NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO YOUR IDENTIFIABLE HEALTH INFORMATION. PLEASE REVIEW THIS NOTICE CAREFULLY.
A. WHO WE ARE
Specialty Care Rx (referenced as “we” or “us”) is dedicated to maintaining the privacy of your identifiable health information (PHI). In conducting our business, we will create records regarding you and the treatment and services we provide to you. We are required by law to maintain the confidentiality of health information that identifies you, notify affected individuals in the event of an unsecured breach of protected health information. and provide you with this Notice of Privacy Practices (“Notice”) privacy concerning your identifiable health information. By law, we maintain the privacy of your PHI and provide you with this Notice of our legal duties and privacy practices with respect to your PHI. We are also obligated to notify you following a Breach of unsecured PHI. When we use or disclose your PHI, we are required to abide by the terms of this Notice (or other notice in effect at the time of the use or disclosure).
To summarize, this Notice provides you with the following important information:
· How we may use and disclose your identifiable health information
· Your privacy rights in your identifiable health information
· Our obligations concerning the use and disclosure of your identifiable health information.
The terms of this Notice apply to all records containing your identifiable health information that are created or retained by our practice. We reserve the right to revise or amend our notice of privacy practices. Any revision or amendment to this notice will be effective for all of your records our practice has created or maintained in the past, and for any of your records we may create or maintain in the future. We will post a copy of our current notice in our offices in a prominent location, and you may request a copy of our most current notice during any office visit.
B. IF YOU HAVE QUESTIONS ABOUT THIS NOTICE, PLEASE CONTACT:
Attention: Compliance Officer
Specialty Care Rx
801 S Rancho Drive Suite D1-A, Las Vegas, NV 89106 Website: www.myscrx.com
Phone Number: (844) 237-3377
C. PERMISSIBLE USES AND DISCLOLSURES WITHOUT YOUR WRITTEN AUTHORIZATION
In certain situations, which we describe in Section D below, we must obtain your written authorization in order to use and/or disclose your PHI. However, we do not need any type of authorization from you for the following uses and disclosures:
Uses and Disclosures for Treatment, Payment, and Health Care Operations. We may use and disclose PHI, but not your “Highly Confidential Information” (defined in Section D below), in order to treat you, obtain payment for services provided to you and conduct our “Health Care Operations” as detailed below:
Treatment. We may use your identifiable health information to treat you. For example, we may perform a follow-up interview and we may use the results to help us modify your treatment plan. Many of the people who work for us may disclose your identifiable health information in order to treat you or to assist others in your treatment. Additionally, we may disclose your identifiable health information to others who may assist in your care, such as your physician, therapists, spouse, children, or parents.
Payment. We may use and disclose your identifiable health information in order to bill and collect payment for the services and items you may receive from us. For example, we may contact your health insurer to certify that you are eligible for benefits (and for what range of benefits), and we may provide your insurer with details regarding your treatment to determine if your insurer will cover, or pay for, your treatment. We also may use and disclose your identifiable health information to obtain payment from third parties who may be responsible for such costs, such as family members. Also, we may use your identifiable health information to bill you directly for services and items.
Health Care Operations. We may use and disclose your identifiable health information to operate our business. As examples of the ways in which we may use and disclose your information for our operations, we may use your health information to evaluate the quality of care you received from us or to conduct cost- management and business planning activities for our practice. We may also disclose PHI to your other health care providers when such PHI is required for them to treat you, receive payment for services they render to you, or conduct certain health care operations, such as quality assessment and improvement activities, reviewing the quality and competence of health care professionals, or for health care fraud and abuse detection or privacy.
Appointment Reminders. We may use and disclose your identifiable health information to contact you and remind you of visits/deliveries.
Health-Related Benefits and Services. We may use and disclose your identifiable health information to inform you of health-related benefits or services that may be of interest to you.
Release of Information to Family/Friends. We may use or disclose your PHI to a family member, other relative, a close personal friend or any other person identified by you when you are present for, or otherwise available prior to, the disclosure, if we (1) obtain your agreement; (2) provide you with the opportunity to object to the disclosure and you do not object; or (3) reasonably infer that you do not object to the disclosure. If you are not present, or the opportunity to agree or object to a use or disclosure cannot practicably be provided because of your incapacity or an emergency circumstance, we may exercise our professional judgment to determine whether a disclosure is in your best interests. If we disclose information to a family member, other relative or a close personal friend, we will disclose only information that we believe is directly relevant to the person’s involvement with your health care
or payment related to your health care. We may also disclose your PHI in order to notify (or assist in notifying) such persons of your location, general condition, or death.
