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Health Information Privacy Practices



Our Agency is required by law to maintain the privacy of protected health information and to provide you adequate notice of your rights and our legal duties and privacy practices with respect to the uses and disclosures of protected health information. [45 CFR §164.520]. We will use or disclose protected health information in a manner that is consistent with this notice.

The agency maintains a record of information we receive and collect about you of the care we provide to you. This record includes physicians’’ orders, assessments, medications lists, clinical progress notes and billing information.

As required by law, the agency maintains policies and procedures about our work practices, including how we provide and coordinate care provided to our patients. These policies and procedures include how we create, maintain and protect medical records; access to medical and information about our patients; how we maintain the confidentiality of all information related to tour patients; security of the building and electronic files; and how we educated staff on privacy of patient information.

How the Agency Uses or Discloses PHI

PHI may be used or disclosed by the Agency as necessary for the operation of the Agency. Specifically, PHI may be used or disclosed for the following Agency purposes:

  • Treatment. Providing, coordinating or managing health care and related services, consultation between health care providers relating to a patient or referral of a patient for health care from one provider to another. For example we meet on a regular basis to discuss how to coordinate care to patients and schedule visits.

  • Payment. Billing and collecting for services provided, determining plan eligibility and coverage, utilization review (UR), precertification, medical necessity review. For example, occasionally the insurance requests a copy of the medical record be sent to them for review prior to paying the bill.

  • Other health care operations. General agency administrative and business functions, quality assurance/improvement activities; medical review; auditing functions; developing clinical guidelines; determining the competence or qualifications of health care professionals; evaluating agency performance; conducting training programs with students or new employees; licensing, survey, certification, accreditation and credentialing activities; internal auditing and certain fundraising and marketing activities. For example, our agency periodically holds clinical record review meetings where the consulting professional of our record review committee will audit clinical records for meeting professional standards and utilization review.

In addition to the typical Agency purposes described above, PHI also may be used or disclosed as permitted or required under applicable law for the following purposes:

  • Use or disclosure required by law. To the extent that the Agency is legally required to provide PHI to a government agency or anyone else, it will do so. In such cases, the Agency will make reasonable efforts to avoid disclosing more information that is required by applicable law.

  • Disclosure for public health activities. The Agency may disclose PHI to a public health authority that is authorized to collect such information (or to a foreign government agency, at the direction of a public health authority) for purposes of preventing or controlling injury, disease or disability.

    The Agency may also disclose PHI to a public health authority or other government agency that is responsible for receiving reports of child abuse or neglect.

    In addition, certain information may be provided to pharmaceutical companies or other business that are regulated by the Food and Drug Administration (FDA), as appropriate for purposes relating to the quality, safety and effectiveness of FDA-regulated products. For example, disclosure might be appropriate for purposes of reporting adverse reactions, assisting with recalls and contacting patients who have received products that have been recalled.

    Also, to the extent permitted by applicable law, the Agency may disclose PHI, as part of a public health investigation or intervention, to an individual who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading a disease or condition.

  • Disclosures about victims of abuse, neglect or domestic violence. (The following does not apply to disclosures regarding child abuse or neglect, which may be made only as provided under Disclosure for public health activities.)

    If required by law, the Agency may disclose PHI relating to a victim of abuse, neglect or domestic violence, to an appropriate government agency. Disclosure will be limited to the relevant required information. The Agency will inform the individual if any PHI is disclosed as provided in this paragraph or the next one.

    If disclosure is not required by law, the Agency may disclose relevant PHI relating to a victim of abuse, neglect or domestic violence to an authorized government agency, to the extent permitted by applicable law, if the Agency determines that the disclosure is necessary to prevent serious harm to the individual or to other potential victims. Also, to the extent permitted by law, the Agency may release PHI relating to an individual to a law enforcement official, if the individual is incapacitated and unable to agree to the disclosure of PHI and the law enforcement official indicated that the information is necessary for an immediate enforcement activity and is not intended to be used against the individual.

  • Health oversight activities. The agency may disclose PHI to a health oversight agency (this includes Federal, State or local agencies that are responsible for overseeing the health care system or particular government program for which health information is needed) for oversight activities authorized by law. This type of disclosure applies to oversight relating to the health care system and various government programs as well as civil rights laws. This disclosure would not apply to any action by the government in investigating a participant in the Agency, unless the investigation relates to the receipt of health benefits by that individual.

  • Disclosures for judicial and administrative proceedings. The Agency may disclose PHI in the course of any judicial or administrative proceeding in response to an order from a court or an administrative tribunal. Also, if certain restrictive conditions are met, the Agency may disclose PHI in response to a subpoena, discovery request or other lawful process. In either case, the Agency will not disclose PHI that has not been expressly requested or authorized by the order or the process.

  • Disclosures for law enforcement purposes. The Agency may disclose PHI for a law enforcement purpose to a law enforcement official if certain detailed restrictive conditions are met.

  • Disclosures to medical examiners, coroners and funeral directors following death. The Agency may disclose PHI to a coroner or medical examiner for the purpose of identifying a deceased person, determining a cause of death, or other duties as authorized by law. The Agency also may disclose PHI to a funeral director as needed to carry out the funeral director’s duties. PHI may also be disclosed to a funeral director, if appropriate, in reasonable anticipation of an individual’s death.

