OXFORD HEALTHCARE NOTICE OF PRIVACY PRACTICES (HIPAA)
Effective date: April 14, 2003
Oxford HealthCare includes:
Long Term Care
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.
If you have any questions about this Notice, please contact Kathy Noojin, Oxford HealthCare Privacy Officer at (918) 258-1111.
WHO WILL FOLLOW THIS NOTICE:
This Notice describes Oxford HealthCare’s practices and that of:
- Any health care professional authorized to enter information into your homecare chart.
- All departments of the homecare agency.
- All employees, staff and other homecare personnel.
OUR PLEDGE REGARDING MEDICAL INFORMATION:
We understand that medical information about you and your health is personal. We are committed to protecting medical information about you. We create a record of the care and services you receive from our home healthcare agency. We need this record to provide you with quality care and to comply with certain legal requirements. This Notice applies to all of the records of your care generated by Oxford HealthCare. This Notice will tell you about the ways in which we may use and disclose medical information about you. We also describe your rights and certain obligations we have regarding the use and disclosure of medical information.
We are required by law to:
- Make sure that medical information that identifies you is kept private
- Give you this Notice of legal duties and privacy practices with respect to medical information about you
- Follow the terms of the Notice that is currently in effect
HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU:
The following categories describe different ways that we use and disclose medical information. For each category of uses or disclosures we will explain what we mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of these categories.
For Treatment. We may use medical information about you to provide you with medical treatment or other homecare services. We may disclose medical information about you to doctors, nurses, or other homecare personnel who are involved in providing care for you at home. For example, we may provide your doctor with progress notes regarding your care so that he can monitor how well you are progressing. Different departments in the homecare agency may need to share medical information about you in order to coordinate the different things you need, such as pharmacy services, personal care or companion/homemaker services. We may also disclose medical information about you to other agencies who may be involved in your medical care, such as other home health agencies, family members, clergy or others we use to provide services that are part of your care.
For Payment. We may use and disclose medical information about you so that the treatment and services you receive from the home care agency may be billed to and payment may be collected from you, an insurance company or a third party. For example, we may need to give your health plan information about wound care you received at home so your health plan will pay us or reimburse you for the wound care. We may also tell your health plan about a treatment or medication (such as IV antibiotics) you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment or medication.
For Health Care Operations. We may use and disclose medical information about you for home healthcare agency operations. These uses and disclosures are necessary to run the home healthcare agency and make sure that all of our clients/consumers receive quality care. For example, we may use medical information to review our treatment and services and to evaluate the performance of our staff in caring for you. We may also combine medical information about many home care clients/consumers to decide what additional services the home healthcare agency should offer, what services are not needed and whether certain treatments are effective. We may also disclose information to doctors, nurses, home health aids, companions, homemakers, and other home care agency personnel for review and learning purposes. We may also combine the medical information we have with medical information from other home healthcare agencies to compare how we are doing and see where we can make improvements in the care and services we offer. We may remove information that identifies you from this set of medical information so others may use it to study home health care and home health care delivery without learning who the specific clients/consumers are.
Appointment Reminders. We may use and disclose medical information to contact you as a reminder that you have an appointment for treatment or services at your home. If you are not at home, we may leave a message with the person who answers the telephone, or an answering machine unless you ask us not to.
Treatment Alternatives. We may use and disclose medical information to tell you about or recommend possible treatment options or alternatives that may be of interest to you.
Health-Related Benefits and Services. We may use and disclose medical information to tell you about health-related benefits or services that may be of interest to you.
Individuals Involved in Your Care or Payment for Your Care. We may release medical information about you to a friend or family member who is involved in your medical care. We may also give information to someone who helps pay for your care. For example case conferences may involve you, a family member, home healthcare agency staff or physician. In addition, we may disclose medical information about you to an entity (such as the Red Cross) assisting in a disaster relief effort so that your family can be notified about your condition, status and location.
Research. Under certain circumstances, we may use and disclose medical information about you for research purposes. For example, a research project may involve comparing the health and recovery of all clients/consumers who received one type of wound care dressing to those who received another for the same condition. All research projects, however, are subject to a special approval process. This process evaluates a proposed research project and its use of medical information, trying to balance the research needs with the client/consumer’s need for privacy of their medical information. Before we use or disclose medical information for research, the project will have been approved through this research approval process, but we may, however, disclose medical information about you to people preparing to conduct a research project, for example, to help them look for clients/consumers with specific medical needs, so long as the medical information they review does not leave the home healthcare agency. We will almost always ask for your specific permission if the researcher will have access to your name, address or other information that reveals who you are, or will be involved in your care through the home healthcare agency.
As Required By Law. We will disclose medical information about you when required to do so by federal, state or local law.
To Avert a Serious Threat to Health or Safety. We may use and disclose medical information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat.
Organ and Tissue Donation. We may release medical information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation, unless you ask us not to.
Military and Veterans. If you are a member of the armed forces, we may release medical information about you as required by military command authorities. We may also release medical information about foreign military personnel to the appropriate foreign military authority.
Workers’ Compensation. We may release medical information about you for workers’ compensation or similar programs to the extent required by state law. These programs provide benefits for work-related injuries or illness.
