HIPAA Notice of Privacy Practices
As required by the Privacy Regulations Promulgate Pursuant to the Health Insurance Portability and Accountability Act of 1996 (HIPAA). This notice describes how health information about you, may be used and disclosed, and how you can get access to your identifiable health information.
- OUR COMMITMENT TO YOUR PRIVACY
Our organization is dedicated to maintaining the privacy of your identifiable health information. In conducting our business, we will create records regarding you and the treatment and services we provide to you. We are required by law to maintain the confidentiality of health information that identifies you. We are also required by law to provide you with this notice of our legal duties and privacy practices concerning your identifiable health information. By law, we must follow the terms of the notice of the privacy practices that we have in effect at the time.
To summarize, this notice provides you with the following important information:
- How we may use and disclose your identifiable health information.
- Your privacy rights in your identifiable health information.
- Our obligations concerning the use and disclosure of your identifiable health information.
The terms of this notice apply to all records containing your identifiable health information that are created or retained by our practice. We reserve the right to revise or amend our notice of privacy practices. Any revisions or amendment to this notice will be effective for all of your records our practice has created or maintained in the past, and for any of your records we may create or maintain in the future. Our organization will post a copy of our current notice during any office visit.
- IF YOU HAVE QUESTIONS ABOUT THIS NOTICE, PLEASE CONTACT:
Utopia Home Care, Inc.
Attn: HIPAA Privacy Officer
60 East Main Street
Kings Park, New York 11754
- WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION IN THE FOLLOWING WAYS:
The following categories describe the different ways in which we may disclose your identifiable health information.
Our organization may use your identifiable health information to treat you. For example, we may ask you to undergo laboratory tests (such as blood or urine tests), and we may use the results to help us research a diagnosis. Many of the people who work for our organization may use or disclose your identifiable health information in order to treat you or assist others in your treatment. Additionally, we may disclose your identifiable health information to others who may assist in your case, such as your hospital, physician, other agencies, therapists, spouse, children and / or parents.
Our organization may use and disclose your identifiable health information in order to bill and collect payment for the services and items you may receive from us. For example, we may contact your health insurer to certify that you are eligible for benefits (and for what range of benefits), and we may provide your insurer with details regarding your treatment to determine if your insurer will cover, or pay for, your treatment. We also may use and disclose your identifiable health information to obtain payment from third parties that may be responsible for such costs, such as family members. Also, we may use your identifiable information to bill you directly for services and items.
- Health Care Operations
Our organization may use and disclose your identifiable health information to operate our business and maintain our license and accreditation. As examples of the ways in which we may use and disclose your information for our operations, our organization may use your health information to evaluate the quality of care you received from us, or to conduct cost-management and business planning activities for our practice. Also, the Department of Health and accrediting bodies may access identifiable health information as needed. Additionally, in the event of an emergency or disaster situation, necessary medical information could be given to any governmental agency, supplemental provider agency, community volunteer service or any other provider of services.
- Appointment Reminders
Our organization may use and disclose your identifiable health information to contact you and remind you of visits / deliveries.
- Health-Related Benefits and Services
Our organization may use and disclose your identifiable health information to inform you of health-related benefits or services that may be of interest to you.
- Release of Information to Family / Friends
Our organization may release your identifiable health information to a friend or family member that is helping you pay for your health care, or who assists in taking care of you.
- Disclosure Required By Law
Our organization will use and disclose your identifiable health information when we are required to do so by federal, state or local law.
- Workers’ Compensation
Our organization may release your identifiable health information for worker’s compensation and similar programs.
- YOUR RIGHTS REGARDING YOUR IDENTIFIABLE HEALTH INFORMATION
You have the following rights regarding the identifiable health information that we maintain about you:
- Confidential Communications
You have the right to request that our organization communicate with you about your health and related issues in a particular manner or at a certain location. For instance, you may ask that we contact you at home, rather than at work. In order to request a type of confidential communication, you must make a written request to the Privacy Officer, Utopia Home Care, Inc., 60 East Main Street, Kings Park, New York, 11754, (631) 544-5077, specifying the requested method of contact, or the location where you wish to be contacted. Our organization will accommodate reasonable requests. You do not need to give a reason for your request.
