HIPPA Notice Of Privacy Practices
Name or Title of Privacy Officer: HIPAA Privacy Officer
Telephone Number: 424-644-4589
Effective Date: July 1, 2019
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.
1. confidentiality of health information. Health information that
Holy Addiction Care Center Inc. d/b/a NoHo Recovery
(“Company”) receives and/or creates about you, personally,
relating to your past, present, or future health, treatment, or
payment for health care services, is “protected health
information” under the federal law known as the Health
Insurance Portability and Accountability Act of 1996 (HIPAA),
45 C.F.R. Parts 160 and 164. The confidentiality of alcohol and
drug abuse records maintained by Company is protected by
another federal law as well, commonly referred to as the
Alcohol and Other Drug (AOD) Confidentiality Law, 42 C.F.R.
Part 2. Generally, Company may not say to a person outside
Company that you are a client of Company, or disclose any
information identifying you as an alcohol or drug abuser, or
use or disclose any other protected health information except in
limited circumstances as permitted by federal law. Your health
information is further protected by any pertinent state law that
is more protective or stringent than either of these two federal
laws.
2. pledge regarding health information. Company understands
that health information about you and your health is personal.
Company is committed to protecting health information about
you. In order to provide you with quality service and to comply
with certain state and federal legal requirements, Company
creates a record of the services you receive at Company. This
Notice of Privacy Practices (the “Notice”) applies to all of the
records of your service generated by Company. This Notice
will tell you about the ways in which Company may use and
disclose protected health information about you. It also
describes your rights and certain obligations Company has
regarding the use and disclosure of protected health
information. Company is required by law to:
(1) Make sure that health information that identifies you is kept
private;
(2) Give you this Notice of its legal duties and privacy practices
concerning health information about you;
(3) Follow the terms of the Notice that are currently in effect; and
(4) Notify you in case there is an unauthorized use or disclosure of
your unsecured health information.
3. who is bound by this notice. This Notice describes
Company’s practices and those of Company staff, volunteers,
and other personnel who are involved in your services.
Company and these individuals will follow the terms of this
Notice, and may use or disclose protected health information
about you as permitted or required by law. This Notice
describes your rights to access and control protected health
information about you, including information that may identify
you and that relates to your past, present, or future physical
health or mental condition, and healthcare and related
healthcare services. Your personal physician may have other
policies that he or she follows and may use his or her own
Notice of Privacy Practices.
4. how Company may use and disclose protected health
information about you. Company collects health information
about you and stores it in a chart, on a computer, and/or in a
personal health record. This is your medical record. The
medical record is the property of Company, but the information
in the medical record belongs to you. The following categories
describe different ways that Company may use or disclose
protected health information. For each category of uses and
disclosures, Company will explain what is meant and may give
some examples. Not every use or disclosure in a category will
be listed. However, all of the ways Company is permitted to
use and disclose information will fall within one of the
categories. Some information such as certain drug and alcohol
information, HIV, or mental health information is entitled to
special restrictions.
4.1 For Internal Communications. Your protected health
information will be used within Company between and among
Company staff who have a need for the information, in connection
with Company’s duty to diagnose, treat, or refer you for treatment.
This means that your protected health information may be shared
between or among personnel for treatment, payment or health care
operation purposes. For example, two or more providers within
Company may consult with each other regarding your best course of
treatment. Company may share your protected health information in
a billing effort to receive payment for healthcare services rendered
to you. And/or, your protected health information may be discussed
within Company about your treatment in connection with others
receiving treatment, in an effort to improve the overall quality of
care provided by Company. Your protected health information will
not be re-disclosed by Company personnel except as is otherwise
permitted herein.
4.2. To Qualified Service Organizations and/or Business
Associates. Some or all of your protected health information may be
subject to disclosure through contracts for services with qualified
service organizations and/or business associates, outside of
Company, that assist Company in providing healthcare. Examples of
qualified service organizations and/or business associates include
billing companies, data processing companies, or companies that
provide administrative or specialty services. To protect your health
information, Company requires these qualified service organizations
and/or business associates to follow the same standards held by
Company through terms detailed in a written agreement.
4.3. In Medical Emergencies. Your health information may be
disclosed to medical personnel in a medical emergency, when there
is immediate threat to the health of an individual, and when
immediate medical intervention is required.
4.4. To Researchers. Under certain circumstances, Company may
use and disclose your protected health information for research
purposes. For example, a research project may involve comparing
the health and recovery of all clients who received one test or
treatment to those who received another, for the same condition. All
research projects, however, must be approved by an Institutional
Review Board, or other privacy review board as permitted within
the regulations, that has reviewed the research proposal and
established protocols to ensure the privacy of your protected health
information.
4.5. To Auditors and Evaluators. Company may disclose protected
health information to regulatory agencies, funders, third-party
payers, and peer review organizations that monitor alcohol and drug
programs to ensure that Company is complying with regulatory
mandates and is properly accounting for and disbursing funds
received.
