NOTICE OF PRIVACY PRACTICES
Effective: November 07, 2014
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOUMAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TOTHIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Northeast Occupational Exchange is required by law to maintain the privacy of protected health information and to provide individuals with notice of our legal duties and privacy practices with respect to protected health information.
If you have questions about this notice, please contact the Northeast Occupational Exchange, Inc. , PO Box 1189 Bangor, ME 04402 or call 1-800-857-0500. This Notice of Privacy Practices is provided to you as required by the Health Insurance Portability and Accountability Act (HIPAA). It describes how we may use or disclose your protected health information, with whom that information may be shared, and the safeguards we have in place to protect it. This notice also describes your rights to access and amend your protected health information. You have the right to approve or refuse the release of specific information outside our department except when the release is required or authorized by law or regulation.
Acknowledgment Of Receipt Of This Notice You are asked to provide a signed statement acknowledging receipt of this notice. Please sign and date the Acknowledgment Form. Our intent is to make you aware of the possible uses and disclosures of your protected health information as well as your privacy rights. The provision of your health care services will in no way be conditioned upon your signed acknowledgment. If you decline to provide a signed acknowledgment, we will continue to provide treatment, and will use and disclose your protected health information for treatment, payment and health care operations when necessary.
We participate in HealthInfoNet, the statewide health information exchange(HIE) designated by the State of Maine. The HIE is a secure computer system for health care providers to share your important health information to support treatment and continuity of care. For example, if you are admitted to a health care facility not affiliated with Northeast Occupational Exchange, health care providers there will be able to see important health information held in our electronic medical record system.
Your record in the HIE includes prescriptions, lab and test results, imaging reports, conditions, diagnoses or health problems. To ensure your health information is entered into the correct record, also included are your full name, birth date, and social security number. All information contained in the HIE is kept private and used in accordance with applicable state and federal laws and regulations. The information is accessible to participating providers to support treatment and healthcare operations.
You do not have to participate in HIE to receive care. For more information about HealthInfoNet and your choices regarding participation, visit www.hinfonet.org or call toll free 1-866-592-4352.
Our Duties Regarding Protected Health InformationProtected health information is individually identifiable health information. This information relates to your past, present or future physical or mental health or condition or related health care services. Northeast Occupational Exchange Inc. is required by law to do the following:
¨ Make sure that your protected health information is kept private;
¨ Give you this notice of our legal duties and privacy practices related to the use and disclosure of your protected health information;
¨ Follow the terms of the notice currently in effect;
¨ Communicate any changes in the notice to you.
We reserve the right to change this notice. The effective date of this notice is at the top of the first page and the bottom of the last page. We reserve the right to make the revised or changed notice effective for health information we already have about you as well as any information we receive in the future.
You may obtain a current Notice of Privacy Practices by calling the Intake Worker and requesting that a copy be mailed to you, or by asking for a copy at your next appointment. If we change our privacy practices and you continue to receive health care from us at the time of the change, you will receive a revised copy.
A sliding fee schedule is available upon request - please contact the billing office for more details.
How We May Use Or Disclose Your Protected Health Information
By law, we must disclose your health information to you unless it has been determined by a competent medical authority that it would be harmful to you. Following are examples of permitted uses and disclosures of your protected health information not requiring your written authorization. These examples are not exhaustive.
Required Uses And Disclosures We must disclose protected health information to the Secretary of the federal Department of Health and Human Services for investigations or determinations of our compliance with laws on the protection of your health information.
Treatment We will use and disclose your protected health information to provide, coordinate, or manage your health care and any related services including the coordination or management of your health care with a third party. For example, we may disclose your protected health information as necessary, to confer with our consulting psychologist, psychiatrist, or to coordinate with a residential facility that provides care for you. If you require emergency treatment, we will use and disclose your protected health information to provide the treatment you require.
Payment Your protected health information will be used, as needed, to obtain payment for your health care services. We will submit your health care information to Mainecare, Medicare, or your private insurance carrier to receive payment for services you have received. Information submitted could include your diagnosis and the treatment or services provided.