Public Health Activities. We may disclose your PHI for the following public health activities: (1) to report health information to public health authorities for the purpose of preventing or controlling disease, injury or disability; (2) to report child abuse and neglect to public health authorities or other government authorities authorized by law to receive such reports; (3) to report information about products and services under the jurisdiction of the U.S. Food and Drug Administration; (4) to alert a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading a disease or condition; and (5) to report information to your employer as required under laws addressing work-related illnesses and injuries or workplace medical surveillance.
Victims of Abuse, Neglect or Domestic Violence. If we reasonably believe you are a victim of abuse, neglect or domestic violence, we may disclose your PHI to a governmental authority, including a social service or protective services agency, authorized by law to receive reports of such abuse, neglect, or domestic violence.
Health Oversight Activities. We may disclose your PHI to a health oversight agency that oversees the health care system and is charged with responsibility for ensuring privacy with the rules of government health programs, such as Medicare or Medicaid.
Judicial and Administrative Proceedings. We may disclose your PHI in the course of a judicial or administrative proceeding in response to a legal order or other lawful process.
Law Enforcement Officers. We may disclose your PHI to the police or other law enforcement officials as required or permitted by law or in compliance with a court order or a grand jury or administrative subpoena.
Decedents. We may disclose your PHI to a coroner, medical examiner, or funeral director as authorized by law.
Research. We may use or disclose your PHI without your consent or authorization if an Institutional Review Board or Privacy Board approves a waiver of authorization for disclosure.
Health or Safety. We may use or disclose your PHI to prevent or lessen a serious and imminent threat to a person’s or the public’s health or safety.
Specialized Government Functions. We may use and disclose your PHI to units of the government with special functions, such as the U.S. military or the U.S. Department of State under certain circumstances.
Workers’ Compensation. We may disclose your PHI as authorized by and to the extent necessary to comply with state law relating to workers’ compensation or other similar programs. As Required By Law. We may use and disclose your PHI when required to do so by any other law not already referred to in the preceding categories.
D. USES AND DISCLOLSURES REQUIRE YOUR WRITTEN AUTHORIZATION
Use or Disclosure with Your Authorization. We must obtain your written authorization for most uses and disclosures of psychotherapy notes, uses and disclosures of PHI for marketing purposes, and disclosures that constitute the sale of PHI. Additionally, other uses and disclosures of PHI not described in this Notice will be made only when you give us your written permission on an authorization form (“Your Authorization”). For instance, you will need to complete and sign an authorization form before we can send your PHI to your life insurance company or to the attorney representing the other party in a lawsuit in which you are involved.
Uses and Disclosures of Your Highly Confidential Information. Federal and state law requires special privacy protections for certain highly confidential information about you (“Highly Confidential Information”). This Highly Confidential Information may include the subset of your PHI that: (1) is maintained in psychotherapy notes; (2) is about mental health and developmental disabilities services; (3) is about alcohol and drug abuse prevention, treatment and referral; (4) is about HIV/AIDS testing, diagnosis or treatment; (5) is about sexually-transmitted disease(s); (6) is about genetic testing; (7) is about child abuse and neglect; (7) is about domestic abuse of an adult with a disability; or (8) is about sexual assault. In order for us to disclose your Highly Confidential Information for a purpose other than those permitted by law, we must have Your Authorization.
Revocation of Your Authorization. You may withdraw (revoke) your Authorization, or any written authorization regarding your Highly Confidential Information (except to the extent that we have taken action in reliance upon it) by delivering a written statement to the Compliance Officer identified below. A form of written revocation is available upon request from the Compliance Officer.
E. YOUR RIGHTS REGARDING YOUR IDENTIFIABLE HEALTH INFORMATION
You have the following rights regarding the identifiable health information that we maintain about you:
Right to Receive Confidential Communications. You have the right to request that we communicate with you about your health and related issues in a particular manner or at a certain location. For instance, you may ask that we contact you at home, rather than work. In order to request a type of confidential communication, you must make a written request to the Compliance Officer of Specialty Care Rx. specifying the requested method of contact or the location where you wish to be contacted. We will accommodate reasonable requests. You do not need to give a reason for your request.
Right to Request Additional Restrictions. You may request, and we will accommodate, any reasonable written request for you to receive your PHI by alternative means of communication or at alternative locations.
