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.
USE AND DISCLOSURE OF
HEALTH INFORMATION
LHC Group, Inc. and its affiliated companies herein referred to as “Provider”,
may use your health information, information that constitutes protected health
information as defined in the Privacy Rule of the Administrative Simplification
provisions of the Health Insurance Portability and Accountability Act of 1996,
as same may be hereinafter amended or re-codified (the “Regulations”), for purposes
of providing you treatment, obtaining payment for your care and conducting
health care operations. The Provider has established policies to guard against
unnecessary disclosure of your health information.
USE OF CONSENTS AND
AUTHORIZATIONS
Consents: The
use of a consent form is optional as set forth by the Regulations. The Provider
will exercise the option to gain the consent of the patient regarding the
disclosure of medical information at the initialization of care or within a
reasonable amount of time post initialization of care. The Provider maintains
the right not to treat the patient if the patient refuses to sign the consent.
Authorizations: Under the Privacy Rule an authorization must be gained for the
disclosure of protected health information when the disclosure is not for
treatment purposes, Provider operations, payment, or required by law.
TERMS OF HEALTH
INFORMATION DISCLOSURE
THE FOLLOWING IS A
SUMMARY OF THE CIRCUMSTANCES UNDER WHICH AND PURPOSES FOR WHICH YOUR HEALTH
INFORMATION MAY BE USED AND DISCLOSED:
To Provide Treatment. The Provider may use your health information to coordinate
care within the Provider and with others involved in your care, such as your
attending physician and other health care professionals who have agreed to
assist the Provider in coordinating care. For example, physicians involved in
your care will need information about your symptoms in order to prescribe
appropriate medications. The Provider also may disclose your health care
information to individuals outside of the Provider involved in your care
including family members, pharmacists, suppliers of medical equipment or other
health care professionals.
To Obtain Payment. The Provider may include your health information in invoices
to collect payment from third parties for the care you receive from the Provider. For example, the Provider may be required by
your health insurer to provide information regarding your health care status so
that the insurer will reimburse you or the Provider. The Provider also may need to obtain prior
approval from your insurer and may need to explain to the insurer your need for
care and the services that will be provided to you.
To Conduct Health Care Operations. The Provider may use and disclose health
information for its own operations in order to facilitate the function of the
Provider and as necessary to provide quality care to all of the Provider ‘s
patients. Health care operations include such activities as:
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Quality assessment and improvement
activities. |
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Activities designed to improve health or reduce
health care costs. |
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Protocol development, case management and
care coordination. |
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Contacting health care providers and
patients with information about treatment alternatives and other related
functions that do not include treatment. |
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Professional review and performance evaluation. |
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Training programs including those in which
students, trainees or practitioners in health care learn under supervision. |
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Training of non-health care professionals. |
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Accreditation, certification, licensing or
credentialing activities. |
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Review and auditing, including compliance
reviews, medical reviews, legal services and compliance programs. |
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Business planning and development including
cost management and planning related analyses and formulary development. |
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Business management and general administrative activities
of the Provider. |
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Fundraising for the benefit of the Provider and certain
marketing activities. |
For
example the Provider may use your health information to evaluate its staff
performance, combine your health information with other Provider patients in
evaluating how to more effectively serve all Provider patients, disclose your
health information to Provider staff and contracted personnel for training
purposes, use your health information to contact you as a reminder regarding a
visit to you, or contact you as part of general fundraising and community
information mailings (unless you tell us you do not want to be contacted).
For
Fundraising Activities. The Provider
may use information about you including your name, address, phone number and
the dates you received care in order to contact you to raise money for the
Provider. The Provider may also release this
information to a related Provider foundation. If you do not want the Provider
to contact you, mark the appropriate opt out clause on your consent form and/or
notify in writing to the attention of the HIPAA Privacy Officer; LHC Group,
Inc.; 420 West Pinhook Road, Suite A; Lafayette, LA 70503 indicating that you
do not wish to be contacted.
For
Appointment Reminders. The Provider
may use and disclose your health information to contact you as a reminder that
you have an appointment with said Provider.
For
Treatment Alternatives. The Provider
may use and disclose your health information to tell you about or recommend
possible treatment options or alternatives that may be of interest to you.
THE
FOLLOWING IS A SUMMARY OF THE CIRCUMSTANCES UNDER WHICH AND PURPOSES FOR WHICH
YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED WITHOUT RECEIVING YOUR
CONSENT.
When
Legally Required. The Provider will disclose your health information when it
is required to do so by any Federal, State or local law.
