Notice of Privacy Practices for Protected Health Information
(PHI)
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.
This Privacy Notice is being provided to you as a
requirement of a federal law, the Health Insurance Portability
and Accountability Act (HIPAA). This Privacy Notice 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 right to access and control your protected
health information. Your "protected health information" means
any written or oral information about you, including
demographic data that can be used to identify you, created or
received by your health care provider, which relates to your
past, present, or future physical or mental health or
condition.
Uses and Disclosures of Protected Health Information for
Treatment, Payment, and Health Care Operations.
We may use your protected health information for the
purposes of providing treatment, obtaining payment for
treatment, and conducting health care operations. Your
protected health information may be used or disclosed only for
these purposes unless we have obtained your authorization or
the use or disclosure is permitted or required by the HIPAA
regulations or other law. Disclosures of your protected health
information for the purposes described in this Privacy Notice
may be made in writing, orally, or by electronic means.
1. Treatment. We will use and disclose your
protected health care information to provide, coordinate, or
manage your health care and related services, including
coordination and management with third parties for treatment
purposes. Here are some examples of how we may use or disclose
your protected health information for treatment:
· We may
disclose your protected health information to a laboratory to
order tests.
· We may
disclose your protected health information to other physicians
who may be treating you or consulting with us regarding your
care.
· We may
disclose your protected health information to those who may be
involved in your care, such as family members or you personal
representative.
2. Payment. We will use your protected health
information to obtain payment for the services we provide to
you. We may also disclose your protected health information to
another provider involved in your care for their payment
activities. We may communicate with your health insurance
company to get approval for the services we render, to verify
your health insurance coverage, to verify that particular
services are covered under you insurance plan, and to
demonstrate medical necessity.
3. Heath Care Operations. We may use and disclose
your protected health information to facilitate our own health
care operations and to provide quality care to all of our
patients. Health care operations include such activities as:
quality assessment and improvement; employee review
activities; conduction or arranging for medical review, legal
services, and auditing functions, including fraud and abuse
detection and compliance reviews; business planning and
development; and business management and general
administrative activities. In certain situations, we may also
disclose your protected health information to another provider
or health plan for their health care operations. Here are some
examples of how we may use or disclose your protected health
information for health care operations: We may use your
protected health information to review our treatment and
services and to evaluate the performance of our staff in
caring for you.
We may combine protected health information about many
patients to decide what additional services we should offer
what services are not needed.
We may also disclose information to doctors, nurses,
technicians, medical students, and other personnel for review
and learning purposes.
We may also use or disclose your protected health
information in the course of maintenance and management of our
electronic health information systems.
4. Other Uses and Disclosures. As part of the
functions above, we may use or disclose your protected health
information to provide you with appointment reminders, to
inform you of treatment alternatives, or to provide you with
information about other health-related benefits and services
which may be of interest to you.
Uses and Disclosures of Protected Health Information
Permitted without Authorization or Opportunity for the
Individual to Object
The federal privacy rules allow us to use or disclose your
protected health information without your authorization and
without your having the opportunity to object to such use or
disclosure in certain circumstances, including:
1. When Required by Law. We will disclose your
protected health information when we are required to do so by
federal, state, or local law.
2. For Public Health Reasons. We may disclose your
protected health information as permitted or required by law
for the following public health reasons:
· For
the prevention, control, or reporting of disease, injury or
disability;
· For
the reporting of vital events such as birth or death;
· For
public health surveillance, investigations, or interventions;
· For
purposes related to the quality, safety, or effectiveness of
FDA-regulated products or activities, including:
·
Collection and reporting of adverse events, product defect or
problems, or biological products deviations.
· Tracking
of FDA - regulated products.
· Product
recalls, repairs or lookback.
· Post
-marketing surveillance.
- To notify a person who has been exposed to a
communicable disease or who may be at risk of contracting
or spreading a disease or condition;
- Under certain limited circumstances, to report to an
employer information about an individual who is a member
of the employer’s workforce.
3. To Report Abuse, Neglect, or Domestic Violence.
We may notify government authorities if we believe a patient
is a victim of abuse, neglect, or domestic violence. We will
make this disclosure only when specifically authorized or
required by law, or when the patient agrees to the disclosure.
4. For Health Oversight Activities. We may disclose
your protected health information to a health oversight agency
for oversight activities authorized by law, including audits;
civil, administrative, or criminal investigations;
inspections; licensure or disciplinary actions; civil,
administrative, or criminal proceedings or actions; or other
activities necessary for appropriate oversight.
