3140 Lilly- Mar Ct.
Dublin, Ohio 43017
Copies of this notice are also available by sending an e-mail
For more information, see www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.