When There Are Risks to Public Health. The Provider may disclose your
health information for public health activities and purposes when required or
authorized by law in order to:
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Prevent or control disease, injury or disability;
report disease, injury, vital events such as birth or death; and the conduct of public health
surveillance, investigations and interventions. |
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Report adverse events and product defects;
to track products or enable product recalls, repairs and replacements; and
conduct post-marketing surveillance and compliance with requirements of the
Food and Drug Administration. |
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Notify a person who has been exposed to a
communicable disease or who may be at risk of contracting or spreading a disease. |
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Notify an employer about an individual who
is a member of the workforce as legally required. |
To
Report Abuse, Neglect Or Domestic Violence. The Provider is allowed to notify government authorities
if the Provider believes a patient is the victim of abuse, neglect or domestic
violence. The Provider will make this disclosure only when specifically
required or authorized by law or when the patient agrees to the disclosure.
To
Conduct Health Oversight Activities. The
Provider may disclose your health information to a health oversight Provider
for activities including audits, civil administrative or criminal
investigations, inspections, licensure or disciplinary action. The Provider,
however, may not disclose your health information if you are the subject of an
investigation and your health information is not directly related to your
receipt of health care or public benefits.
In
Connection With Judicial And Administrative Proceedings. The Provider may disclose your health information in the
course of any judicial or administrative proceeding in response to an order of
a court or administrative tribunal as expressly authorized by such order, or in
response to a subpoena, discovery request or other lawful process, but only
when the Provider makes reasonable efforts to either notify you about the
request or to obtain an order protecting your health information.
For
Law Enforcement Purposes. As permitted
or required by State law, the Provider may disclose your health information to
a law enforcement official for certain law enforcement purposes as follows:
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As required by law for reporting of certain
types of wounds or other physical injuries, or pursuant to a court order, warrant,
subpoena or summons or similar process. |
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For the purpose of identifying or locating a
suspect, fugitive, material witness or missing person. |
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Under certain limited circumstances, when you are the
victim of a crime. |
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To a law enforcement official if the Provider
has a suspicion that your death was the result of criminal conduct including
criminal conduct at the Provider. |
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In an emergency in order to report a crime. |
To
Coroners And Medical Examiners.
The Provider may disclose your health information to coroners and medical
examiners for purposes of determining your cause of death or for other duties,
as authorized by law.
To
Funeral Directors. The Provider may disclose your health
information to funeral directors consistent with applicable law and if
necessary, to carry out their duties with respect to your funeral arrangements.
If necessary to carry out their duties, the Provider may disclose your health
information prior to and in reasonable anticipation of your death.
For
Organ, Eye Or Tissue Donation.
The Provider may use or disclose your health information to organ procurement
organizations or other entities engaged in the procurement, banking or
transplantation of organs, eyes or tissue for the purpose of facilitating the
donation and transplantation.
For
Research Purposes. The Provider may, under very
select circumstances, use your health information for research. Before the
Provider discloses any of your health information for such research purposes,
the project will be subject to an extensive approval process. The Provider will
almost always request your written authorization before granting access to your
individually identifiable health information.
In
the Event of A Serious Threat To Health Or Safety. The Provider may, consistent with applicable law and
ethical standards of conduct, disclose your health information if the Provider,
in good faith, believes that such disclosure is necessary to prevent or lessen
a serious and imminent threat to your health or safety or to the health and
safety of the public.
For
Specified Government Functions.
In certain circumstances, the Federal regulations authorize the Provider to use
or disclose your health information to facilitate specified government
functions relating to military and veterans, national security and intelligence
activities, protective services for the President and others, medical
suitability determinations, and inmates and law enforcement custody.
For
Workers’ Compensation. The Provider
may release your health information for workers’ compensation or similar
programs.
AUTHORIZATION TO USE OR DISCLOSE
HEALTH INFORMATION
Other
than is stated above, the Provider will not disclose your health information other
than with your written authorization. If you or your representative authorizes
the Provider to use or disclose your health information, you may revoke that
authorization in writing at any time.
YOUR RIGHTS WITH
RESPECT TO YOUR HEALTH INFORMATION
You have the following rights regarding your health information
that the Provider maintains:
Right
to request restrictions. You may
request restrictions on certain uses and disclosures of your health
information. You have the right to request a limit on the Provider‘s disclosure
of your health information to someone who is involved in your care or the
payment of your care. However, the Provider is not required to agree to your
request. If you wish to make a request for restrictions, please contact the
HIPAA Privacy Officer; LHC Group, Inc.; 420 West Pinhook Road, Suite A;
Lafayette, LA 70503.
Right to receive confidential communications. You have the right to request that the Provider
communicate with you in a certain way.
For example, you may ask that the Provider only conduct communications
pertaining to your health information with you privately with no other family
members present. If you wish to receive confidential communications, please
contact the HIPAA Privacy Officer; LHC Group, Inc.; 420 West Pinhook Road,
Suite A; Lafayette, LA 70503.
