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 is being provided to you as a requirement of the Health Insurance Portability and Accountability Act (HIPAA). This Notice describes how we may disclose your child’s protected health information to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your child’s protected health information in some cases. “Protected health information” means any of your child’s written and oral health information, including demographic data that can be used to identify him/her. This is health information that is created or received by your health care provider, and that relates to your child’s past, present or future physical or mental health or condition.
Uses and Disclosures of Protected Health Information
Children’s Home Care may use protected health information for purposes of providing treatment, obtaining payment for treatment, and conducting health care operations. Your child’s protected health information may be used or disclosed only for these purposes unless Children’s Home Care has obtained your (parent/guardian) authorization or the use or disclosure is otherwise permitted by the HIPAA Privacy Regulations or State law. Disclosures of the protected health information for the purposes described in this Notice may be made in writing, orally, or by facsimile.
Treatment Children’s Home Care will use your child’s protected health information to provide, coordinate, or manage his/her health care and any related services. This includes the coordination or management of health care with a third party for treatment purposes. For example, CHC may disclose protected health information to a pharmacy to fill a prescription or to a laboratory to order a blood test. CHC may also disclose protected health information to other physicians who may be treating your child or consulting with his/her physician with respect to care. In some cases, we may also disclose protected health information to an outside treatment provider, such as a therapy provider for purposes of the treatment activities of the other provider.
Payment Your child’s protected health information will be used, as needed, to obtain payment for the services that CHC provides. This may include certain communications to your health insurer to get approval for the treatment that is recommended by CHC. For example, if a child needs private duty services, CHC may disclose information to the payor for authorization to provide services. We may also disclose protected health information to your insurance company to determine whether you are eligible for benefits or whether a particular service is covered under the plan. In order to get payment for your child’s services, we may also need to disclose protected health information to the insurer to demonstrate the medical necessity of the services, or as required by the insurance company, for utilization review. We may also disclose patient information to another provider involved in your child’s care for the other provider’s payment activities.
Operations We may use or disclose your child’s protected health information as necessary for our own health care operations in order to facilitate the function of Children’s Home Care and to provide quality care to all patients. Performance of health care operations may include activities such as:
In certain situations, we may also disclose patient information to another provider or health plan for their health care operations.
Other Uses and Disclosures As part of treatment, payment and healthcare operations, we may also use or disclose protected health information for the following purposes:
Uses and Disclosures Beyond Treatment, Payment, and Health Care Operations Permitted Without Authorization or Opportunity to Object
Federal privacy rules allow Children’s Home Care to use or disclose your child’s protected health information without your permission or authorization for a number of reasons including the following:
When Legally Required We will disclose your protected health information when we are required to do so by Federal, State or local law. When There Are Risks to public Health We may disclose your child’s protected health information for the following public activities and purposes:
For Law Enforcement Purposes We may disclose your child’s protected health information to a law enforcement official for law enforcement purposes as follows:
For Research Purposes We may use or disclose your child’s protected health information for research when the use or disclosure for research has been approved by an institutional review board or privacy board that has reviewed the research proposal and research protocols to address the privacy of your child’s protected health information.
In the Event of A Serious Threat to Health or Safety We may, consistent with applicable law and ethical standards of conduct, use or disclose protected health information if we believe, in good faith, that such use or disclosure is necessary to prevent or lessen a serious imminent threat to your child’s safety or to the health and safety of the public.
For Specified Government Functions In certain circumstances, the Federal regulations authorize Children’s Home Care to use or disclose protected health information to facilitate specified government functions relating to military activities, national security and intelligence activities, protective services for the President and others, medical suitability determinations, correctional institutions, and law enforcement custodial situations.
For Worker’s Compensation CHC may release protected health information to comply with Worker’s Compensation laws or similar programs.
Uses and Disclosures Permitted Without Authorization But With Opportunity To Object Children’s Home Care may disclose your child’s protected health information to other family members or a close personal friend if it is directly relevant to the person’s involvement in your child’s care or payment related to his/her care. We can also disclose the information in connection with trying to locate or notify other family members or others involved in your child’s care concerning his/her location, condition, or death.
