HIPAA'S PRIVACY RULES
I. Family Care Partners may Use or Disclose Your Health Information for Treatment, Payment and Health Care Operations
Family Care Partners collects health information from you and stores it in a chart and on a computer. This is your medical record. The medical record is the property of Family Care Partners, but the information in the medical record belongs to you. Family Care Partners protects the privacy of your health information. The law permits Family Care Partners to use or disclose your health information without your authorization for the following purposes:
- Treatment. Family Care Partners may use your health information to determine a course of treatment, to coordinate care within the office; to coordinate care with other Family Care Partners healthcare professionals or to other healthcare professionals outside of Family Care Partners involved in your care. For example, a Family Care Partners office might disclose your health information to others outside our practice including a designated personal representative (as long as they are approved by you), a pharmacist, medical equipment supplier or any other healthcare professional (in the opinion of the physician or physician's representative) who needs your information to continue your care.
- Payment. Family Care Partners may use your health information to seek approval for certain services, bill for those services and collect payment from third party payers. For example, our office will send an invoice to your health insurance company to provide them with the necessary information for payment for our services or our office might contact your insurance company to seek approval for tests we deem necessary to determine a course of treatment for which the insurance company requires us to disclose your personal health information.
- Regular Health Care Operations. Family Care Partners may use and disclose health information for its own operations to facilitate the function of our practice as necessary to provide quality care to all of our patients. Family Care Partners' healthcare operations include such activities as:
- Quality assessment and improvement activities.
- Activities designed to improve health or reduce healthcare costs.
- Professional review and performance evaluation
- Review and auditing, including compliance reviews, medical reviews and compliance programs.
- Information provided to you. Family Care Partners may also use and disclose your health information to contact you as a reminder that you have an appointment and may, in some instances, leave a message on your answering machine. If you do not wish for us to leave a message, please inform us using the "Acknowledgement of Receipt of Privacy Notice" form.
- Notification and communication with family . We may disclose your health information to notify or assist in notifying a family member, your personal representative or another person responsible for your care about your location, your general condition or in the event of your death. If you are able and available to agree or object, we will give you the opportunity to object prior to making this notification. If you are unable or unavailable to agree or object, our health professionals will use their best judgment in communication with your family and others.
II. Family Care Partners may Use or Disclose Your Health Information for Other Legal or Health Related Purposes
- Public health. As required by law, we may disclose your health information to public health authorities for purposes related to: preventing or controlling disease, injury or disability; reporting child abuse or neglect; reporting domestic violence; reporting to the Food and Drug Administration problems with products and reactions to medications; and reporting disease or infection exposure.
- Health oversight activities. We may disclose your health information to health agencies during the course of audits, investigations, inspections, licensure and other proceedings.
- Judicial and administrative proceedings. We may disclose your health information in the course of any administrative or judicial proceeding.
- Law enforcement. We may disclose your health information to a law enforcement official for purposes such as identifying of locating a suspect, fugitive, material witness or missing person, complying with a court order or subpoena and other law enforcement purposes.
- Deceased person information. We may disclose your health information to coroners, medical examiners and funeral directors.
- Organ donation. We may disclose your health information to organizations involved in procuring, banking or transplanting organs and tissues.
- Research. We may disclose your health information to researchers conducting research that has been approved by an Institutional Review Board or Family Care Partners' privacy board.
- Public safety. We may disclose your health information to appropriate persons in order to prevent or lessen a serious and imminent threat to the health or safety of a particular person or the general public.
- Worker's compensation. We may disclose your health information as necessary to comply with worker's compensation laws.
- Change of Ownership. In the event that Family Care Partners is sold or merged with another organization, your health information/record will become the property of the new owner.
III. When Family Care Partners May Not Use or Disclose Your Health Information
Except as described in this Notice of Privacy Practices, Family Care Partners will not use or disclose your health information without your written authorization. If you do authorize Family Care Partners to use or disclose your health information for another purpose, you may revoke your authorization in writing at any time.
IV. Your Health Information Rights
- You have the right to request restrictions on certain uses and disclosures of your health information. Family Care Partners is not required to agree to the restriction that you requested.
