HIPAA 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.

Health Information Portability and Accountability Act (HIPAA) notice of privacy policy

Federal law protects your health information. We’ll ask for written permission before sharing it — unless the law requires us to do so, such as in cases of abuse or a court order. The following paragraphs outline our HIPAA Notice of Privacy Practices, which explains your rights and how we use your information for care, payment, and operations.

This document contains important information about federal law, the Health Information Portability and Accountability Act (HIPAA), which provides privacy protections and patient rights about the use and disclosure of your Protected Health Information (PHI) used for treatment, payment, and health care operations.

HIPAA requires that we provide you with a Notice of Privacy Practices (the Notice) for the use and disclosure of PHI for treatment, payment, and healthcare operations. The Notice explains HIPAA and its application to your PHI in greater detail.

The law requires that we obtain your signature acknowledging that we have provided you with this. If you have any questions, it is your right and obligation to ask so we can have a further discussion before signing this document. When you sign this document, it will also represent an agreement between us. You may revoke this Agreement in writing at any time. That revocation will be binding unless we have taken action in reliance on it.

Use and disclosure of protected health information

For treatment
We use and disclose your health information internally in the course of your treatment. If we wish to provide information outside of our practice for your treatment by another healthcare provider, we will have you sign an authorization for the release of information. Furthermore, authorization is required for most uses and disclosures of psychotherapy notes.

For payment
We may use and disclose your health information to obtain payment for services provided to you.

For operations
We may use and disclose your health information as part of our internal operations. For example, this could mean a review of records to assure quality. We may also use your information to tell you about services, educational activities, and programs that we feel might be of interest to you.

For HIV disclosure
Under the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule, public health authorities are authorized to collect and receive private health information “for the purpose of preventing or controlling disease” and in the “conduct of public health surveillance…” without patient or provider consent or authorization other than state or local public health law.

This clause authorizes providers to report HIV/AIDS cases to the HIV Epidemiology Program without obtaining patient consent and it authorizes health department personnel to review medical records and any other source of information needed to report the case.

Any other disclosure of HIV-related information must be made on the “HIPAA-Compliant Authorization for Release of Medical Information and Confidential HIV-Related Information”.

State law prohibits any further disclosure of HIV-related private health information without the specific written consent of the person to whom it pertains, or as otherwise permitted by law.