4.6. Pursuant to Authorizing Court Order. Company may
disclose your protected health information pursuant to an
authorizing court order. This is a unique kind of court order in which
certain application procedures have been taken to protect your
identity, and in which the court makes certain specific
determinations as outlined in the federal regulations and limits the
scope of the disclosure.
4.7. Crime on Company Premises or Against Company
Personnel. Company may disclose a limited amount of protected
health information to law enforcement when a client commits or
threatens to commit a crime on Company premises or against
Company personnel. Federal law and regulations do not protect any
information about a crime committed by a client either at Company
or against any person who works for Company or about any threat
to commit such a crime.
4.8. Reporting Suspected Child Abuse and Neglect. Company
may report suspected child abuse or neglect as mandated by state
law. Federal law and regulations do not protect any information
about suspected child abuse or neglect from being reported under
state law to appropriate state or local authorities.
4.9. As Required By Law. Company will disclose protected health
information as required by state law in a manner otherwise
permitted by federal privacy and confidentiality regulations.
4.10. Appointment Reminders. Company reserves the right to
contact you, in a manner permitted by law, with appointment
reminders or information about treatment alternatives and other
health related benefits that may be appropriate to you.
4.11. Other Uses and Disclosure of Protected Health
Information. Other uses and disclosures of protected health
information not covered by this Notice will be made only with your
written authorization or that of your legal representative. If you or
your legal representative authorize Company to use or disclose
protected health information about you, you or your legal
representative may revoke that authorization, at any time, except to
the extent that Company has already taken action relying on the
authorization.
5. your rights regarding health information Company
maintains about you. You have the following rights regarding
your health information. In order to exercise these rights, you
must contact the HIPAA Privacy Officer at Company. You may
be asked to submit a written request. The HIPAA Privacy
Officer may be contacted using the following information:
NoHo Recovery Centers
Attn: HIPAA Privacy Officer
5437 Laurel Canyon Blvd, Floor 2
North Hollywood, CA 91607
Phone: 424-644-4589
Email: info@nohorecovery.com
5.1. Right to Inspect and Copy. With certain exceptions, you have
the right to inspect and receive copies of your health information
that Company maintains about you. In some very limited
circumstances Company may, as authorized by law, deny your
request to inspect and obtain a copy of your protected health
information. You will be notified of a denial to any part or parts of
your request. Some denials, by law, are reviewable, and you will be
notified regarding the procedures for invoking a right to have a
denial reviewed. Other denials, however, as set forth in the law, are
not reviewable. Each request will be reviewed individually, and a
response will be provided to you in accordance with the law.
5.2. Right to Amend Your Health Information. If you believe that
protected health information about you is incorrect or incomplete,
you may ask Company to amend the information. Company may
deny your request if it is not in writing or does not include a reason
that supports the request. In addition, Company may deny your
request if you ask Company to amend protected health information
that Company believes: (i) is accurate and complete; (ii) was not
created by Company, unless the person or entity that created the
protected health information is no longer available to make the
amendment; (iii) is not part of the protected health information kept
by or for Company; or (iv) is not part of the protected health
information which you would be permitted to inspect and copy. If
your right to amend is denied, Company will notify you of the
denial and provide you with instructions on how you may exercise
your right to submit a written statement disagreeing with the denial
and/or how you may request that your request to amend and a copy
of the denial be kept together with the protected health information
at issue, and disclosed together with any further disclosures of the
protected health information at issue.
5.3. Right to an Accounting of Disclosures. You have the right to
receive a list of certain disclosures that Company may have made of
your protected health information. This list will not include certain
disclosures as set forth in the HIPAA regulations, including those
made for treatment, payment, or health care operations within
Company or made pursuant to your authorization or made directly
to you.
5.4. Right to Request Restrictions. You have the right to request a
restriction or limitation on the protected health information that
Company uses or discloses about your treatment, payment or health
care operations within Company. While Company will consider
your request, Company is not required to agree to it. If Company
does agree to it, Company will comply with your request, except in
emergency situations where your protected health information is
needed to provide you with emergency treatment. Company will not
agree to restrictions on uses or disclosures that are legally required,
or those which are legally permitted and which Company reasonably
believes to be in the best interest of your health.
5.5. Right to Request Confidential Communications. You have
the right to request that Company communicate with you about your
protected health information in a specific way or at a specific
location. For example, you can ask that Company only contact you
at work or by mail. Company will accommodate all reasonable
requests.
5.6. Right to File a Complaint. Violation of the federal law and
regulations by Company is a crime and suspected violations may be
reported to appropriate authorities in accordance with federal
regulations. If you have any questions or believe that your privacy
rights have been violated, you may contact Company’s HIPAA
Privacy Officer in person or mail a written summary of your concern
to the address listed above. You may also file a written complaint
with the Department of Health and Human Services. You will not be
penalized or retaliated against for filing a complaint.
5.7. Right to Receive a Copy. You have the right to obtain a copy
of this Notice.
6. changes to this notice. Company reserves the right to change
the terms of this Notice at any time. Company reserves the
right to make the revised or changed notice effective for
protected health information Company already has about you
as well as any protected health information Company receives
in the future. Company will post a copy of the current Notice.
The Notice will contain an effective date.