Privacy Notice (HIPAA)

Our Notice of Privacy Practices describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

EFFECTIVE DATE: April 14, 2003

Our Philosophy on Patient Privacy

Oncology Hematology Care, Inc. (“OHC”) recognizes the importance of patient privacy. As such, it is OHC’s policy to treat all medical information as personal and confidential; OHC is committed to protecting your privacy rights. OHC will create a record of the care and services you receive from OHC. OHC needs this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by OHC.

Uses and Disclosures of Medical Information

The following categories describe different ways that OHC uses and discloses medical information. For each category of uses or disclosures OHC will try to explain what we mean and give examples. Not every possible use or disclosure in a category will be listed. However, all of the ways OHC is permitted to use and disclose information will fall within one of the categories.

Uses and Disclosures for Patient Treatment, Payment, Health Care Operations and Administrative Matters:
1. For Treatment - OHC may use medical information about you to provide you with medical treatment or services. OHC may disclose medical information about you to doctors, nurses, and other staff of OHC who are involved in taking care of you. OHC may also disclose medical information about you to people outside our office who may be involved in your medical care. For example, we may disclose medical information to a referring physician who will be involved in treating you after you leave our office.
2. For Payment - OHC may use or disclose medical information about you to your insurance company, a governmental payer or other responsible third party for the purpose of receiving payment for the medical treatment you have received. For example, OHC may tell your health plan about a medical treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment.
3. For Health Care Operations - OHC may use and disclose medical information about you for purposes of health care operations. These uses and disclosures are necessary to insure that all of our patients receive quality care. For example, OHC may use medical information to review our treatment and services and to evaluate the performance of our staff in caring for you.
4. For Certain Administrative Matters - OHC may also use and disclose medical information about you to:
  - Contact you as a reminder that you have an appointment for treatment with OHC;
  - Tell you about or recommend possible treatment options or alternatives that may be of interest to you; and
  - Tell you about health-related benefits or services that may be of interest to you.
Additional Uses and Disclosures for which Patient Consent is Not Necessary
Additionally, in limited instances, OHC may use and disclose medical information without your consent in the following situations:
1. Uses and Disclosures Required by Law - OHC may use or disclose medical information to the extent that such use or disclosure is required by federal, state, or local law and the use or disclosure complies with and is limited to the relevant requirements of such law;
2. Uses and Disclosures for Public Health Activities – OHC may use or disclose medical information about you for public health activities to:
  - a public health authority that is authorized by law to collect or receive information for the purposes of preventing or controlling disease, injury, or disability;
  - a public health authority or other appropriate government entity authorized by law to receive reports of child abuse or neglect;
  - an FDA agent or official to report reactions to medication or problems with products;
  - 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; or
  - to an employer, but only such information that is intended to evaluate whether the individual has a work-related illness, or such information that relates to medical surveillance of the workplace (but only if the patient is notified of such disclosure in advance).
3. Disclosures about Victims of Abuse, Neglect or Domestic Violence – OHC may disclose medical information about you to a government authority, including a social service or protective agency, as required by law, if OHC reasonably believes a patient to be a victim of abuse, neglect, or domestic violence.
4. Uses and Disclosures for Health Oversight Activities – OHC may disclose or use protected health information to a health oversight agency for oversight activities authorized by law, including audits; civil, administrative, or criminal investigations; inspections; or licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.
5. Disclosures for Judicial and Administrative Proceedings – If you are involved in a legal dispute, OHC may disclose medical information about you in the course of any judicial or administrative proceeding with a valid court order or appropriate subpoena or discovery request. OHC will make all reasonable efforts to tell you about this request before making this disclosure.
6. Disclosures for Law Enforcement Purposes – OHC may disclose medical information 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, if, under certain limited circumstances, we are unable to obtain the person’s agreement;
  - About a death we believe may be the result of criminal conduct;
  - About criminal conduct here at OHC; and
  - In emergency circumstances to report a crime; the location of the crime or victims; or the identity, description, or location of the person who committed the crime.
7. Uses and Disclosures to Coroners, Medical Examiners and Funeral Directors– OHC may release medical information to a coroner or medical examiner for the purpose of identifying a deceased person, determining the cause of death, or other duties as authorized by law. OHC may also release medical information to funeral directors as necessary to carry out their duties.
8. Uses and Disclosures for Organ, Eye or Tissue Donation Purposes – OHC may use or disclose medical information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of cadaveric organs, eyes, or tissue for the purpose of facilitating organ, eye, or tissue donation and transplantation.
9. Uses and Disclosures for Research Purposes – OHC may use or disclose medical information about you for research purposes. For example, a research project may involve comparing the health and recovery of all patients who received one medication to those who received another. All research projects, however, are subject to a special approval process. This process evaluates a proposed research project and its use of medical information, specifically trying to balance the research needs with patients’ needs for privacy of their medical information. Before OHC uses or discloses medical information for research, the project will have been approved through this research approval process.
10. Uses and Disclosures to Avert a Serious Threat to Health or Safety – OHC may use or disclose medical information about you if we reasonably believe, in good faith, that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person.
11. Uses and Disclosures for Specialized Government Functions – OHC may use or disclose medical information of individuals who are Armed Forces personnel for activities deemed necessary by appropriate military command authorities. OHC may use or disclose medical information to authorized federal officials for national security and intelligence purposes and for protection of the President of the United States or other heads of state. In some circumstances, OHC may use or disclose medical information about an inmate or individual that the correctional institution has lawful custody of.
12. Uses and Disclosures for Workers’ Compensation – OHC may disclose medical information as authorized by and to the extent necessary to comply with laws relating to workers’ compensation or other similar programs. These programs provide benefits for work-related injuries.
Other Uses and Disclosures
Use and disclosure of medical information for purposes not listed above in parts 1 and 2 above will only be made with your specific written authorization. You may revoke this authorization at any time by providing us with written notice of such revocation. Your revocation shall become effective immediately upon our receipt of such notice, except to the extent that we have already relied upon your previous authorization.

