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.
This Notice of Privacy Practices ("Notice") applies to Protected Health Information ("PHI") associated with CareHealth® programs,
carehealth.me™ or www.chfor.me™ ("CareHealth"), its employees, and its contractors. This Notice describes how CareHealth ("we" or
"us"), or our business associates, may use and disclose PHI to carry out our services and for other purposes that are permitted
or required by law.
We are required by law to maintain the privacy of PHI and to provide you with notice of our legal duties and privacy practices with respect to PHI. We must comply with the Notice that is currently in effect. This Notice will tell you about the ways in which we may use and disclose your PHI. PHI means individually identifiable health information, as defined by the Health Insurance Portability and Accountability Act of 1996 ("HIPAA"), that is created or received by us and that relates to the past, present, or future physical or mental health or condition of an individual; the provision of health care to an individual; or the past, present, or future payment for the provision of health care to an individual; and that identifies the individual or for which there is a reasonable basis to believe the information can be used to identify the individual. PHI includes information of persons living or deceased.
We also describe your rights and certain obligations we have regarding the use and disclosure of your PHI. With a few exceptions, we are required to obtain your authorization for the use and disclosure of information for reasons other than treatment, payment or health care operations. This Notice will list some of the reasons why we might use or disclose your PHI and provide examples of these uses and disclosures.
We may change our privacy practices and revise our Notice effective for all information we maintain. The Notice will contain the effective date at the bottom of the last page. Copies of our current/updated Notice may be obtained by contacting CareHealth at the telephone number or address at the end of this Notice, or on our Website at http://www.carehealth.me/.
HOW WE MAY USE AND DISCLOSE YOUR PHI
The following categories describe different ways that we may use and disclose PHI. For each category of uses and disclosures we will explain what we mean and, where appropriate, provide examples for illustrative purposes. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted or required to use and disclose PHI will fall within one of the categories.
Some uses and disclosures of PHI may be subject to additional restrictions under federal and state laws and regulations, such as those that apply to substance abuse treatment, HIV/AIDS testing and treatment, and mental health treatment. For example, if you are receiving alcohol or drug abuse services, information that would identify you as a person seeking help for a substance abuse problem is protected under a separate set of federal regulations known as "Confidentiality of Alcohol and Drug Abuse Patient Records", 42 C.F.R. Part 2. Under certain circumstances these regulations will provide your medical information with additional privacy protections beyond what is described in this Notice.
Your Authorization
Except as provided in this Notice, we will not use or disclose your PHI unless you have signed a written authorization for us to do so. Disclosures that require your authorization include disclosure of psychotherapy notes, disclosures for marketing other than as provided in this Notice, and other disclosures that we would get paid to make, with some exceptions. If you provide us authorization to use or disclose your PHI, you may revoke that authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose your PHI for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your authorization.
Business Associates
At times we use outside persons or organizations to help us provide you with the benefits of our services. Examples of these outside persons and organizations might include vendors that help us process direct mailings. At times it may be necessary for us to provide certain portions of your PHI to one or more of these outside persons or organizations so that they can perform the job we have asked them to do. To protect your PHI, however, we require our business associates to appropriately safeguard your information and uphold the same confidentiality standards that we are required to meet.
Appointment Reminders, Treatment Alternatives and Health-Related Products and Services
We may use and disclose your PHI to remind you of a scheduled appointment or tell you about or recommend possible treatment options and alternatives that may be of interest to you. We may also contact you to provide information about other health-related products and services that may be of interest to you. For example, we may use and disclose your PHI for the purpose of communicating to you about new value-added services. If we receive payment for making treatment communications to you about treatment alternatives or health-related products and services, we will clearly state that in the communication and give you the choice to opt out of receiving more of those types of communications.
Fundraising
We may use and disclose your PHI so that we (or one of our business associates) may contact you when we are in the process of raising funds. We will only release demographic information, such as your name and address, and the dates of health care services provided to you. If we contact you for such purposes, we will give you the choice to opt out of receiving more of those types of communications.
Treatment (as described in applicable regulations)
We may use and disclose your PHI to provide you with services relating to the coordination, or management of health care provided to you by a health care provider. For example, we may obtain information from a physician or other provider that may assist with the management of your medication therapy or overall health.
Payment (as described in applicable regulations)
We may use and disclose your PHI for payment activities, including the determination of health plan benefits or to facilitate payment for treatment you receive from health care providers. For example, we may tell your health plan about a drug treatment you are receiving for purposes of determining eligibility of coverage, appropriateness of care, or justification of charges.
Health Care Operations (as described in applicable regulations)
We may use and disclose your PHI as necessary to conduct our health care operations. For example, we may use and disclose medical information to conduct our business management and general administrative activities. We may also use and disclose your PHI for care coordination activities, including contacting you with information about treatment alternatives as described above, and related functions that do not include treatment.
Other Uses and Disclosures
We may make certain other uses and disclosures of your PHI without your authorization.
- We may use or disclose your PHI for any purpose required by federal, state or local law. For example, we may be required by law to use or disclose your PHI to respond to a court order.
- We may disclose your PHI to a public health or other government authority that is permitted by law to collect or receive the information. The disclosure may be necessary to do the following:
- Prevent or control disease, injury or disability.
- Report births and deaths.
- Report child abuse or neglect.
- Report reactions to medications or problems with health care products.
- Notify individuals of recalls of products they may be using.
- Notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition.
- Notify the appropriate government authority if we believe you have been the victim of abuse, neglect or domestic violence. We will only make this disclosure if you agree or when we are required to do so by law.
- Report adverse events with respect to food, supplements, and product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement.
- We may disclose your PHI if authorized by law to a government oversight agency (e.g., a state insurance department) conducting audits, investigations, or civil or criminal proceedings.
- We may disclose your PHI in the course of a judicial or administrative proceeding (e.g., to respond to a court order, subpoena, discovery request or other lawful process).
- We may disclose your PHI to a properly identified law enforcement official in the following situations:
- In response to a court order, subpoena, warrant, summons or similar process.
- To assist law enforcement in identifying or locating a suspect, fugitive, material witness or missing person.
- In certain limited circumstances, if you are, or we suspect you are, the victim of a crime and we are unable to obtain your agreement.
- If we believe that a death may be the result of criminal conduct.
- If we believe that the information constitutes evidence of criminal conduct occurring on our premises.
- In emergency circumstances to report a crime, if it appears necessary to disclose the information related to the commission and nature of a crime, the location of the crime or victims, or the identity, description or location of the person who committed the crime.
- We may disclose your PHI to a coroner or medical examiner to identify the person, determine the cause of death or perform other duties recognized by law. We may also release your PHI to funeral directors as necessary to carry out their duties.
- We may use or disclose your PHI for cadaveric organ, eye or tissue donation.
- We may use or disclose your PHI for research purposes, but only as permitted by law.
- We may use or disclose PHI to avert a serious threat to your health or safety or the health and safety of any other person(s).
- We may use or disclose your PHI if you are a member of the military as required by armed forces services, and we may also disclose your PHI for other specialized government functions such as national security or intelligence activities.
- We may disclose your PHI as authorized by, and to the extent necessary to comply with, laws relating to workers’ compensation or similar programs that provide benefits for work-related injuries or illness.
- If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may disclose your PHI to the correctional institution or law enforcement official as necessary (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) for the safety and security of the correctional institution.
- We will, if required by law, release your PHI to the Secretary of the Department of Health and Human Services for enforcement of HIPAA.
In the event applicable law, other than HIPAA, prohibits or materially limits our uses and disclosures of PHI, as described above, we will restrict our uses or disclosure of your PHI in accordance with the more stringent standard.
YOUR RIGHTS
Access to Your PHI
You have the right of access to copy and/or inspect your PHI that we maintain in designated record sets. Requests for access to your PHI must be in writing, must state that you want access to your PHI and must be signed by you or your representative (e.g., requests for medical records provided to us directly from your health care provider). Access request forms are available from us at the address below. We may charge you a fee for copying, mailing or other supplies associated with your request. We may deny your request to inspect and copy in certain very limited circumstances.
Amendments to Your PHI
You have the right to request that PHI that we maintain about you be amended or corrected. You have the right to request an amendment for as long as we keep the information. To request an amendment, your request must be made in writing and submitted to us at the address below. In addition, you must provide a reason that supports your request. Although you are permitted to request that we amend your PHI, we may deny your request if it is not in writing or does not include a reason to support your request. In addition, we may deny your request if you ask us to amend information that:
- was not created by us, unless the person or entity that created the information is no longer available to make the amendment;
- is not part of the information that we keep;
- is not part of the information which you would be permitted to inspect and copy; or
- is accurate and complete.
The Right to an Accounting of Disclosures of Your PHI
You have the right to receive an accounting of certain disclosures made by us of your PHI. Examples of disclosures that we are required to account for include those to state insurance departments, pursuant to valid legal process, or for law enforcement purposes. To be considered, your accounting requests must be in writing and signed by you or your representative. Accounting request forms are available from us at the address below. The first accounting in any 12-month period is free; however, we may charge you a fee for the cost of providing subsequent accountings you request within the same 12-month period. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.
The Right to Request Restrictions on Use and Disclosure of Your PHI
You have the right to request restrictions on how we use and disclose your PHI for treatment, payment and health care operations. You also have a right to request a limitation on the PHI that we disclose to someone who is involved in your care or payment for such care (such as a family member, other relative or close friend) or disclosures for disaster relief purposes. To request restrictions, you must make your request in writing to us at the address below. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply, for example, disclosures to your spouse. We are not required to agree to any restriction you request, with some exceptions, but will attempt to accommodate reasonable requests when appropriate. We retain the right to terminate an agreed-to restriction if we believe such termination is appropriate. In the event of a termination by us, we will notify you of such termination. You also have the right to terminate, in writing or orally, any agreed-to restriction. You may make a request for a restriction (or termination of an existing restriction) by contacting us at the telephone number or address below.
The Right to Request Confidential Communications
You have the right to request that communications regarding your PHI be made by alternative means or at alternative locations. For example, you may request that messages not be left on voicemail or sent to a particular address. To request confidential communications, you or your representative must submit your request in writing to us at the address below. In addition, your request must specify how or where you want to be contacted. We will not ask you the reason for your request. We will accommodate all reasonable requests, in particular if you have clearly stated that the disclosure of all or part of your information could endanger you.
The Right to a Paper Copy of this Notice
You have the right to a paper copy of this Notice at any time, even if you have agreed to receive this Notice electronically. You may request a paper copy by contacting us at the address or telephone number below.
COMPLAINTS
If you believe your privacy rights have been violated, you may file a complaint with us in writing at the address below. You may also file a complaint in writing with the Secretary of the U.S. Department of Health and Human Services in Washington, D.C., within 180 days of your knowledge of a violation of your rights. There will be no retaliation for filing a complaint.
FOR FURTHER INFORMATION
If you have questions or need further assistance regarding this Notice, you may contact the CareHealth Privacy Office by calling 877-345-1601 or by writing to:
CareHealth® information for your health™
Attn: Privacy Office
10845 Olive Boulevard
Suite 308
St Louis, Missouri 63141
EFFECTIVE DATE
This Notice is effective October 4, 2010.
Any duplication or distribution of the information contained herein is strictly prohibited.
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