You may object to these disclosures. If you do not object to these disclosures or we can infer from the circumstances that you do not object or we determine, in the exercise of our professional judgment, that it is in your child’s best interests for us to make disclosure of information that is directly relevant to the person’s involvement with your child’s care, we may disclose his/herprotected health information as described.
Uses And Disclosures Which You Authorize
Other than as stated above, we will not disclose your child’s protected health information other than with your written authorization. You may revoke your authorization in writing at any time except to the extent that we have taken action in reliance upon the authorization.
You have the following rights regarding your child’s protected health information:
Please contact your Privacy Officer if you have questions about access to your medical record.
The Right to Request a Restriction on Uses and Disclosures of Protected Health Information You may ask us not to use or disclose certain parts of your child’s protected health information for the purposes of treatment, payment or health care operations. You may also request that we not disclose the health information to other family members or friends who may be involved in your child’s care or for notification purposes as described in this Notice of Privacy Practices. Your request must state the specific restriction requested and to whom you want the restriction to apply.
Children’s Home Care is not required to agree to a restriction that you may request. We will notify you if we deny your request to a restriction. If we do agree to the requested restriction, we may not use or disclose the protected health information in violation of that restriction unless it is needed to provide emergency treatment. Under certain circumstances, we may terminate our agreement to a restriction. You may request a restriction by contacting the Privacy Officer.
The Right to Request to Receive Confidential Communications From Us By Alternative Means or At An Alternative Location You have the right to request that we communicate with you in certain ways. We will accommodate reasonable requests. We may 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 require you to provide an explanation for your request. Requests must be made in writing to our Privacy Officer.
The Right to Have Us Amend Your Child’s Protected Health Information You may request an amendment of protected health information about your child 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 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. Requests for amendment must be in writing and must be directed to the Privacy Officer. In this written request, you must also provide a reason to support the requested amendments.
The Right To Receive an Accounting You have the right to request an accounting of certain disclosures of the protected health information made by Children’s Home Care. This right applies to disclosures for purposes other than treatment, payment, or health care operations as described in this Notice of Privacy Practices. We are also not required to account for disclosures that you requested, disclosures that you agreed to by signing an authorization form, disclosures for a facility directory, to friends or other family members involved in your child’s care, or certain other disclosures we are permitted to make without your authorization. The request for an accounting must be made in writing to our Privacy Officer. The request should specify the time period sought for the accounting. We are not required to provide an accounting of disclosures that took place prior to April 14, 2003. Accounting requests may not be made for periods of time in excess of six years. We will provide the first accounting you request during any 12-month period without charge. Subsequent accounting requests may be subject to a reasonable cost-based fee.
The Right to Obtain a Paper Copy of This Notice Upon request, we will provide a separate paper copy of this notice even if you have already received a copy of the notice or have agreed to accept this notice electronically.
Children’s Home Care is required by law to maintain the privacy of your child’s health information and to provide you with this Notice of our duties and privacy practices. We are required to abide by the terms of this Notice as may be amended from time to time. 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. If we change this Notice, we will provide a copy of the revised Notice by sending a copy of the Revised Notice via regular mail or through in-person contact.
You have the right to express complaints to CHC and to the Secretary of Health and Human Services if you believe that your privacy rights have been violated. You may complain to us by contacting the Privacy Officer verbally or in writing, using the contact information below. We encourage you to express any concerns you may have regarding the privacy of your information. You will not be retaliated against in any way for filing a complaint.
Children’s Home Care’s contact person for all issues regarding patient privacy and your rights under the Federal privacy standards is the Privacy Officer. Information regarding matters covered by this Notice can be requested by contacting the Privacy Officer. Complaints against CHC can be mailed to the Privacy Officer by sending it to:
Children’s Home Care
14950 Heathrow Forest Parkway
Houston, Texas 77032
Attn: Privacy Officer
The Privacy Officer can be contacted by telephone at 281-921-2301.
Effective Date: This Notice was effective April 14, 2003.