IN ACCORDANCE WITH THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT, ALL EMPLOYEES, BUSINESS ASSOCIATES AND CONTRACTORS OF THE COMPANY SHALL COMPLY WITH THE FOLLOWING PRIVACY PRACTICES RELATING TO PERSONS SUPPLYING PERSONAL HEALTH INFORMATION
NOTICE OF PRIVACY PRACTICES
OF
Center For Physical Rehabilitation, LLC
This notice describes how medical information may be used and disclosed and how access to this information shall be controlled. Please review it carefully. If you have any questions about this Notice, please contact the President, our Privacy Contact at (208) 734-5313
This Notice of Privacy Practices describes how Center For Physical Rehabilitation, LLC (the “Company”) may use and disclose protected health information. It also describes rights to access and control of protected health information. "Protected health information" is information about a person, including demographic information, that may identify a person and that relates to their past, present or future physical or mental health or condition and related health care services. The Company, its employees, business associates and contractors 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. Copies of any revised Notice of Privacy Practices will be made available as appropriate.
1. Uses and Disclosures of Protected Health Information
The following are some of the ways we may use or disclose protected health information. These examples are not meant to be exhaustive, but to describe the types of uses and disclosures that may be made by our office. For many of these uses prior authorization is not required (such as uses for treatment, payment and health care operations). To the extent a use or disclosure requires prior written authorization from an individual, the individual may revoke this authorization, at any time, in writing, except to the extent that we have already taken an action in reliance on the use or disclosure indicated in the authorization.
Treatment: We will use and disclose protected health information to provide, coordinate, or manage an individual’s health care and any related services. This includes the coordination or management of an individual’s health care with a third party. For example, protected health information may be provided to a physician to whom an individual has been referred to ensure that the physician has the necessary information to diagnose or treat them. In addition, we may disclose protected health information from time to time to a physician or another health care provider who, at the request of an individual’s physician, becomes involved in the individual’s health care by providing assistance with health care diagnosis or treatment to the individual’s physician.
Payment: Protected health information will be used, as needed, to obtain payment for health care services. This may include certain activities that an individual’s health insurance plan may undertake before it approves or pays for the health care services we recommend for that individual, such as: making a determination of eligibility or coverage for insurance benefits, reviewing services provided for medical necessity, and undertaking utilization review activities. For example, obtaining approval for a treatment or supply may require that relevant protected health information be disclosed to the health plan to obtain approval for the covering it.
Health Care Operations: We may use or disclose, as needed, protected health information in order to support the business activities of our practice. These activities include, but are not limited to, quality assessment activities, employee review activities, training of therapy students, licensing, marketing and fundraising activities, and conducting or arranging for other business activities. For example, we may disclose protected health information to therapy school students that see patients at our office. We may call an individual by name in the waiting room when their therapist is ready to see them. We may use or disclose protected health information, as necessary, to contact an individual to remind them of their appointment. We will also share protected health information with third party "business associates" that perform various activities (e.g., billing, transcription services) for our business. Whenever an arrangement between our office and a business associate involves the use or disclosure of protected health information, we will have a written contract that contains terms that will protect the privacy of protected health information.
We may use or disclose protected health information, as necessary, to provide an individual with information about treatment alternatives or other health-related benefits and services that may be of interest to them. We may also use and disclose protected health information for other marketing activities, which will generally require a prior written authorization from the individual. However, to the extent a communication to an individual is about the following, it is not considered marketing, and does not require prior authorization: (i) communications about participating providers and health plans in a network, the services we offer or the benefits covered by a health plan; (ii) the individual’s treatment; or (iii) case management or care coordination for the individual, directions or recommendations for alternative treatments, therapies, health care provides, or setting of care. All other marketing communications and disclosures require prior written authorization except when (i) the communication occurs in a face-to-face encounter between us and the individual, or (ii) the communication involves a promotional gift of nominal value. The following are examples of permitted marketing without prior authorization: an individual’s name and address may be used to send them a newsletter about our practice and the services we offer; and we may send an individual information about products or services that we believe may be beneficial to them. An individual may contact our Privacy Contact at any time to request that these marketing materials not be sent to them. We may also use or disclose demographic information and the dates that an individual received treatment from a physician, as necessary, in order to contact them for fundraising activities supported by our office. If an individual does not want to receive fundraising materials, they may contact our Privacy Contact to request that these materials not be sent to them. To the extent any marketing or fundraising activities will use or disclose to others information as to diagnosis, the nature of services received, treatment or disclosure of the place where services were received (to the extent such disclosure would identify the type of treatment or condition), we are required to first obtain prior written authorization to use or disclose this information.
Required By Law: We may use or disclose protected health information to the extent that the use or disclosure is required by law. An individual will be notified, as required by law, of any such uses or disclosures.
Public Health: We may disclose 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. The disclosure will be made for the purpose of controlling disease, injury or disability. We may also disclose protected health information, if directed by public health authority, to a foreign government agency that is collaborating with the public health authority.
Communicable Diseases: We may disclose 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 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 protected health information if we believe that an individual has 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 protected health information to a person or company required by the Food and Drug Administration to report adverse events, product defects or problems, biologic product deviations, track products; to enable product recalls, to make repairs or replacements; or to conduct post-marketing surveillance, as required.
Law Enforcement and Legal Proceedings: We may disclose protected health information, so long as applicable legal requirements are met, for the following purposes: (1) to identify or locate a suspect, fugitive, material witness or missing person; (2) to extent it is information about a victim of a crime, if, under certain limited circumstances, we are unable to obtain the person’s agreement; (3) to the extent the information is about a death we believe may be the result of criminal conduct; (4) in the event that a crime occurs on the premises of the practice, (5) in a medical emergency to report a crime, the location of a crime or victims, or the identity, description or location of the person who committed the crime; and (6) 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, or in certain conditions in response to a subpoena, discovery request or other lawful process.
Research: We may disclose 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 the protected health information.
To Avert a Serious Threat to Health or Safety: Consistent with applicable federal and state laws, we may disclose 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.
National Security and Intelligence Actions: We may release medical information about an individual to authorized federal officials for intelligence, counter-intelligence and other national security activities authorized by law.
Workers' Compensation: Protected health information may be disclosed by us as authorized to comply with worker's compensation laws and other similar legally established programs.
Inmates: We may use or disclose protected health information if an individual is an inmate of a correctional facility and their therapist created or received the protected health information in the course of providing care to them.
Special Situations
Others Involved in Your Health Care: Unless an individual objects, we may disclose to a member of his or her family, a relative, a close friend or any other person the individual identifies, protected health information that directly relates to that person's involvement in the individual’s health care. If the individual is unable to agree or object to such a disclosure, we may disclose such information as necessary if we determine that it is in his or her 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 the individual’s care of the individual’s location, general condition or death. Finally, we may use or disclose 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 an individual’s health care.
Communication Barriers: We may use and disclose protected health information if we attempt to obtain consent from an individual but are unable to do so due to substantial communication barriers, and we determine, using professional judgment, that the individual intends to consent to use or disclosure under the circumstances.
2. Individual Rights
An individual has the right to inspect and copy protected health information. This means the individual may inspect and obtain a copy of protected health information about himself or herself that is contained in a designated record set for as long as we maintain the protected health information. A "designated record set" contains medical and billing records and any other records that the Company uses for making decisions about the individual. If the individual requests a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies associated with the request.
Under federal law, however, an individual 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 protected health information that is subject to law that prohibits access to protected health information. Depending on the circumstances, a decision to deny access may be reviewable. If an individual is denied access to his or her protected health information, he or she may request that the denial be reviewed.
An individual has the right to request a restriction of protected health information. This means an individual may ask us not to use or disclose any part of his or her protected health information for the purposes of treatment, payment or health care operations. The individual may also request that any part of his or her protected health information not be disclosed to family members or friends who may be involved in the individual’s care or for notification purposes as described in this Notice of Privacy Practices. The request must be made in writing to the Privacy Contact and must state the specific restriction requested and to whom the individual wants the restriction to apply. We are not required to agree to a restriction that is requested.
An individual has the right to request to receive confidential communications from us by alternative means or at an alternative location. The request must be made in writing to the Privacy Contact and must specify how or where the individual wishes to be contacted. We will accommodate reasonable requests.
An individual may request an amendment of protected health information. If an individual reviews his or her protected health information and believes it is in error or incomplete, the individual may make a written request to amend the information. The individual has the right to request an amendment for as long as the information is kept by or for us. The request must be made in writing to the Privacy Contact, and must contain a reason to support the individual’s request. We may deny the request for an amendment if the information sought to be amended is not part of the medical information kept by or for us, and/or was not created by us, unless the person or entity that created the information is no longer available to make the amendment, is not part of the information which an individual is permitted to inspect and copy, or is, in our reasonable belief, accurate and complete. If we deny the request for amendment, we must provide the individual with a written explanation for the denial and an explanation of the right to submit a written statement disagreeing with the denial.
An individual has the right to receive an accounting of certain disclosures we have made, if any, of protected health information. An individual may make a written request to the Privacy Contact for an accounting of disclosures of the individual’s protected health information made by us for a period up to the last six years. The first accounting request made by an individual within a 12-month period is free; the individual will be charged for additional requests within the 12-month period. The right to receive this information is subject to certain exceptions, restrictions, and limitations, including the following. We do not have to account for disclosures (i) made to carry out treatment, payment or healthcare operations; (ii) made to the individual or his or her representatives; (iii) made to correctional institutions or law enforcement officials; or (iv) made for national security or intelligence purposes.
An individual has the right to obtain a paper copy of this notice from us, upon request, even if the individual has agreed to accept this notice electronically.
3. Complaints
If an individual believes his or her privacy rights have been violated, the individual may file a written complaint with the Privacy Contact or the Secretary of Health and Human Services. We may not retaliate against the individual for filing a complaint. The individual may contact our Privacy Contact at (208) 734-5313, for further information about the complaint process.
This notice was published and becomes effective on April 14, 2003.