- You have the right to receive your health information through a reasonable alternative means or at an alternative location. For example, you might not wish us to discuss your health condition or other health information in private with no family members present. You can request that we not leave messages on your answering machine. Family Care Partners will make every effort to comply with your reasonable requests for confidential communications.
- You have the right to inspect and copy your health information including billing records. If you make a request for copies of your records a nominal fee may be charged for copying and assembling costs associated with your requests.
- You have a right to request that Family Care Partners amend your health information that is incorrect or incomplete. Family Care Partners is not required to change your health information and will provide you with information about Family Care Partners' denial and how you can disagree with the denial. Family Care Partners may deny your request if your health information was not created by us, if the records you are requesting are not part of our 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 Family Care Partners the records containing your health information are accurate and complete.
- You have a right to receive an accounting of disclosures of your health information made by Family Care Partners, except that Family Care Partners does not have to account for the disclosures described in parts 1 (treatment), 2 (payment), 3 (health care operations) and 4 (information provided to you) of section I of this Notice of Privacy Practices.
- You have a right to a paper copy of this Notice of Privacy Practices.
If you would like to have a more detailed explanation of these rights or if you would like to exercise one or more of these rights, contact the office manager of this practice or Family Care Partners Administrative Office at (904) 744.7300 extensions 3067 or 3077.
V. Changes to this Notice of Privacy Practices
Family Care Partners reserves the right to amend this Notice of Privacy Practices at any time in the future, and to make the new provisions effective for all information that it maintains, including information that was created or received prior to the date of such amendment. Until such amendment is made, Family Care Partners is required by law to comply with this Notice. Any amendments to this Notice of Privacy Practices will be posted in our centers and on our website (www.familycarepartners.com) within ten business days of the change.
In December 2000, the U.S. Department of Health and Human Services (DHHS) published privacy rules mandated by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Some of the HIPAA provisions were enacted to help healthcare entities save money by encouraging electronic transactions. Along with these provisions, the Privacy Rule provides safeguards for protecting the privacy of individually identifiable health information.
- Healthcare providers conducting electronic billing and Administrative transactions
- Health plans
- Healthcare clearinghouses
- Medical records and other individually identifiable health information used or disclosed in any form-electronically, on paper, or orally
- Final ruling became effective April 14, 2001
- Compliance with final rules by April 14, 2003
- The Office of Civil Rights is responsible for enforcement and may seek civil and criminal prosecution of violations.
- Civil penalties - $100 per violation, up to $25,000 per person, per year for each requirement or probation violated.
- Federal criminal penalties – Up to $50,000 and one year in prison for obtaining or disclosing protected health information. Up to $100,000 and up to five years in prison for obtaining protected health information fraudulently. Up to $250,000 and up to 10 years in prison for obtaining or disclosing protected health information with the intent to sell, transfer, or use it for commercial advantage, personal gain, or malicious harm.
Requirements of Healthcare Providers
- Provide information to patients about their privacy and how their health information will be used and disclosed.
- Implement privacy procedures for the practice.
- Train employees in the practice's privacy procedures.
- Designate an individual to be responsible for ensuring procedures are followed.
- Secure patient records to restrict access to individually identifiable health information.
- Provide a history of non-routine disclosures to patients, if requested.
- Obtain patient consent prior to sharing the patient's information for treatment, payment, and healthcare operations.
- Obtain separate patient authorization for non-routine Disclosures and non-healthcare purposes.
- The signed consent should be retained for six years from the date it was last in effect.
- Some integrated entities may obtain one joint consent for multiple entries.
- Providers may rely on consents received prior to April 14, 2003, for uses and disclosure of health Information obtained prior to that date.
- A patient's revocation of consent must be in writing. If a patient revokes consent immediately after a service is provided, the revocation does not interfere with the billing or reimbursement for that care.
- Providers relying on business associates who use or disclose protected health information on the provider's behalf should have a contract with the associate regarding safeguarding the protected information from misuse.
Access and Transfer Limitations
*Health information generally may not be disclosed for non-health purposes without explicit authorization from the patient.
*Disclosures of information will generally be limited to the Minimum amount of information necessary for the Purpose of the disclosure. This does not apply to Disclosure of medical records for treatment purposes since providers need access to the full record to provide quality care.