NOTICE OF 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
Rehabilitation Associates, PSC is required by law to maintain the
privacy of PROTECTED HEALTH INFORMATION and to provide individuals
with notice of its legal duties and privacy practices with respect
to protected health information.
This Notice describes how we may use or disclose your "protected
health information" for various purposes. It also describes your
rights to access and control your protected health information. "Protected
Health Information" is information about you that may identify
you and relates to your past, present or future physical or mental
health or condition and related health services.
Rehabilitation Associates, PSC is required to abide by the terms
of the Notice of Privacy Practices currently in effect. We reserve
the right to change the terms of this Notice and to make the new Notice
provisions effective for all protected health information that we
maintain. Upon your request, we will provide you with any revised
Notice of Privacy Practices.
Uses and Disclosures of Protected Health Information For
Treatment, Payment and Health Care Operations
Your Protected Health Information may
be used and disclosed by your physician, our office staff and others
outside of our office that 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 this practice.
Following are examples of the types
of uses and disclosures of your protected health care information that
the practice 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 a third party that has already obtained your
permission to have access to your protected health information. 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 diagnosis 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. Finally we may use and disclose
protected health information for the treatment activities of another
health care entity or provider.
Payment: Your protected health information will
be used, as needed, to obtain payment for your health care services.
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. We may also use
and disclose protected health information for the payment activities
of another health care entity or provider.
Healthcare Operations: We may use or disclose, as-needed,
your protected health information in order to support the business
activities of this practice. These activities include, but are not
limited to, quality assessment activities, employee review activities,
training of medical students, licensing, marketing and fund-raising
activities, and conducting or arranging for other business activities.
For example, we may disclose your protected health information to
medical school students that see patients in our office. In addition,
we may use a sign-in sheet at the registration desk where you will
be asked to sign your name and indicate your physician. We may also
call you by name in the waiting room when your physician is ready
to see you. We may use or disclose your protected health information,
as necessary, to contact you to remind you of your appointment. In
addition, we may use or disclose your protected health information
to another entity in order for that entity to conduct specific health
care operations, which include quality assessment activities and reviewing
the competence of health care professionals.
We will share 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 Contact to request that these materials
not be sent to you.
We may use or disclose your demographic information and the dates
that you received treatment from your physician, as necessary, in
order to contact you for fund-raising activities supported by our
office. If you do not want to receive these materials, please contact
one of our Privacy Contacts and request that these fund-raising materials
not be sent to you.
Uses and Disclosures That May Be Made With 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 such
authorization, at anytime, in writing, except to the extent that your
physician or the practice has taken an action in reliance on the use
or disclosure indicated in the authorization.
Uses and Disclosures That May
Be Made Unless You Object
We may also use and disclose your protected health information in
the following instances. In these 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 judgement, determine whether
the disclosure is in your best interest. In this case, only the protected
health information that is relevant to your health care will be disclosed.
Others Involved in Your Healthcare: 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 judgement. 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.
Disaster Relief: 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 you health care.
Disclosures That May Be Made Without Your Authorization or
Opportunity to Object
We may use or disclose your protected health information in the following
situations without your authorization. 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.
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. The disclosure will be made for the purpose of controlling
disease, injury or disability. We may also disclose your protected
health information, if directly by the public health authority, to
a foreign government agency that is collaborating with the public
health authority.
Communicable Diseases: We may disclose your protected
health information, as 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 public officials who are authorized by law to
receive reports of abuse, neglect or domestic violence.
Food and Drug Administration: We may disclose your
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.
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), and in certain
conditions in response to a subpoena, discovery request or other lawful
process.
Law Enforcement: We may also disclose protected
health information for law enforcement purposes. These law enforcement
purposes include (1) legal processes and otherwise required by law,
(2) requests for limited information for identification and location
purposes, (3) requests pertaining to victims of a crime, and (4) alerting
law enforcement officials when (a) there is suspicion that a death
has occurred as a result of criminal conduct, (b) in the event that
a crime occurs on the Practice's premises, or (c) a medical emergency
exists (not on the 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 also 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.
Threatening 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 or 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: Your protected health information
may be disclosed by us 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.
Required Uses and Disclosures: Under the law, we
must make disclosures to you and when required by the Secretary of
the Department of Health and Human Services to investigate or determine
our compliance with the privacy standards applicable to your protected
health information.
Your Rights Regarding Your Protected Health Information
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 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 your physician and the practice use for making decisions
about you. 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 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.
In some circumstances, you may have a right to have this decision
reviewed. Please contact our Privacy Contact 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 your may ask us not to use or disclose any
part of your protected health information for the purposes of treatment,
payment or healthcare 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 the 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 Contact.
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 as long
as we maintain this information. In certain cases, we may deny your
request for an amendment. If we deny your request for an 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 Contact to
determine 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 that treatment, payment
or healthcare operations as described in the Notice of Privacy Practices,
as well as disclosures made pursuant to your authorization. It also
excludes disclosures we may have made to you, for a facility directory,
to family members or friends involved in your care, or for notification
purposes. You have the right to receive specific information regarding
these disclosures that occurred after April 14, 2003. You may request
a shorter time frame. 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.
Making a Complaint
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 Contact of your complaint. We will not retaliate against you
for filing a complaint.
You may contact our Privacy Contact,
Lynn Kissel at (502)584-3376 for further information about the complaint
process. This notice was published and becomes effective on April 14,
2003.