The Provider will not request that you provide any reasons for
your request and will attempt to honor your reasonable requests for
confidential communications.
Right to inspect and copy your health information. You have the right to inspect and copy your
health information, including billing records. A request to inspect and copy
records containing your health information may be made to the HIPAA Privacy
Officer; LHC Group, Inc.; 420 West Pinhook Road, Suite A; Lafayette, LA 70503.
If you request a copy of your health information, the Provider may charge a
reasonable fee for copying and assembling costs associated with your request.
Right to amend health care information. You, or your representative, have the right
to request that the Provider amend your records if you believe that your health
information is incorrect or incomplete. That request may be made as long as the
information is maintained by the Provider.
A request for an amendment of records must be made in writing to the
HIPAA Privacy Officer; LHC Group, Inc.; 420 West Pinhook Road, Suite A;
Lafayette, LA 70503. This right to amend health care information does not mean
the deletion, removal, or erasure of health information. Instead, this right allows
you or your representative the ability to append, or attach, a counter-opinion
in regard to the health care information that is in question. The Provider may
deny the request if it is not in writing or does not include a reason for the
amendment. The request also may be denied if your health information records
were not created by the Provider, if the records you are requesting are not
part of the Provider‘s records, if the health information you wish to amend is
not part of the health information you or your representative are permitted to
inspect and copy, or if, in the opinion of the Provider, the records containing
your health information are accurate and complete.
Right to an accounting. You or your representative have the right to request an accounting
of disclosures of your health information made by the Provider for any reason
other than for treatment, payment or health operations. The request for an
accounting must be made in writing to HIPAA Privacy Officer; LHC Group, Inc.;
420 West Pinhook Road, Suite A; Lafayette, LA 70503. The request should
specify the time period for the accounting starting on or after April 14,
2003. Accounting requests may not be
made for periods of time in excess of six (6) years or the normal record
retention policy of the Provider, whichever is later. The Provider would
provide the first accounting you request during any 12month period without
charge. Subsequent accounting requests may be subject to a reasonable
cost-based fee.
Right to a paper copy of this notice. You, or your representative, have a right to
a separate paper copy of this Notice at any time even if you, or your
representative, have received this Notice previously. To obtain a separate paper copy, please contact
the HIPAA Privacy Officer, LHC Group, Inc.; 420 West Pinhook Road, Suite A;
Lafayette, LA 70503.
You, or your representative, may also obtain a copy of the
current version of the Provider’s Notice of Privacy Practices at its website,
www.lhcgroup.com.
DUTIES OF THE PROVIDER
The Provider is required by law to maintain the privacy of your
health information and to provide to you and your representative this Notice of
its duties and privacy practices. The Provider is required to abide by the
terms of this Notice as may be amended from time to time. The Provider reserves
the right to change the terms of its Notice and to make the new Notice
provisions effective for all health information that it maintains. If the
Provider changes its Notice, the Provider will provide a copy of the revised
Notice to you or your appointed representative. You, or your personal
representative, have the right to express complaints to the Provider and to the
Secretary of DHHS if you, or your representative, believe that your privacy
rights have been violated. Any complaints to the Provider should be made in
writing to the attention of the HIPAA Privacy Officer, LHC Group, Inc.; 420
West Pinhook Road, Suite A; Lafayette, LA 70503. The Provider encourages you to
express any concerns you may have regarding the privacy of your information.
You will not be retaliated against in any way for filing a complaint.
RESPECT TO CULTURAL
DIVERSITY
The Provider, in its efforts to abide by the provisions set
forth in the Regulations, realizes that there may be situations where the
Regulations could potentially conflict with the cultural values, traditions,
and rules of conduct of the individual receiving care. The Provider respects
the cultural diversity of all its patients and will do its utmost to balance
this respect for cultural diversity while maintaining the integrity of the
Regulations. In situations where conflict would exist between the regulations
and cultural beliefs, the Provider is required to follow the rules and policies
as set forth by the Regulations.
CONTACT PERSON
The Provider has designated a HIPAA Privacy Officer as
its contact person for all issues regarding patient privacy and your rights
under the Federal privacy standards. You may contact this person at LHC Group,
Inc.; 420 West Pinhook Road, Suite A; Lafayette, LA 70503.
EFFECTIVE DATE
This Notice is effective April 14, 2003.
IF YOU HAVE ANY QUESTIONS REGARDING THIS NOTICE, PLEASE CONTACT
THE HIPAA PRIVACY OFFICER AT LHC Group, Inc.; 420 WEST PINHOOK ROAD, SUITE A;
LAFAYETTE, LA 70503 OR CALL 1-800-489-1307 OR 1-337-233-1307.