NationsMed Health Care
NOTICE OF HOME CARE PRIVACY PRACTICES
USE AND DISCLOSURE OF HEALTH INFORMATION
NationsMed Health Care ["Agency"] may use your health
information, information that constitutes protected health information
as defined in the Privacy Rule of the Administrative Simplification
provisions of the Health Insurance Portability and Accountability
Act of 1996, for purposes of providing you treatment, obtaining
payment for your care and conducting health care operations. Your
health information may be used or disclosed only after the Agency
has obtained your written consent. The Agency has established policies
to guard against unnecessary disclosure of your health information.
THE FOLLOWING IS A SUMMARY OF THE CIRCUMSTANCES UNDER WHICH AND
PURPOSES FOR WHICH YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED
AFTER YOU HAVE PROVIDED YOUR WRITTEN CONSENT:
To Provide Treatment. The Agency may use your health information
to coordinate care within the Agency and with others involved in
your care, such as your attending physician and other health care
professionals who have agreed to assist the Agency in coordinating
care. For example, physicians involved in your care will need information
about your symptoms in order to prescribe appropriate medications.
The Agency also may disclose your health care information to individuals
outside of the Agency involved in your care including family members,
pharmacists, suppliers of medical equipment or other health care
professionals.
To Obtain Payment. The Agency may include your health information
in invoices to collect payment from third parties for the care you
receive from the Agency. For example, the Agency may be required
by your health insurer to provide information regarding your health
care status so that the insurer will reimburse you or the Agency.
The Agency also may need to obtain prior approval from your insurer
and may need to explain to the insurer your need for home care and
the services that will be provided to you.
To Conduct Health Care Operations. The Agency may use and disclose
health information for its own operations in order to facilitate
the function of the Agency and as necessary to provide quality care
to all of the Agency 's patients. Health care operations includes
such activities as:
- Quality assessment and improvement activities.
- Activities designed to improve health or reduce health care costs.
- Protocol development, case management and care coordination.
- Contacting health care providers and patients with information
about treatment alternatives and other related functions that do
not include treatment.
- Professional review and performance evaluation.
- Training programs including those in which students, trainees
or practitioners in health care learn under supervision.
- Training of non-health care professionals.
- Accreditation, certification, licensing or credentialing activities.
- Review and auditing, including compliance reviews, medical reviews,
legal services and compliance programs.
- Business planning and development including cost management and
planning related analyses and formulary development.
- Business management and general administrative activities of
the Agency.
- Fundraising for the benefit of the Agency and certain marketing
activities.
For example the Agency may use your health information to evaluate
its staff performance, combine your health information with other
Agency patients in evaluating how to more effectively serve all
Agency patients, disclose your health information to Agency staff
and contracted personnel for training purposes, use your health
information to contact you as a reminder regarding a visit to you,
or contact you as part of general fundraising and community information
mailings (unless you tell us you do not want to be contacted).
For Appointment Reminders. The Agency may use and disclose your
health information to contact you as a reminder that you have an
appointment for a home visit.
For Treatment Alternatives. The Agency may use and disclose your
health information to tell you about or recommend possible treatment
options or alternatives that may be of interest to you.
THE FOLLOWING IS A SUMMARY OF THE CIRCUMSTANCES UNDER WHICH AND
PURPOSES FOR WHICH YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED
WITHOUT FIRST RECEIVING YOUR WRITTEN CONSENT.
When Legally Required. The Agency will disclose your health information
when it is required to do so by any Federal, State, or local law.
When There Are Risks to Public Health. The Agency may disclose
your health information for public activities and purposes in order
to:
- Prevent or control disease, injury or disability, report disease,
injury, vital events such as birth or death and the conduct of public
health surveillance, investigations and interventions.
- Report adverse events, product defects, to track products or
enable product recalls, repairs and replacements and to conduct
post-marketing surveillance and compliance with requirements of
the Food and Drug Administration.
- Notify a person who has been exposed to a communicable disease
or who may be at risk of contracting or spreading a disease.
- Notify an employer about an individual who is a member of the
workforce as legally required.
To Report Abuse, Neglect Or Domestic Violence. The Agency is allowed
to notify government authorities if the Agency believes a patient
is the victim of abuse, neglect or domestic violence. The Agency
will make this disclosure only when specifically required or authorized
by law or when the patient agrees to the disclosure.
To Conduct Health Oversight Activities. The Agency may disclose
your health information to a health oversight agency for activities
including audits, civil administrative or criminal investigations,
inspections, licensure or disciplinary action. The Agency, however,
may not disclose your health information if you are the subject
of an investigation and your health information is not directly
related to your receipt of health care or public benefits.
In Connection With Judicial And Administrative Proceedings. The
Agency may disclose your health information in the course of any
judicial or administrative proceeding in response to an order of
a court or administrative tribunal as expressly authorized by such
order or in response to a subpoena, discovery request or other lawful
process, but only when the Agency makes reasonable efforts to either
notify you about the request or to obtain an order protecting your
health information.
For Law Enforcement Purposes. As permitted or required by State
law, the Agency may disclose your health information to a law enforcement
official for certain law enforcement purposes as follows:
- As required by law for reporting of certain types of wounds or
other physical injuries pursuant to the court order, warrant, subpoena
or summons or similar process.
- For the purpose of identifying or locating a suspect, fugitive,
material witness or missing person.
- Under certain limited circumstances, when you are the victim
of a crime.
- To a law enforcement official if the Agency has a suspicion that
your death was the result of criminal conduct including criminal
conduct at the Agency.