5. For Judicial or Administrative Proceedings. We
may disclose your protected health information in the course
of any judicial or administrative proceeding in response to an
order of a court or administrative tribunal as expressly
authorized by such order. We may disclose your protected
health information in response to a subpoena, discovery
request, or other lawful process that is not accompanied by an
order of a court or administrative tribunal if we have
received satisfactory assurances that you have been notified
of the request or that an effort has been made to secure a
protective order.
6. For Law Enforcement Purposes. We may disclose
your protected health information to a law enforcement
official for law enforcement purposes, including:
· Wound or
physical injury reporting, as required by law.
· In
compliance with, and as limited by the relevant requirements
of a court order or court-ordered warrant, a subpoena,
summons, or similar process.
·
Identification or location of a suspect, fugitive, material
witness, or missing person.
· Under
certain limited circumstances when you are the victim of a
crime.
· Alerting
law enforcement of the death of an individual where there is
suspicion that the death may have resulted from criminal
conduct.
·
Reporting criminal conduct that occurred on the premises of
the provider.
· In an
emergency to report a crime.
7. To Coroners, Medical Examiners, and Funeral
Directors. We may disclose protected health information to
a coroner or medical examiner for the purpose of identifying a
deceased person, determining a cause of death, or other duties
as authorized by law. We may disclose protected health
information to funeral directors, consistent with applicable
law, as necessary to carry out their duties with respect to
the decedent. In some cases such disclosures may occur prior
to, and in reasonable anticipation of, the individual’s death.
8. For Organ or Tissue Donation. We may use or
disclose protected health information to organ procurement
organizations or other entities engaged in the procurement,
banking, or transplantation of cadaveric organs, eyes, or
tissue for the purpose of facilitating donation and
transplant.
9. For Research Purposes. We may use or disclose your
protected health information for research purposes when an
institutional review board that has reviewed the research
proposal and protocols to safeguard the privacy of your
protected health information has approved such use or
disclosure.
10. To Avert a Serious Threat to Health or Safety.
We may, consistent with applicable law and standards of
ethical conduct, use or disclose your protected health
information if we believe, in good faith, that such use or
disclosure is necessary to prevent or lessen a serious and
imminent threat to your health and safety or that of the
public.
11. For Specialized Government Functions. We may use
or disclose your protected health information, as authorized
or required by law, to facilitate specified government
functions related to military and veterans activities;
national security and intelligence activities; protective
services for the President and others; medical suitability
determinations; correctional institutions and other law
enforcement custodial situations.
12. For Workers’ Compensation. We may use and
disclose your protected health information, as necessary, to
comply with workers’ compensation laws or similar programs.
Uses and Disclosures of Protected Health Information
Permitted without Authorization but with an Opportunity for
the Individual to Object
We may use your protected health information to maintain a
directory of patients in our facility. The information
included in the directory will be limited to your name, and
your condition described in general terms.
We may disclose your protected health information to a
friend or family member who is involved in your medical care
or payment for care. In addition, if applicable, we may
disclose medical information about you to an entity assisting
in a disaster relief effort so that your family can be
notified about your condition, status, and location.
You may object to these disclosures. If you do not object
to these disclosures, or we determine in the exercise of our
professional judgment that it is in your best interest for us
to disclose information that is directly relevant to the
person’s involvement with your care, we may disclose your
protected health information.
Uses and Disclosures of Protected Health Information which
You Authorize
Other than the uses and disclosures described above, we
will not use or disclose your protected health information
without your written authorization. Authorizations are for
specific uses of your protected health information, and once
you give us authorization, any disclosures we make will be
limited to those consistent with the terms of the
authorization. You may revoke your authorization, by
submitting a revocation in writing, at any time, except to the
extent that we have already taken action in reliance upon your
authorization.
Your Rights Regarding Your Protected Health Information
You have the following rights regarding your protected
health information:
1. The Right to Request Restriction of Uses and
Disclosures. You have the right to request that we not use
or disclose certain parts of your protected health information
for the purposes of treatment, payment, or healthcare
operations. You also have the right to request that we do not
disclose your protected health information to friends or
family members who may be involved in your care, or for
notification purposes as described earlier in this notice.
Your request must be made in writing and must state the
specific restriction requested and the individuals to whom the
restriction applies.
We are not required to agree to a restriction you may
request. We will notify you if we do not agree to your
restriction request. If we do agree to the restriction
request, we will not use or disclose your protected health
information in violation of the agreed upon restriction,
unless necessary for the provision of emergency treatment.