  • Disclosures to avert a serious threat to health or safety. The Agency may, consistent with applicable law and standards of ethical conduct, use or disclose PHI, (1) if it believes the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public; and the disclosure is made to a person or persons reasonably able to prevent or lessen the threat, including the target of the threat; or (2) if it believes the disclosure is necessary for law enforcement authorities to identify or apprehend an individual because of a statement by an individual admitting participation in a violent crime that the Agency reasonably believes may have caused serious physical harm to the victim or where it appears that the individual has escaped from a correctional institution or from lawful custody.

  • Disclosures for specialized government functions. If certain conditions are met, the Agency may use and disclose the PHI of individuals who are Armed Forces personnel for activities deemed necessary by appropriate military command authorities to assure the proper execution of the military mission. Also, the Agency may use and disclose the PHI of individuals who are foreign military personnel to their appropriate foreign military authority and similar conditions.

    The Agency may also use or disclose PHI to authorized federal officials for the conduct of lawful intelligence, counter-intelligence, and other national security activities or for the provision of protective services to the President or other persons as authorized by Federal law to those protective services.

  • Disclosures for workers’ compensation purposes. The Agency may disclose PHI as authorized by and to the extent necessary to comply with laws relating to workers’ compensation or other similar programs.

Uses and Disclosures Not Mentioned Above: Authorization Required

The Agency will not use or disclose PHI for any purpose that is not mentioned above, except as specifically authorized by you. If the Agency needs to use or disclose PHI for a reason not listed above, it will request your permission for that specific use and will not use PHI for that purpose except according to the specific terms of your authorization. You may complete an Authorization form if you want the Agency to use or disclose health information to you, or to someone else at your request, for any reason.

Any authorization you provide will be limited to specified information, and the intended use or disclosure as well as any person or organization that is permitted to use, disclose or receive the information must be specified in the Authorization Form. Also, an authorization is limited to a specific limited time period and it expires at the end of that period. Finally, you always have the right to revoke a pervious authorization by making a written request to the Agency. The Agency will honor your request to revoke an authorization but the revocation will not apply to any action that the Agency took in accord with the authorization before you informed the Agency that you were revoking the authorization.

Your Health Information rights

Under Federal law, you have the following rights:

  • You may request restrictions with regard to certain types of uses and disclosures. This includes the uses and disclosures described above for treatment, Payment and other health agency operations purposes. If the Agency agrees to a restriction you request, it will abide by the terms of that restriction. However, under the law, the Agency is not required to accept any restrictions. If the Agency determines that a requested restriction will interfere with the efficient administration of the Agency, it may decline the request.

  • If PHI is begin provided to you, you may request that the information be provided to you in a confidential manner. This right applies only if you inform the Agency in writing that the ordinary disclosure of part or all of the information might endanger you. For example, an individual may not want information about certain types of treatment to be sent to his or her home address because someone else who lives there might have access to it. In such a case, the individual could request that the information be sent to an alternate address. The Agency will honor such request as long as they are reasonable, but the Agency reserves the right to reject a request that would impose too much of an administrative burden or financial risk on the Agency.

  • You may request access to certain medical records possessed by the Agency and you may inspect or copy those records. This right applies to all enrollments, claims processing, medical management and payment records maintained by the Agency and also to any other information possessed by the Agency that is used to make decisions about you or your health coverage. However, there are certain limited exceptions. For example, the Agency may deny access to psychotherapy notes and to information prepared in anticipation of litigation.

  • You may request that PHI maintained by the Agency be amended. If you feel that certain information maintained by the Agency is inaccurate or incomplete, you may request that the information be amended. The Agency may reject your request if it finds that the information is accurate and complete. Also, if the information you are challenging was created by some other person or organization, the Agency ordinarily would not be responsible for amending that information unless you provide sufficient information to the Agency to establish that the originator of the information is not in a position to amend it.

  • You have the right to receive details about certain non-routine disclosures of health information made by the Agency. You may request an account of all disclosures of health information, with certain exceptions. This accounting would not include disclosures that are made for Treatment, Payment and other health agency operations purposes, disclosures made pursuant to an individual authorization from you, disclosures made to you and certain other types of disclosures. Also, your request will not apply to any disclosures made before April 16, 2003 or for any period earlier than 6 years from the date your request is properly submitted to the Agency. You may receive an accounting of disclosures once every 12 months at no charge. The Agency may charge a reasonable fee for any additional request during a 12 month period.

  • You have the right to request and receive a paper copy of this Privacy Notice. If the Agency provides this Notice to you in an electronic form, you may request a paper copy and the Agency will provide one.

Health Information Complaint Procedures

If you believe your health information privacy rights have been violated, you may file a complaint with the Agency. To file a complaint you should contact Cathy Harrison at (409) 935-1234 extension 106. In addition to your right to file a complaint wit the Agency, if you feel your privacy rights have been violated you may file a complaint with the U.S. Department of Health and Human Services at 1-800-458-9858. You will never be retaliated against in any way as a result of any complaint that you file.

Additional Information

We are required to abide by the terms of this notice currently in effect, but we reserve the right to change these terms as necessary for all protected health information that we maintain. If we change the terms of this notice (while you are receiving service), we will promptly revise and distribute a revised notice to you as soon as practicable by mail, email (if you have agreed to electronic notice) or hand delivery.

If you require further information about matters covered by this notice, please contact: Cathy Harrison at 409-935-1234 extension 106 or write to 8901 EF Lowry Expressway, Suite A, Texas City, TX 77591.