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.

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal program that requires that all medical records and other individually identifiable health information used or disclosed by us in any form, whether electronically, on paper, or orally, are kept properly confidential. This Act gives you, the patient, significant new rights to understand and control how your health information is used. HIPAA provides penalties for covered entities that misuse personal health information.

As required by HIPAA, we have prepared this explanation of how we are required to maintain the privacy of your health information and how we may use and disclose your health information.

We may use and disclose your medical records only for each of the following purposes: treatment, payment, and health care operations.

Treatment means providing, coordinating, or managing health care and related services by one or more health care providers. An example of this would include a physical examination. This may also include disclosures of protected health information to pharmaceutical companies for indigent patients receiving free medicines.

Payment means activities such as obtaining reimbursement for services, confirming coverage, billing or collection activities, and utilization review. An example of this would be sending a bill for your visit to your insurance company for payment.

Health care operations include the business aspects of running our practice, such as conducting quality assessment and improvement activities, auditing functions, cost-management analysis, and customer service. An example would be an internal quality assessment review.

We may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.

We may disclose your protected health information in special circumstances as listed: as we are required to by federal, state, and local law; for public health risks (ex. child abuse or neglect); for health oversight activities; for activities authorized by law (ex. inspections or civil administrative and criminal procedures); for lawsuits and similar proceedings (ex. in response to subpoenas or other lawful processes); for law enforcement if asked to do so by a law enforcement official (ex. regarding criminal situations); for deceased patients (ex. to a medical examiner or coroner, for organ and tissue donation, regarding organ, eye, or tissue transplantation); for serious threats to health or safety (only to persons or organizations able to help prevent the threat); for the military if required by appropriate authorities; for National Security (for federal officials to protect the president); for inmates (to correctional institutions or law enforcement officials to provide healthcare services to you, for safety and security of the institution or for your health and safety and that of other individuals); for workers compensation (or similar programs).

We must generally obtain an authorization from you for the use or disclosure of psychotherapy notes.  Your authorization is not required for uses or disclosures of such notes which are necessary for treatment, payment or health care operations, including the use, by the originator of the psychotherapy notes, for treatment, or the use or disclosure of such information for training purposes as provided by law. We may also use and disclose such notes to defend against litigation or other legal proceedings brought by you or on your behalf. We must obtain an authorization from you for any use or disclosure of protected health information for marketing purposes, except as otherwise provided by law, or for any disclosures that constitute a sale of protected health information. Any other uses and disclosures will be made only with your written authorization. You may revoke such authorization in writing and we are required to honor and abide by that written request, except to the extent that we have already taken actions relying on your authorization.

You have the following rights with respect to your protected health information, which you can exercise by presenting a written request to the privacy officer. The privacy officer should be contacted at the address at the bottom of this notice regarding any questions about the requirements of written requests.

The right to restrict certain disclosures of protected health information to a health plan pertaining to a health care item or service where you, or someone on your behalf other than the health plan, pay out of pocket in full for the health care item or service.

The right to request restrictions on certain other uses and disclosures of protected health information, including those related to disclosures to family members, other relatives, close personal friends, or any other person identified by you. We are, however, not required to agree to such a requested restriction. If we do agree to a restriction, we must abide by it unless you agree in writing to remove it.

The right to reasonable requests to receive confidential communications of protected health information from us by alternative means or at alternative locations.

The right to inspect and copy your protected health information.

The right to amend your protected health information.

The right to receive an accounting of disclosures of protected health information.

The right to obtain a paper copy of this notice from us upon request.

Minors have certain rights to consent for treatment and disclosure of their records. Some examples are for treatment related to birth control, prenatal care, drug rehab or related services, venereal disease, HIV testing, and other related services.

If we intend to contact you for fundraising purposes, you will be given an opportunity to opt-out of receiving such communications.

You have a right to be notified in the event of a breach of unsecured protected health information when required by 45 C.F.R. § 164.410.

We are required by law to maintain the privacy of your protected health information and to provide you with notice of our legal duties and privacy practices with respect to protected health information.

This notice is effective as of April 14, 2003 (revised May 23, 2013), and we are required to abide by the terms of the Notice of Privacy Practices currently in effect. We reserve the right to change the terms of our Notice of Privacy Practices and to make the new notice provisions effective for all protected health information that we maintain. We will post and you may request a written copy of a revised Notice of Privacy Practices from this office.

You have recourse if you feel that your privacy protections have been violated. You have the right to file a formal written complaint with our office, with the Department of Health and Human Services, or with the Office of Civil Rights, about violations of the provisions of this notice or the policies and procedures of our office. We will not retaliate against you for filing a complaint.