ACUPUNCTURE & ALTERNATIVE MEDICINE - HIPAA PRIVACY NOTICE

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.
 

INTRODUCTION

ACUPUNCTURE & ALTERNATIVE MEDICINE’S CLINIC understands that your medical information is private and confidential. Further, we are required by law to maintain the privacy of ‘protected health information’. PHI’ includes any individually identifiable information that we obtain from you or others that relates to your past, present or future physical or mental health, the health care you have received, or payment for your health care.

As required by law, this notice provides you with information about your rights and our legal duties and privacy practices with respect to the privacy of PHI. This notice also discusses the uses and disclosures we will make of your PHI. We must comply with the provisions of this notice as currently in effect, although we reserve the right to change the terms of this notice from time to time and to make the revised notice effective for all PHI we maintain. You can always request a written copy of our most current privacy notice from the admissions office at the clinic or you can access it on our website at www.aamedicine.com.
 

PERMITTED USES AND DISCLOSURES

We can use or disclose your PHI for purposes of treatment, payment and health care operations. For each of these categories of uses and disclosures, we have provided a description and an example below. However, not every particular use or disclosure in every category will be listed.

• Treatment means the provision, coordination or management of your health care, including consultations between health care providers relating to your care and referrals for health care from one health care provider to another. For example, a doctor treating you for an infection may need to know if you have hepatitis C because antibiotics used for treating infection may be harmful to the liver.
  
• Payment means the activities we undertake to obtain reimbursement for the health care provided to you, including billing, collections, claims management, determinations of eligibility and coverage and other utilization review activities. For example, we may need to provide information to your Third Party Payer about your medical condition to determine whether the proposed acupuncture treatment will be covered. When we subsequently bill the Third Party Payer for the services rendered to you may require us to obtain a written release from you prior to disclosing certain specially PHI for payment purposes, and we will ask you to sign a release when necessary under applicable law.
  
• Health care operations means the support functions of the clinic, related to treatment and payment, such as quality assurance activities, case management, receiving and responding to patient comments and complaints, physician reviews, compliance programs, audits, business planning, development, management and administrative activities. For example, we may use your PHI to evaluate the performance of our caring for you. We may also combine PHI about many patients to decide what additional services we should offer, what services are not needed, and whether certain new treatments are effective. We may also disclose information to doctors, nurses, technicians, medical students and others for review and learning purposes. In addition, we may remove information that identifies you from your patient information so that others can use the de¬-identified information to study health care and health care delivery without learning who you are.

• We may contact you to provide appointment reminders for treatment.
  
• We may contact you to tell you about or recommend possible treatment alternatives or other health-related benefits and services that may be of interest to you.
  
• We may disclose to your family or friends or any other individual identified by you PHI directly related to such person’s involvement in your care or the payment for your care. We may use or disclose your PHI to notify, or assist in the notification of, a family member, a personal representative or another person responsible for your care, of your location, general condition. If you are present or otherwise available, we will give you an opportunity to object to these disclosures, and we will not make these disclosures if you object. If you are not present or otherwise available, we will determine whether a disclosure to your family or friends is in your best interest, taking into account the circumstances and based upon our professional judgment.
  
• When permitted by law, we may coordinate our uses and private entities authorized by law or by charter to assist in disaster relief efforts.
  
• We will allow your family and friends to act on your behalf to pick-up filled supplements, medical supplies, and similar forms of PHI, when we determine, in our professional judgment that it is in your best interest to make such disclosures.
  
• Subject to applicable law, we may make incidental uses and disclosures of PHI. Incidental uses and disclosures are by-products of otherwise permitted uses or disclosures which are limited in nature and cannot be reasonably prevented.
  
• We may use or disclose your PHI for research purposes, subject to the requirements of applicable law. For example, a research project may involve comparisons of the health and recovery of all patients who received a particular treatment. All research projects are subject to a special approval process, which balances research needs with a patient’s need for privacy. When required, we will obtain a written authorization from you prior to using your PHI for research.
  
• We will use or disclose PHI about you when required to do so by applicable law.

SPECIAL SITUATIONS
Subject to the requirements of applicable law, we will make the following uses and disclosures of your PHI:

• Military and Veterans. If you are a member of the Armed Forces, we may release PHI about you as required by military command authorities. We may also release PHI about foreign military personnel to the appropriate foreign military authority.
  
• Worker1s Compensation. We may release PHI about you for programs that provide benefits for work-related injuries or illnesses.
  
• Public Health Activities. We may disclose PHI about you for public health activities, including disclosures:
  
  * to prevent or control disease, injury or disability;
  * to report child abuse or neglect;
  * to persons subject to the jurisdiction of the Food and Drug Administration (FDA) for activities related to the quality, safety, or effectiveness of FDA-regulated products or services and to report reactions to medications or problems with products;
  * to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; to notify the appropriate government authority if we believe that an adult patient has been the victim of abuse, neglect or domestic violence. We will only make this disclosure if the patient agrees or when required or authorized by law.
  
• Health Oversight Activities. We may disclose PHI to Federal or State agencies that oversee our activities. These activities are necessary for the government to monitor the health care system, government benefit programs, and compliance with civil rights laws or regulatory program standards.
  
• Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may disclose PHI about you in response to a court or administrative order. We may also disclose PHI about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if the clinic is given assurances that efforts have been made by the person making the request to tell you about the request or to obtain an order protecting the information requested.
  
• Law Enforcement. We may release PHI 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 under certain limited circumstances;
  * About a death we believe may be the result of criminal conduct:
  * About criminal conduct on our premises; and
  * In emergency circumstances, to report a crime, the location of the crime or the victims, or the identity, description or location of the person who committed the crime.
• Coroners. Medical Examiners and Funeral Directors. We may release PHI to a coroner or medical examiner. Such disclosures may be necessary, for example, to identify’ a deceased person or determine the cause of death. We may also release PHI about patients to funeral directors as necessary to carry out their duties.
  
• National Security and intelligence Activities. We may release PHI about you to authorized Federal officials for intelligence, counterintelligence, or other national security activities authorized by law.
  
• Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release PHI about you to the correctional institution or law enforcement official. This release would be necessary (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) for the safety and security of the correctional institution.
  
• Serious Threats. As permitted by applicable law and standards of ethical conduct. we may use and disclose PHI if we, in good faith, believe that the use disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public or is necessary for law enforcement authorities to identify or apprehend an individual.
  Note: HIV-related information, genetic information, alcohol and/or substance abuse records, mental health records and other specially PHI may enjoy certain special confidentiality protections under applicable State and Federal law. Any disclosures of these types of records will be subject to these special protections.

YOUR RIGHTS

1. You have the right to request restrictions on our uses and disclosures of PHI for treatment, payment, and health care operations. However, we arc not required to agree to your request. To request a restriction, you must make your request in writing to the clinic.
2. You have the right to reasonably request to receive confidential communications of PHI by alternative means or at alternative locations. To make such a request, you must submit your request in writing at the time of registration.
3. You have the right to inspect and copy the PHI contained in your medical and billing records and in any other records used by us to make decisions about you. except:
(i) for information compiled in reasonable anticipation of, or for use in, a civil, criminal, or administrative action or proceeding;
(ii) for PHI involving laboratory tests when your access is restricted by law;
(iii) if you are a prison inmate, obtaining a copy of your information may be restricted if it would jeopardize your health, safety, security, custody, or rehabilitation or that of other inmates, or the safety of any officer, employee, or other person at the correctional institution or person responsible for transporting you;
(iv) if we obtained or created PHI as part of a research study, your access to the PHI may be restricted for as long as the research is in progress, provided that you agreed to the temporary denial of access when consenting to participate in the research;
(v) for PHI contained in records kept by a Federal agency or contractor when your access is restricted by law; and
(vi) for PHI obtained from someone other than us under a promise of confidentiality when the access requested would be reasonably likely to reveal the source of the information.
In order to inspect and copy your PHI, you must submit your request in writing to the clinic. If you request a copy of your PHI. we may charge you a fee for the costs of copying and mailing your records, as well as other costs associated with your request.
We may also deny a request for access to PHI if:
• the clinic has determined, in the exercise of professional judgment, that the access requested is reasonably likely to endanger your life or physical safety or that of another person;
• the PHI makes reference to another person (unless such other person is a health care provider) and the clinic has determined, in the exercise of professional judgment, that the access requested is reasonably likely to cause substantial harm to such other person; or
• the request for access is made by the individual’s personal representative and the clinic has determined, in the exercise of professional judgment, that the provision of access to such personal representative is reasonably likely to cause substantial harm to you or another person.
If we deny a request for access for any of the three reasons described above, then you have the right to have our denial reviewed in accordance with the requirements of applicable law.
4. You have the right to request an amendment to your PHI, but we may deny your request for amendment, if we determine that the PHI or record that is the subject of the request;
(i) was not created by us, unless you provide a reasonable basis to believe that the originator of PHI is no longer available to act on the requested amendment;
(ii) is not part of your medical or billing records or other records used to make decisions about you;
(iii) is not available for inspection as set forth above; or
(iv) is accurate and complete.
In any event, any agreed upon amendment will be included as an addition to, and not a replacement of, already existing records. In order to request an amendment to your PHI, you must submit your request in writing to the clinic.
5. You have the right to receive an accounting of disclosures of PHI made by us to individuals or entities other than to you for the five years prior to your request, except for disclosures:
(i) to carry out treatment, payment and health care operations as provided above;
(ii) incident to a use or disclosure otherwise permitted or required by applicable law;
(iii) pursuant to a written authorization obtained from you;
(iv) to persons involved in your care or for other notification purposes as provided by law;
(v) for national security or intelligence purposes as provided by law;
(vi) to correctional institutions or law enforcement officials as provided by law;
(vii) as part of a limited data set as provided by law; or
(viii) that occurred prior to April 18, 2005.
To request an accounting of disclosures of your PHI, you must submit your request in writing to the clinic. Your request must state a specific time period for the accounting (e.g., the past three months). The first accounting you request within a twelve (12) month period will be free. For additional accountings, we may charge you for the costs of providing the list. We will notify you of the costs involved, and you may choose to withdraw or modify your request at that time before any costs are incurred.

CONTACT
If you have any questions or would like further information about this notice, please contact at 626-446-7027 ext. 350
This notice is effective as of April 18, 2005