- Requesting Restrictions
You have the right to request a restriction in our use or disclosure of your identifiable health information for treatment, payment or health care operations. Additionally, you have the right to request that we limit our disclosure of your identifiable health information to individuals involved in your care or the payment for your care, such as family members and friends. We are not required to agree to your request; however, if we do agree, we are bound by our agreement except when otherwise required by law, in emergencies, or when the information is necessary to treat you. Your request must be made in writing to the Privacy Officer, Utopia Home Care, Inc., 60 East Main Street, Kings Park, NY, 11754, (631) 544-5077, and must describe in a clear and concise fashion:
- The information you wish restricted;
- Whether you are requesting to limit our practice’s use, disclosure or both;
- To whom you want the limits to apply.
You may specifically request to restrict disclosure of your protected health information if that information pertains solely to a healthcare item or services for which you, or someone on your behalf other than the health plan, has paid us as the covered entity in full.
- Inspection and Copies
You have the right to inspect and obtain a copy of the identifiable health information that may be used to make decisions about you, including medical records and billing records. You must submit your request in writing to the Privacy Officer, Utopia Home Care, Inc., 60 East Main Street, Kings Park, NY, 11754, (631) 544-5077, in order to inspect and/or obtain a copy of your identifiable health information. The agency will charge $0.75 per page for copies of the medical record. A copy of your record in electronic format can be provided if you wish. This will be provided to you on a flash drive. Our agency may deny your request to inspect and/or copy in certain limited circumstances; however, you may request a review of our denial. Another licensed health professional chosen by us will conduct reviews. We must also have your written permission to release a copy of your medical record to a person other than yourself, or allow that person to view your medical record, except where permitted by HIPAA Privacy laws.
You may ask us to amend your health information if you believe it is incorrect or incomplete, and you may request an amendment for as long as the information is kept by or for our organization. To request an amendment, your request must be made in writing and submitted to the Privacy Officer, Utopia Home Care, Inc., 60 East Main Street, Kings Park, NY, 11754, (631) 544-5077. You must provide us with a reason that supports your request for amendment. Our organization will deny your request if you fail to submit your request (and the reason supporting your request) in writing if you ask us to amend information that is:
- Accurate and complete
- Not part of the identifiable health information kept by or for the organization
- Not part of the identifiable health information that you would be permitted to inspect or copy
- Not created by our organization, unless the individual or entity that created the information is not available to amend the information.
- Accounting of Disclosures
All of our clients have the right to request an “accounting of disclosures”. An accounting of disclosures is a list of certain disclosures our organization has made of your identifiable information. In order to obtain an accounting of disclosures, you must submit your request in writing to the Privacy Officer, Utopia Home Care, Inc., 60 East Main Street, Kings Park, NY, 11754, (631) 544-5077. All requests for an “Accounting of Disclosures” must state a period of time that may not be longer than six (6) years and may not include dates before April 14, 2003. The first list you request within a twelve (12) month period is free of charge, but our agency may charge you additional lists within the same twelve (12) month period. Our organization will notify you of the costs involved with the additional lists within the same twelve (12) month period. Our organization will notify you of the costs involved with the additional requests, and you may withdraw your request before you incur any costs.
- Right to Paper Copy of this Notice
You are entitled to receive a paper copy of our notice of privacy practices. You may ask us to give you a copy of this notice at any time. To obtain a paper copy of this notice, contact the Privacy Officer at (631) 544-5077.
- Right to File a Complaint
If you believe your privacy rights have been violated, you may file a complaint with our organization or with the Secretary of the Department of Health and Human Services. To file a complaint with our organization, contact the Privacy Officer, Utopia Home Care, Inc., 60 East Main Street, Kings Park, NY, 11754, (631) 544-5077. All complaints must be submitted in writing. You will not be penalized for filing a complaint.