We may terminate our agreement to a restriction if you
agree to the termination in writing; if you agree to the
termination orally and the oral agreement is documented, or if
we notify you of termination of the agreement and the
termination applies only to protected health information
created or received by us after you receive the notice of
termination of the restriction.
Request for restrictions much be made in writing to the
Privacy Officer.
2. The Right to Request Confidential
Communications. You have the right to request that you
receive communications of protected health information from us
by alternative means or at alternative locations. We must
accommodate any reasonable request of this nature. We may
condition the provision or accommodation by requesting
information from you describing how payment will be handled,
or by requesting specification of an alternative address or
alternative form of contact.
Requests for confidential communications must be made in
writing to the Privacy Officer.
3. The Right to Inspect and Copy Protected Health
Information. You have the right to inspect and obtain a
copy of your protected health information that is maintained
in a designated record set for as long as we maintain the
protected health information. The designated record set is a
collection of records maintained by us, which contains medical
and billing information used in the course of your care, and
any other information used to make decisions about you.
By law, you do not have a right to access psychotherapy
notes; information compiled in reasonable anticipation of, or
for use in, a civil, criminal, or administrative proceeding;
and protected health information which is subject to a law
which prohibits access to protected health information.
Depending on the circumstance of your request, you may have
the right to have a decision to deny access reviewed.
We may deny your request to inspect or copy your protected
health information if, in our professional judgment, we
determine that the access requested is likely to endanger you
or another person, or is likely to cause substantial harm to
another person referenced within the protected health
information. You have a right to request a review of a denial
of access.
If you request a copy of your information, we may charge
you a fee for the costs of copying, mailing, or other costs
incurred by us as a result of complying with your request.
Requests for access to your protected health information
must be made in writing to the Privacy Officer.
4. The Right to Ament Protected Health Information.
You have the right to request that we amend your protected
health information in a designated record set for as long as
we maintain that information. In certain cases we may deny
your request. If we deny your request you will be notified in
writing, and you will have the right to file a statement of
disagreement with us. We may prepare a rebuttal to your
statement of disagreement and if we do so we will provide a
copy of our rebuttal to you.
Request for amendment of protected health information must
made in writing to the Privacy Officer, and must include a
reason to support the requested amendments.
5. The Right to Receive and Accounting of Disclosures of
Protected Health Information. You have the right to
request an accounting of disclosures of your protected health
information made by us. This right applies to disclosures made
by us except for disclosures: to carry out treatment, payment,
or health care operations as described in the Notice or
incidental to such use; to your or your personal
representatives; pursuant to your authorization; for our
directory, or other notification purposes, or to persons
involved in your care; or for certain other disclosures we are
permitted to make without your authorization.
Requests for disclosure of accounting
must specify a time period sought for the accounting, with the
maximum time period being six years prior to the date of the
request. We are not required to provide accounting for
disclosures made before April 14th, 2003. We will
provide the first disclosure accounting you request during any
12- month period without charge. Subsequent disclosure
accounting request will be subject to a reasonable cost-based
fee.
6. The Right to Obtain a Paper Copy of this Notice.
Upon request, we will provide a paper copy of this notice.
Your Rights Regarding Your Protected Health Information
We are required by law to maintain the privacy of your
health information and to provide you with this Privacy Notice
of our legal duties and privacy practices with respect to
protected health information. We are required to abide by the
terms of the Notice currently in effect. We reserve the right
to change the terms of this Notice and to make any new
provisions effective for all protected health information that
we maintain. If we change the Notice, we will provide a copy
of the revised notice through in-person contact.
Your Right Regarding Your Protected Health Information
You have the right to express complaints to us and to the
Secretary of the Department of Health and Human Services if
you believe that your privacy rights have been violated.
If you wish to complain to us, please do so in writing, and
direct your complaint to the Privacy Officer.
You will not be penalized for filing a compliant.
Contact Information
For further information about this Notice,
please contact:
HIPAA Privacy Officer
3470 Washington Parkway
Idaho Falls, Idaho 83404
If you have privacy issues, or if you
believe that your privacy rights have been violated, please
contact:
HIPAA Privacy Officer
3470 Washington Parkway
Idaho Falls, Idaho 83404
The Privacy Contact and Privacy Officer can
be contacted by telephone at:
(208) 529-0800
Effective Date: This notice is
effective April 14th, 2003
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