Notice Of Privacy Practices
NOTICE OF PRIVACY PRACTICES
Your Information. Your Rights. Our Responsibilities.
This notice describes how personal health information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
You have the right to:
• Get a copy of your paper or electronic medical record
• Correct your paper or electronic medical record
• Request confidential communication
• Ask us to limit the information we share
• Get a list of those with whom we’ve shared your information
• Get a copy of this privacy notice
• Choose someone to act for you to obtain this information
• File a complaint if you believe your privacy rights have been violated
You have some choices in the way that we use and share information:
• Any disclosure of confidential information requires a signed consent form from yourself or guardian
• Exceptions would include a medical emergency or major crime as defined in Federal Regulations 42CFR Part 2
• Provide care for your substance use disorder
Our Uses and Disclosures
We may use and share your information as defined by Federal Regulation 42CFR Part 2 to:
• Treat you
• Run our organization
• Bill for our services
• Comply with the law
• Address workers’ compensation, law enforcement, and other government requests
• Respond to lawsuits and legal actions when presented with an appropriate subpoena that adheres to the regulations as defined in 42CFR Part 2
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
You can get an electronic or paper copy of your medical record
• You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
• We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
You can ask us to correct your medical record
• You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us for the procedures on how to do this.
• We may say “no” to your request, but we’ll tell you why in writing within 60 days.
You can request confidential communications
• You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
• We will say “yes” to all reasonable requests.
You can ask us to limit what we use or share
• You can refuse to sign a release for the release of confidential information pertaining to certain health information. We may refuse treatment if the request prohibits our billing for services or providing treatment as recommended.
• If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.
You can get a list of those with whom we’ve shared information
• You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
• We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
You can get a copy of this privacy notice
• You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
You can choose someone to act for you
• If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
• We will make sure the person has this authority and can act for you before we take any action.
You can file a complaint if you feel your rights are violated
• You can complain if you feel we have violated your rights. Contact us using the information in our handbook or on our website.
• You can file a complaint with the Office for Alcohol and Substance Abuse Services at 1450 Western Avenue, Albany, N.Y. 12203 [www.oasas.ny.gov] or the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
• We will not retaliate against you for filing a complaint.
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to:
• Share information with your family, close friends, or others involved in your care
• Share information in a disaster relief situation
If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
In these cases we never share your information unless you give us written permission:
• Marketing purposes
• Sale of your information
• Most sharing of psychotherapy notes
Our Uses and Disclosures
How do we typically use or share your health information?
We typically use or share your health information in the following ways.
We can use your health information and share it with other professionals who are treating you.
Example: A doctor treating you for an injury asks another doctor about your overall health condition.
Running our organization
We can use and share your health information to run our practice, improve your care, and contact you when necessary.
Example: We use health information about you to manage your treatment and services.
Billing for your services
We can use and share your health information to bill and get payment from health plans or other entities.
Example: We give information about you to your health insurance plan so it will pay for your services.
How else can we use or share your health information?
We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
Helping with public health and safety issues
We can share health information about you for certain situations such as:
• Preventing disease
• Helping with product recalls
• Reporting adverse reactions to medications
• Preventing or reducing a serious threat to anyone’s health or safety
Complying with the law
We will share information about you if state or federal laws require it. This includes the Office of Alcohol and Substance Abuse Services for routine reviews and audits of our chart and procedures and the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
Addressing workers’ compensation, law enforcement, and other government requests
We can use or share health information about you:
• For workers’ compensation claims
• With health oversight agencies (i.e. OASAS) for activities authorized by law
Responding to lawsuits and legal actions
We can share health information about you in response to a court or administrative order, or in response to a subpoena, provided the documentation meets the federal regulatory requirements as outlined in 42CFR Part 2.
• We are required by law to maintain the privacy and security of your protected health information.
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• We will identify the extent of the breach as it pertains to your PHI.
• We must follow the duties and privacy practices described in this notice and give you a copy of it.
• We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
Changes to the Terms of this Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.
Other Instructions for Notice
• Effective Date of this Notice: November 25, 2013
• Corporate Compliance Officer: Robert Schaffer, LCSW, CASAC: Roberts@pyhit.org or (518) 377-2448 ext 226.
• This agency has never marketed or sold personal information.
• We will never share any substance abuse disorder treatment records without your written permission.