Right to Inspection and Copy Your Health Information. You have the right to inspect and obtain a copy of the identifiable health information that may be used to make decisions about you, including patient medical records and billing records. You must submit your request in writing to the Compliance Officer of Specialty Care Rx in order to inspect and/or obtain a copy of your identifiable health information. We may charge a fee for the costs, consistent with state law, that includes(1) labor for copying the PHI; (2) supplies for creating the paper copy or electronic media if you request an electronic copy on
portable media; (3) our postage costs, if you request that we mail the copies to you; and (4) if you agree in advance, the cost of preparing an explanation or summary of the PHI.
Right to Request to Amend Your Records. You may ask us to amend your health information if you believe it is incorrect or incomplete, and you may request an amendment for as long as the information is kept by or for us. To request an amendment, your request must be made in writing and submitted to the Compliance Officer of Specialty Care Rx. You must provide us with a reason that supports your request for amendment. We will deny your request if you fail to submit your request (and the reason supporting your request) in writing. Also, we may deny your request if you ask us to amend information that is: (a) accurate and complete; (b) not part of the identifiable health information kept by or for the organization; (c) not part of the identifiable health information which you would be permitted to inspect and copy; or (d) not created by we , unless the individual or entity that created the information is not available to amend the information.
Right to Receive An Accounting of Disclosures. All of our patients have the right to request an “accounting of disclosures.” An “accounting of disclosures” is a list of certain disclosures we have made of your PHI. In order to obtain an accounting of disclosures, you must submit your request in writing to the Compliance Officer of Specialty Care Rx. All requests for an “accounting of disclosures” must state a time period which may not be longer than six years. If you request an accounting more than once during a twelve (12) month period, we will charge you a reasonable fee for additional accountings of disclosure and will inform you in advance of any fee to provide you with an opportunity to withdraw or modify the request.
Right to Receive a Paper Copy of This Notice. You are entitled to receive a paper copy of the Notice. You may ask us to give you a copy of this notice at any time.
Right to File a Complaint. You have the right to request a restriction on the uses and disclosures of your PHI (1) for treatment, payment, and health care operations purposes, and (2) to individuals (such as a family member, other relative, close personal friend or any other person identified by you) involved in your care or with payment related to your care. For example, you have the right to request that we not disclose your PHI to a health plan for payment or health care operations purposes, if that PHI pertains solely to a health care item or service for which we have been involved and which has been paid out of pocket in full. Unless otherwise required by law, we are required to comply with your request for this type of restriction. For all other requests for restrictions on use and disclosures of your PHI, we are not required to agree to your request, but will attempt to accommodate reasonable requests when appropriate. If you wish to request additional restrictions, please obtain a request form from our Compliance Officer and submit the completed form to the Compliance Officer. We will send you a written response. Also, you may make a complaint by calling our hotline at 1-877-706-9911. You may also file written complaints with the Director, Office for Civil Rights of the U.S. Department of Health and Human Services. Upon request, the Compliance Officer will provide you with the correct address for the Director. We will not retaliate against you if you file a complaint with us or the Director.
Right to Provide an Authorization for Other Uses and Disclosures. We will obtain your written authorization for uses and disclosures that are not identified by this notice or permitted by applicable law. These uses or disclosures of protected health information that require your authorization include, but are not limited to, marketing (except communications made face-to-face or communications through a promotional gift of nominal value) and exchanges of protected health information in
exchange for compensation unless otherwise permitted under HIPAA. Any authorization you provide to us regarding the use and disclosure of your identifiable health information may be revoked at any time in writing. After you revoke your authorization, we will no longer use or disclose your identifiable health information for the reasons described in the authorization. Please note that we are required to retain records of your care.
F. EFFECTIVE DATE AND DURATION OF THIS NOTICE
Effective Date. This Notice is effective on January 1, 2019.
Right to Change Terms of this Notice. We may change the terms of this Notice at any time. If we change this Notice, we may make the new notice terms effective for all Protected Health Information that we maintain, including any information created or received prior to issuing the new notice. If we change this Notice, we will post the new notice on our website at www.myscrx.com/privacy-practices. You also may obtain any new notice by contacting the Compliance Officer.
Your privacy is important to us. It is Specialty Care Rx’s policy to respect your privacy and comply with any applicable law and regulation regarding any personal information we may collect about you, including across our website, https: www.myscrx.com.