- Right to Provide and Authorization for Other Uses and Disclosures
Our organization will obtain your written authorization for uses and disclosures that are not identified by this notice or permitted by applicable law. We will need an authorization from you to disclose any behavioral or psychiatric information, for release of any information for the purpose of marketing, and for the sale of Protected Health Information. You also have the right to opt out of fundraising communications. If applicable, genetic information will not be used for health underwriting. Any authorization you provide to us regarding the use and disclosure of your identifiable health information may be revoked at any time in writing. After you revoke your authorization, we will no longer use or disclose your identifiable health information for the reasons described in the authorization. Please note we are required to retain records of your case.
- Marketing, Fundraising, and Sale of Identifiable Health Information
Our organization may not use your identifiable health information for marketing or fundraising activities, nor may your information be sold without your specific written permission to do so.
- Notification of Unauthorized Use or Disclosure of Identifiable Health Information
You have the right to be notified of, and the organization has a legal duty to report to you, any unauthorized use or disclosure (also known as a breach) of identifiable health information. Such notification is required unless it has been determined through a thorough risk assessment, that there is an extremely low probability that the unauthorized use or disclosure will result in your being personally identified. Notification to you of a breach of unsecured information will incur within 30 days of discovering that a breach of your protected health information has occurred. We will also tell you what we have done to mitigate the breach.
USE AND DISCLOSURE OF YOUR IDENTIFIABLE HEALTH INFORMATION IN CERTAIN SPECIAL CIRCUMSTANCES
The following categories describe unique scenarios in which we may use or disclose your identifiable health information:
- Public Health Risks
Our organization may disclose your identifiable health information to public health authorities that are authorized by law to collect information for the purpose of:
- Maintaining vital records such as births and deaths
- Reporting child abuse or neglect
- Preventing or controlling disease, injury or disability
- Notifying a person regarding potential exposure to a communicable disease
- Notifying a person regarding a potential risk for spreading or contracting a disease or condition
- Reporting reactions to drugs or problems with products or devices
- Notifying individuals if a product or device they may be using has been recalled
- Notifying appropriate government agency(ies) and authority(ies) regarding the potential abuse or neglect of an adult patient (including domestic violence); however, we will only disclose this information if the patient agrees or we are required or authorized to do so by law to disclose this information
- Notifying your employer under limited circumstances related primarily to workplace injury or illness or medical surveillance.
- Health Oversight Activities
Our organization may disclose your identifiable health information to a health oversight agency for activities authorized by law. Over sight activities can include, for example, investigations, inspections, audits, surveys, licensure and disciplinary actions; civil, administrative, and criminal procedures or actions; or other activities necessary for the government to monitor government programs, compliance with civil rights laws and the health care system in general.
- Lawsuits and Similar Proceedings
Our organization may use and disclose your identifiable health information in response to a court or administrative order, if you are involved in a lawsuit or similar proceeding. We may also disclose your identifiable health information in response to a discovery request, subpoena, or other lawful process by another party involved in the dispute, but only if we have made an effort to inform you of the request or to obtain an order protecting the information the party has requested.
- Law Enforcement
We may release identifiable health information is asked to do so by a law enforcement official:
- Regarding a crime victim in certain situations, if we are unable to obtain the person’s agreement
- Concerning a death we believe might have resulted from a criminal conduct
- Regarding criminal conduct in our offices
- In response to a warrant, summons, court order, subpoena or similar legal process
- To identify / locate a suspect, material witness, fugitive or missing person
- In an emergency, to report a crime (including the location of victim(s) of the crime, or the description, identity or location of the perpetrator)
- Serious Threats to Health or Safety
Our organization may use and disclose your identifiable health information when necessary to reduce or prevent a serious threat to your health and safety or the health and safety of another individual or the public. Under these circumstances, we will only make disclosures to a person or organization able to prevent the threat.
Our organization may disclose your identifiable health information if you are a member of the U.S. or foreign military forces (including veterans) and if required by the appropriate military command authorities.
- National Security
Our organization may use and disclose your identifiable health information to federal officials for intelligence and national security activities authorized by law. We also may disclose your identifiable health information to federal officials in order to protect the President, other officials or foreign heads of state, or to conduct investigations.
- Workers’ Compensation
Our organization may release your identifiable health information for workers’ compensation and similar programs.