Patient Rights

Right to Request Restrictions
You have the right to request that OHC restricts the uses or disclosures of your medical information to carry out treatment, payment, or health care operations. You also have the right to request a limit on the medical information OHC discloses about you to someone who is involved in your care, like a family member or friend. For example, you could ask that we not disclose or use information about a certain medical treatment you received. OHC is not required to agree to your request. If OHC does agree, OHC will comply with your request unless the information is needed to provide you emergency treatment.

To request restrictions, you must make your request in writing to the OHC Privacy Officer identified below. In your request, you must tell us:
- what information you want to limit;
- whether you want to limit our use, disclosure, or both; and
- to whom you want the limits to apply, for example, disclosures to your spouse.
Right to Receive Confidential Communications
You have the right to request that OHC communicates with you about your medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work. To request confidential communications, you must make your request in writing to the OHC Privacy Officer identified below. OHC will attempt to accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.
Right to Inspect and Copy Protected Health Information
You have the right to inspect and copy medical information that may be used to make decisions about your care.

To inspect and copy medical information that may be used to make decisions about you, you must submit your request in writing to the OHC Privacy Officer identified below. If you request a copy of the information, OHC may charge a reasonable fee for the costs of copying, mailing, or other supplies associated with your request.

OHC may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to certain medical information, you may request that the denial be reviewed.
Right to Amend Protected Health Information
You have the right to request an amendment of your medical information if you feel the information is incomplete or incorrect for as long as the information is maintained by OHC. To request an amendment, your request must be made in writing and submitted to the OHC Privacy Officer identified below. If for some reason OHC, in compliance with state and federal law, rejects your amendment, OHC shall permit you to submit to us a written statement of disagreement to be kept with your medical information. OHC may reasonably limit the length of such statement of disagreement.
Right to Receive an Accounting of Disclosures of Protected Health Information
You have the right to receive an accounting of disclosures of your medical information in the six years prior to the date on which the accounting is requested, except for disclosures made:
- to carry out treatment, payment and health care operations;
- to the Patients themselves (or the Patients’ legal representative);
- for the facility’s directory or to persons involved in the individual’s care;
- for national security or intelligence purposes;
- to correctional institutions or law enforcement officials; or
- that occurred prior to the compliance date for OHC.
To request this list or accounting of disclosures, you must submit your request in writing to the OHC Privacy Officer identified below.

OHC Duties Regarding Private Health Information

OHC is required by law to maintain the privacy of protected health information. In other words, OHC must make sure that medical information that identifies you is kept private.
OHC is required by law to give you this notice of our legal duties and privacy practices with respect to medical information about you.
OHC is required to abide by the terms of the privacy notice that is currently in effect.
OHC reserves the right to change the terms of this notice policy at any time. OHC reserves the right to make the revised or changed notice effective for medical information OHC already has about you as well as any information OHC receives in the future. OHC will post a copy of the current notice in the office waiting area.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with OHC or with the Secretary of the Department of Health and Human Services. To file a compliant with OHC, contact the OHC Privacy Officer identified below. All complaints must be submitted in writing. You will not be penalized in any way for filing a compliant.

Questions

If you have questions you want answered about your privacy rights, you may contact OHC’s Privacy Officer as follows: