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Notice of Privacy Practices – HIPAA Compliance

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.

EFFECTIVE: APRIL 14, 2003

As a patient receiving hospice or home health services, we understand you may be concerned about how your medical and other health-related information may be handled. That is why we, as an organization, are committed to ensuring patient privacy and confidentiality to you and to others that we serve. This is also why we have developed this Notice, made it available to you, and why we, as an organization, are dedicated to abiding by the terms of this Notice, as currently in effect. To the extent you may have any questions or concerns relating to the matters and issues addressed in the Notice, please do not hesitate to contact our Privacy Officer.

I. General

This Notice is drafted and provided to you, consistent with the requirements of the privacy rules of the Health Insurance Portability and Accountability Act (HIPAA). As a health care provider, we are committed to meet the requirements of the law to maintain the privacy of your and other patients’ Protected Health Information (PHI) and to provide you with this Notice of your legal duties and our privacy practices relating to your PHI.
We, as a hospice and home care provider, are subject to the requirements of the HIPAA Privacy Rules. Equally and perhaps more important, we are committed as an organization to continually strive to act consistently with the underlying purpose and philosophy of the HIPAA Privacy Rules- to properly safeguard and protect from improper disclosure of health information that either identifies you or can be reasonably used to ascertain your identity, and which is transferred or maintained to another party in electronic or other form. This information is what this Notice refers to as “Protected Health Information.”

II. Uses/Disclosures Related to Treatment, Payment or Health Care Operations

This law permits us to use and/or disclose PHI to carry out treatment, payment and other health care operations.
Treatment: When your medical information is needed by another health care provider such as a hospital.
Payment: When we need to receive reimbursement from your health insurance company.
Operations: When we perform chart audit for quality improvement activities.

III. Uses/Disclosures When an Authorization is Not Required

In some cases, the law permits us to use and/or disclose PHI, without requiring you to sign an authorization. In many cases, these types of uses and/or disclosures are permitted to promote the government’s need to ensure a safe and healthy society. In other cases, the law does not require an authorization because it would be impractical to require an authorization.
The law permits us to use/disclose PHI without obtaining an authorization to properly treat and care for patients. These types of uses/disclosures include: activities for national security, reporting of abuse/neglect or averting communicable or spreading diseases.

IV. Use/Disclosures Where an Authorization is Required

For other types of uses and/or disclosures of PHI, the law requires us to obtain what is known as an authorization. An authorization can be revoked by you at any time, as long as we have not already reasonably relied on it to make a particular use and/or disclosure.
Examples of where the authorization form would be required include when the uses/disclosures are made to a patient’s employer for disability, fitness for duty or drug testing purposes.

V. Appointment Reminders and Information On Treatment Alternatives

We may use and/or disclose your PHI, as appropriate, for appointment reminders and to provide you with information on potential treatment alternatives.

VI. Uses/Disclosures for Fundraising Purposes

To the extent permitted by the HIPAA Privacy Rules, we may use and/or disclose your PHI for fundraising purposes.

VII. Your Right to Request Additional Restrictions on the Use/Disclosure of Protected Health Information

You have the right to request additional restrictions relating to the use and/or disclosure of your PHI. Although we are not legally required to grant such additional restrictions, it is your right to make such a request.

VIII. Your Right to Obtain Access to Protected Health Information

You have the right to obtain access to your PHI, consistent with the provisions of the HIPAA Privacy Rules.
We reserve the right to charge you a reasonable, cost-based fee for copying any PHI required to be copied to adequately respond to your access request. We reserve the right to deny access to PHI that is not otherwise required to be given under the HIPAA Privacy Rules or other applicable law.

IX. Your Right to Amend Protected Health Information

You have the right to amend your PHI, to the extent permitted and consistent with the provisions of the HIPAA Privacy Rules.
We reserve the right, among other things, to deny requests for amendments that are not required to be granted under HIPAA including when the PHI at issue is accurate and complete.

X. Your Right to an Accounting of Disclosures of Protected Health Information

You have the right to an accounting of disclosures of your PHI, to the extent permitted and consistent with the provisions of the HIPAA Privacy Rules.
We reserve the right to, among other things, limit as well as deny such accountings to disclosures not required under the HIPAA Privacy Rules. We reserve the right to charge you a reasonable, cost-based fee for any second or other subsequent accounting request you may make during a twelve (12) month period.

XI. Your Right to Obtain a Copy of this Notice

You have the right to obtain a paper copy of this Notice.
If you do not have a copy of the Notice, do not hesitate to contact the office in order to receive one.

XII. Your Right to Complain about How your Protected Health Information is Handled

We recognize and respect your right to file a complaint, if you believe in good faith that we have violated your privacy rights, including HIPAA Privacy Rules. We do not retaliate against persons who file such complaints either with us or with the United States Department of Health and Human Service, Office of Civil Rights.
We would like to ask you to provide us with the necessary information to properly follow up with you, about your concern/complaint. If you believe we have not been attentive and have violated your privacy rights, you may contact us or you have the right to contact: Medical Privacy, Complaint Division, Office of Civil Rights, Department of Health & Human Services, 200 Independence Ave., S.W., Room 509F, HHH Building, Washington, DC 20201; Voice Hotline Number (800) 368-1019; Internet Address: www.hhs.gov/ocr. Should you believe that we might have retaliated against you in any way upon your filing a complaint with us or with the HHS OCR, please contact the Privacy Officer immediately so we may address that issue with you.

XIII. Changes to the Terms of our Notice of Privacy Practices

We reserve the right to change the terms of our notice of privacy practices at any time and to make the new notice provisions effective for all PHI that we maintain. If there is a change, we will notify you as soon as practicable.

XIV. Contact Information

Should you have any questions, concerns or issues relating to the topics covered in this Notice, we have designated a person to receive and properly handle any privacy issues you have, including where you in good faith believe we have violated your privacy rights under the HIPAA Privacy Rules. We have designated the following person to assist you as a patient of Assisted Home Care, Assisted Healthcare Services or Assisted Home Hospice: Lois Meeker, Privacy Officer, 468 Pennsfield Pl. Thousand Oaks, CA. 91360, (805) 371-9988


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