Public Health Risks. We may disclose medical information about you for public health activities. These activities generally include the following:
- To prevent or control disease, injury or disability;
- To report births, infant eye infections, birth defects and deaths;
- To report cancer diagnoses or tumors;
- To report child abuse or neglect;
- To report reactions to medications or problems with products;
- To notify people of recalls of products they may be using;
- To notify the Oklahoma State Department of Health that a person may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition such as human immunodeficiency virus (HIV), acquired immunodeficiency syndrome (AIDS), syphilis or other sexually transmitted diseases;
- To notify the appropriate government authority if we believe a client has been the victim of abuse, neglect or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.
Health Oversight Activities. We may disclose medical information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, licensure and accreditation. These activities are necessary for the government and other accrediting bodies to monitor the health care system, government programs, compliance with civil rights laws and compliance with nationally recognized home healthcare standards.
Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may disclose medical information about you in response to a court or administrative order. We may also disclose medical information about you in response to a subpoena, discovery request or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.
Law Enforcement. We may release medical information if asked to do so by a law enforcement official:
- In response to a court order, subpoena, warrant, summons or similar process;
- To identify or locate a suspect, fugitive, material witness or missing person;
- About the victim of a crime if, under certain limited circumstances, we are unable to obtain the person’s agreement.
- About a death we believe may be the result of criminal conduct;
- About criminal conduct at the home; and
- In emergency circumstances to report a crime; the location of the crime or victim; or the identity, description or location of the person who committed the crime.
Coroners, Medical Examiners and Funeral Directors. We may release medical information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release medical information about clients/consumers of the home care agency to funeral directors as necessary to carry out their duties.
National Security and Intelligence Activities. We may release medical information about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.
Protective Services for the President and Others. We may disclose medical information about you to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of sate or conduct special investigations.
Change of Ownership. In the event our company is sold or merged with another organization, your medical information will become the property of the new owner, who will have access to it. You will have the right to ask that copies of your medical information be sent to another health care agency.
YOUR RIGHTS REGARDING MEDICAL INFORMATION ABOUT YOU:
You have the following rights regarding medical information we maintain about you:
Right to Inspect and Copy. You have the right to inspect and copy medical information that may be used to make decisions about your care. Usually, this includes medical and billing records, but does not include psychotherapy notes.
To inspect and copy medical information that may be used to make decisions about you, you must submit your request in writing to Kathy Noojin, Oxford HealthCare Privacy Officer. If you request a copy of the information, we may charge a reasonable fee for the costs of copying, up to 25 cents per page, mailing or other supplies associated with your request.
We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to medical information, you may request that the denial be reviewed. Another licensed health care professional chosen by the home healthcare agency will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.
Right to Amend. If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for the home healthcare agency. To request an amendment, your request must be made in writing and submitted to Kathy Noojin, Oxford HealthCare Privacy Officer. In addition, you must provide a reason that supports your request. We may deny a request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:
- Was not created by us, unless the person or entity that created the information is no longer available to make the amendment;
- Is not part of the medical information kept by or for the home healthcare agency;
- Is not part of the information which you would be permitted to inspect and copy; or
- Is accurate and complete.
Even if we agree to an amendment to your medical records, we may not delete any information already in your medical record.
Right to an Accounting of Disclosures. You have the right to request an “accounting of disclosures.” This is a list of the disclosures we made of medical information about you.
To request this list or accounting of disclosures, you must submit your request in writing to Kathy Noojin, Oxford HealthCare Privacy Officer. Your request must state a time period, which may not be longer than six years and may not include dates before April 14, 2003. Your request should indicate in what form you want the list (for example, on paper, electronically). The first list you request within a 12-month period will be free. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at the time before any costs are incurred.
Right to Request Restrictions: You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment or health care operations. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. For example, you could ask that we not use or disclose information about treatment you had.
We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment.
To request restrictions, you must make your request in writing to Kathy Noojin, Oxford HealthCare Privacy Officer. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply, for example, disclosures to your spouse.
Right to Request Confidential Communications. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail.
To request confidential communications, you must make your request in writing to Kathy Noojin, Oxford HealthCare Privacy Officer. We will not ask you the reason for the request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.
Right to a Paper Copy of This Notice: You have the right to a paper copy of this Notice. You may ask us to give you a copy of this Notice at any time. Even if you have agreed to receive this Notice electronically, you are still entitled to a paper copy of this Notice.
CHANGES TO THIS NOTICE
We reserve the right to change this Notice. We reserve the right to make the revised or changed Notice effective for medical information we already have about you as well as any information we receive in the future. This Notice will contain on the first page, in the top right-hand corner, the effective date. In addition, each time you are admitted to the home healthcare agency for treatment or services, we will offer you a copy of the current Notice in effect.
If you believe your privacy rights have been violated, you may file a complaint with the home healthcare agency or with the Secretary of the Department of Health and Human Services. To file a complaint in writing with the home healthcare agency contact Kathy Noojin, Oxford HealthCare Privacy Officer at (918) 258-1111 to obtain the necessary form. To file a complaint with the U.S. Department of Health and Human Services contact:
U.S. Department of Health and Human Services
200 Independence Ave., S.W.
Washington, D.C. 20201
Complaints made to the Secretary of Health and Human Services must be in writing using whatever form you wish.
You will not be penalized for filing a complaint.
OTHER USES OF MEDICAL INFORMATION
Other uses and disclosures of medical information not covered by this Notice or the laws that apply to use will be made only with your written authorization. If you provide us authorization to use or disclose medical information about you, you may revoke that authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose medical information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your authorization, and that we are required by law to retain our records of the care and services that we provided to you.