- In an emergency in order to report a crime.
To Coroners And Medical Examiners. The Agency may disclose your
health information to coroners and medical examiners for purposes
of determining your cause of death or for other duties, as authorized
by law.
To Funeral Directors. The Agency may disclose your health information
to funeral directors consistent with applicable law and if necessary,
to carry out their duties with respect to your funeral arrangements.
If necessary to carry out their duties, the Agency may disclose
your health information prior to and in reasonable anticipation
of your death.
For Organ, Eye Or Tissue Donation. The Agency may use or disclose
your health information to organ procurement organizations or other
entities engaged in the procurement, banking or transplantation
of organs, eyes or tissue for the purpose of facilitating the donation
and transplantation.
In the Event of A Serious Threat To Health Or Safety. The Agency
may, consistent with applicable law and ethical standards of conduct,
disclose your health information if the Agency, in good faith, believes
that such disclosure is necessary to prevent or lessen a serious
and imminent threat to your health or safety or to the health and
safety of the public.
For Specified Government Functions. In certain circumstances, the
Federal regulations authorize the Agency to use or disclose your
health information to facilitate specified government functions
relating to military and veterans, national security and intelligence
activities, protective services for the President and others, medical
suitability determinations and inmates and law enforcement custody.
For Worker's Compensation. The Agency may release your health information
for worker's compensation or similar programs.
AUTHORIZATION TO USE OR DISCLOSE HEALTH INFORMATION
Other than as stated above, the Agency will not disclose your
health information other than with your written authorization. If
you or your representative authorizes the Agency to use or disclose
your health information, you may revoke that authorization in writing
at any time.
YOUR RIGHTS WITH RESPECT TO YOUR HEALTH INFORMATION
You have the following rights regarding your health information
that the Agency maintains:
- Right to request restrictions. You may request restrictions on
certain uses and disclosures of your health information. You have
the right to request a limit on the Agency 's disclosure of your
health information to someone who is involved in your care or the
payment of your care. However, the Agency is not required to agree
to your request. If you wish to make a request for restrictions,
please contact Theresa Breaux, Privacy Official 281-568-0094.
- Right to receive confidential communications. You have the right
to request that the Agency communicate with you in a certain way.
For example, you may ask that the Agency only conduct communications
pertaining to your health information with you privately with no
other family members present. If you wish to receive confidential
communications, please contact Theresa Breaux, Privacy Official 281-568-0094.
The Agency will not request that you provide any reasons for your
request and will attempt to honor your reasonable requests for confidential
communications.
- Right to inspect and copy your health information. You have the
right to inspect and copy your health information, including billing
records. A request to inspect and copy records containing your health
information may be made to Theresa Breaux, Privacy Official, 281-568-0094.
If you request a copy of your health information, the Agency may
charge a reasonable fee for copying and assembling costs associated
with your request.
- Right to amend health care information. You or your representative
has the right to request that the Agency amend your records, if
you believe that your health information is incorrect or incomplete.
That request may be made as long as the information is maintained
by the Agency. A request for an amendment of records must be made
in writing to Theresa Breaux, Privacy Official, 10530 Rockley Road, Suite #120, Houston, TX 77099. The Agency may deny the request if it is not
in writing or does not include a reason for the amendment. The request
also may be denied if your health information records were not created
by the Agency, if the records you are requesting are not part of
the Agency's records, if the health information you wish to amend
is not part of the health information you or your representative
are permitted to inspect and copy, or if, in the opinion of the
Agency, the records containing your health information are accurate
and complete.
- Right to an accounting. You or your representative have the right
to request an accounting of disclosures of your health information
made by the Agency for any reason other than for treatment, payment
or health operations. The request for an accounting must be made
in writing to Theresa Breaux, 10530 Rockley Road, Suite #120, Houston, TX 77099.
The request should specify the time period for the accounting starting
on or after April 14, 2003. Accounting requests may not be made
for periods of time in excess of six (6) years. The Agency would
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.
- Right to a paper copy of this notice. You or your representative
has a right to a separate paper copy of this Notice at any time
even if you or your representative have received this Notice previously.
To obtain a separate paper copy, please contact Theresa Breaux, Privacy
Official, 281-568-0094.
DUTIES OF THE AGENCY
The Agency is required by law to maintain the privacy of your
health information and to provide to you and your representative
this Notice of its duties and privacy practices. The Agency is required
to abide by the terms of this Notice as may be amended from time
to time. The Agency reserves the right to change the terms of its
Notice and to make the new Notice provisions effective for all health
information that it maintains. If the Agency changes its Notice,
the Agency will provide a copy of the revised Notice to you or your
appointed representative. You or your personal representative has
the right to express complaints to the Agency and to the Secretary
of DHHS if you or your representative believes that your privacy
rights have been violated. Any complaints to the Agency should be
made in writing to Theresa Breaux, Privacy Official, 10530 Rockley Road, Suite #120, Houston, TX 77099. The Agency encourages 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.
CONTACT PERSON
The Agency has designated Theresa Breaux, Privacy Official as
its contact person for all issues regarding patient privacy and
your rights under the Federal privacy standards. You may contact
this person at 10530 Rockley Road, Suite #120, Houston, TX 77099 Ph: 281-568-0094.
EFFECTIVE DATE
This Notice is effective April 14, 2003.
IF YOU HAVE ANY QUESTIONS REGARDING THIS NOTICE, PLEASE CONTACT
Theresa Breaux, Privacy Official, 10530 Rockley Road, Suite #120, Houston, TX 77099 Ph: 281-568-0094.
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