NOTICE OF PRIVACY PRACTICES
Please review it carefully. – This notice does not apply to health information that does not identify you or anyone else.
We are required by applicable federal and state law to maintain the privacy of your protected health information. “Protected Health Information” (PHI) is information about you, including demographic information, that may identify you and that relates to your past, present, or future physical or mental health or condition and related health care services.
We are also required to give you this notice about our privacy practices, our legal duties, and your rights concerning your PHI. We must follow the privacy practices that are described in this notice while it is in effect. This notice is effective August 24, 2020 and will remain in effect until we replace it.
We reserve the right to change our privacy practice and the terms of this notice at any time, provided such changes are permitted by applicable law. We reserve the right to make the changes in our privacy practices and the new terms of our notice effective for all PHI that we maintain, including PHI we created or received before we made the changes.
Before we make a significant change in our privacy practices, we will change this notice and make the new notice available upon request. For more information about the privacy practices, or for additional copies of this notice, please contact us using the information listed at the end of this notice.
Uses and Disclosures of Protected Health Information
We use and disclose PHI about you for treatment, payment and health care operations. Following are examples of the types of uses and disclosures that we are permitted to make.
Treatment: We may use or disclose your PHI to physician or other health care provider providing treatment to you. We may use or disclose your PHI to a health care provider so that we can make prior authorization decisions under your benefit plan. Payment: We may use and disclose your PHI to get benefit payments for the health care services provided to you. We may disclose your PHI to another health plan, to a health care provider, or other entity subject to the federal Privacy Rules for their payment purposes. Payment activities may include processing claims, determining eligibility or coverage for claims.
Health Care Operations: We may use and disclose your PHI in connection with our healthcare operations and disclose PHI to business associates with whom we have written agreements containing terms to protect the privacy of your PHI.
Your Privacy Rights
The Law gives you the right to:
Look at or get a copy of the health information we have about you, in most situations
Ask us to correct certain information, including certain health information, about you if you believe the information is wrong or incomplete. Most of the time we cannot change or delete information, even if it is incorrect. However, if we decide to make a change, we will add the correct information to the record and note that the new information takes the place of the old information. The old information will remain in the record. If we deny your request to change the information, you can have your written disagreement placed in your record.
Ask for a list of the times we have disclosed health information about you
Tell us where and how to send messages that include health information about you, if you think sending the information to your usual address could put you in danger. You must put this request in writing, and you must specify where and how to contact you
Ask us for and get a paper copy of this Notice from us Withdraw permission you gave us to use or disclose health information that identifies you, unless we have already taken action based on your permission. You must withdraw your permission in writing.
Our Duty to Protect Health Information That Identifies You
The law requires us to protect the privacy of health information that identifies you.
It also requires us to give you a Notice of its legal duties and privacy practices. In most situations, we may not use or disclose health information that identifies you without your written permission. This Notice explains when we may use or disclose health information that identifies you without your permission. For all other uses and disclosures, we must obtain your written permission, which you may withdraw at any time.
Our company’s employees must protect the privacy of health information that identifies you as part of their jobs.
We do not give employees access to health information unless they need it for a business reason. business reasons for needing access to health information include making benefit decisions, paying bills, and planning for the care you need. We will punish employees who do not protect the privacy of that information that identifies you.
How We Use Medical Information That Identifies You
We may use or disclose health information about you to pay or collect payment for your health care.
2. Health care operations
We may use or disclose health information about you for health care operations. Health care operation includes: Conducting quality assessment and improvement activities Reviewing the competence qualifications, and performance of health care professionals or health plans Training health care professionals or others Conducting accreditation, certification, licensing, or credentialing activities Carrying out activities related to the creation, renewal or replacement of a contract for health insurance or health benefits Providing medical reviews, legal services, or auditing functions Engaging in business management or the general administrative activities of our company.
3. Family member, other relative, or close personal friend
We may disclose health information about you to a family member, other relative or close personal friend when: The health information is related to that person’s involvement with your care or payment for your care You have had an opportunity to stop or limit the disclosure before it happens Our company may not disclose health information about you to family members, relatives, or friends without your written permission or the written permission of your guardian.
4. Government programs providing public benefits
We may disclose health information about you to another government agency offering public benefits if: The information relates to whether you qualify for or are signed up for an insurance program and the law requires or specifically allows the disclosure. The other government agency has the same privacy protections we do as programs that serve similar types of people, and the disclosure is needed to coordinate or improve how the programs are run.
5. Health oversight activities
We may sometimes use or disclose health information about you for health oversight activities. Health oversight activities include looking into: Insurance Fraud Whether a nursing home is providing good care Whether a nurse has hurt a nursing home resident Our company may disclose health information for oversight activities only to another health oversight agency. A health oversight agency must be a governmental agency or someone acting on behalf of a government agency.
6. Public Health
We may disclose health information about you to:
A public health authority for purposes of preventing or controlling disease, injury or disability
An official of a foreign government agency who is acting with the public health authority
A government agency allowed to receive reports of child abuse or neglect
7. Victims of abuse, neglect, or domestic violence
If we believe you are the victim or abuse, neglect, or domestic violence, we may sometimes disclose health information about you to a government agency that receives reports of abuse, neglect or domestic violence if:
A law requires the disclosure
You agree to the disclosure
A law allows the disclosure, and the disclosure is needed to prevent serious harm to you or someone else
A law allows the disclosure, you are unable to agree or disagree, the information will not be used against you
8. Serious threat to health or safety
We may use or disclose health information about you if it believes the use or disclosure is needed:
To prevent or lessen serious and immediate threat to the health and safety of a person or the public
For law enforcement authorities to identify or catch an individual who has admitted participating in a violent crime that resulted in serious physical harm to the victim, unless the information was learned while initiating or in the source of counseling or therapy
For law enforcement authorities to catch an individual who has escaped from lawful custody
9. For other law enforcement purposes
We may disclose health information about you to a law enforcement official for the following law enforcement purposes:
To comply with a grand jury subpoena
To comply with an administrative request, such as a civil investigative demand, if the information is relevant to an investigation that relates to the administration of one of our programs
To identify and locate a suspect, fugitive, witness, or missing person
In response to a request for information about an actual or suspected crime victim
To alert a law enforcement official of a death that DMAS suspects is the result of criminal conduct
To report evidence of a crime on our property
10. For judicial or administrative proceedings
We may disclose health information about you in response to:
An order from a regular or administrative court; or
A subpoena or other discovery request by a party to a lawsuit
11. As required by law
We must use or disclose health information about you when a law requires the use or disclosure.
We may disclose health information about you to one of its contractors if the contractor:
Needs the information to perform services for our company; and Agrees to protect the privacy of the information.
13. Secretary of Health and Human Services
We must disclose health information about you to the Secretary of Health and Human Services when the Secretary wants it to enforce privacy protections.
We may use or disclose health information about you for research if a research board approves the use.
The board will ensure that your privacy is protected when your information is used in research.
Your health information may also be used:
To allow a researcher to prepare for research, as long as the researcher agrees to keep the information confidential
After you die, for research that involves information about people who have died
15. Other uses and disclosures
We may use or disclose health information about you:
To create health information that does not identify any specific individual
To the U.S. military or foreign military for military purposes, if you are a member of the group asking for the information
For purposes of lawful national security issues
To Federal officials to protect the President and others
To a prison or jail, if you are an inmate of that prison or jail, or to law enforcement personnel if you are in custody
To comply with worker’s compensation laws or similar laws; and
To tell or help in telling a family member or another person involved with your case about your location, general condition or death.
We may not share health information about you with a family member or anyone without your written permission or the written permission or your guardian
Questions and Complaints
if you want more information about our privacy practices or have questions or concerns, please contact us using the information listed at the end of this notice.
If you are concerned that we may have violated your privacy rights, you may complain to us using the contact information listed at the end of this notice.
You also may submit a written complaint to the U.S. Department of Health and Human Services; see information at its web site: htt://www.hhs.gov/.
If you request, we will provide you with the address to file your complaint with the U.S. Department of Health and Human Services.
We support your right to the privacy of your PHI. We will not retaliate in any way if you choose to file a complaint with us or with the U.S. Department of Health and Human Services.
Contact HIPAA Privacy Officer at:
4400 W Loop 250 N Ste 102
Midland, Texas 79707