Health Care Operations We may use or disclose your protected health information, as needed, to improve the quality or cost of services provided to you. These activities may include but are not limited to evaluating the performance of your counselor or other provider, or examining the effectiveness and quality of your services compared to similar individuals served elsewhere.
We may look at your protected health information to determine the date and time of your next appointment, and send you a letter notifying or reminding you of the appointment. We may contact you to provide information about treatment alternatives or other health-related benefits and services that may interest you.
We may disclose your protected health information to business associates with whom we have a contract or agreement. A business associate would be a person other than a member of our agency who performs a function or assists our department with activities such as accounting, auditing, computer network and information systems, or legal services. We may also disclose your health information to a collection agency or court to collect payment of medical bills.
As Required Or Permitted By LawWe may use or disclose your protected health information if law or regulation requires such disclosure. For example, we may disclose information to law enforcement agencies, court officials, or other government agencies in order to report child abuse or neglect or to respond to a court order. We may disclose that we believe you are a victim of abuse, neglect, or domestic violence, to a government agency authorized by law to receive such reports.
Public Health ActivitiesWe may disclose your protected health information to a public health authority to prevent or control disease, injury, or disability. This could include the reporting of birth or death information, and child abuse or neglect. It could also include reporting such things as adverse events or product defects to the Food and Drug Administration. We may have to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or a condition. We may also have to report certain work-related illnesses or injuries so your workplace can be surveyed for safety.
Health Oversight ActivitiesWe may disclose protected health information to a health oversight agency for activities authorized by law such as audits, investigations, and inspections. These health oversight agencies might include government agencies that oversee the health care system, government benefit programs, or other government regulatory programs which determine compliance with program standards or civil rights laws.
Legal ProceedingsWe may disclose your protected health information during any judicial or administrative proceeding in response to an order of a court or administrative tribunal (if such disclosure is expressly authorized) or, in certain instances in response to a subpoena, discovery request, or other lawful process.
Law EnforcementWe may disclose your protected health information for law enforcement purposes as required by law and in response to legal proceedings:
¨ For the purpose of identifying or locating a suspect, fugitive, material witness or missing person;
¨ Upon a law enforcement official’s request for information about an individual who is suspected to be a victim of a crime;
¨ To report on an individual who has died if we suspect the death may have resulted from criminal conduct;
¨ To report criminal conduct that has occurred on the premises of Northeast Occupational Exchange, Inc.;
¨ To respond to a medical emergency (other than on our premises) believed to result from criminal conduct.
Coroners, Medical Examiners, And Funeral Directors We may disclose protected health information to coroners or medical examiners for the purpose of identification, to determine the cause of death, or for the performance of other duties as authorized by law. We may also disclose protected health information to funeral directors to carry out their duties as authorized by law. Protected health information may be used or disclosed for cadaver organ, eye, or tissue donations.
Research We may disclose your protected health information to researchers when authorized by law, for example, if their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your protected health information.
To Avert A Serious Threat To Health Or Safety Under applicable federal and state laws, we may disclose your protected health information if we believe that its use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public. We may also disclose protected health information if it is necessary for law enforcement authorities to identify or apprehend an individual who has escaped from lawful custody or may have participated in a violent crime.
Military Activity And National Security If you are in the Armed Forces or involved with national security or intelligence activities, we may disclose your protected health information to the proper federal authorities to enable them to carry out their duties under the law. We may disclose your protected health information to federal officials conducting national security and intelligence activities including protective services to the President or others.
Workers’ Compensation We may disclose protected health information to comply with Workers’ Compensation laws or other programs established by law that provide benefits for work-related injuries or illness.
Correctional Institutions And Other Law Enforcement Custodial SituationsWe may use or disclose your protected health information if you are an inmate of a correctional institution or are otherwise in the custody of a law enforcement official, if the disclosure is necessary for the institution to provide you with health care, for your health and safety or the health and safety of others, or for the safety and security of the correctional institution.
Individuals Involved With Your Health Care Unless you object, we may disclose to a member of your family, a relative, a close friend, or any other person you identify, your protected health information that directly relates to that person’s involvement in your health care. We may also give information to someone who helps pay for your care. Additionally, we may use or disclose protected health information to notify or assist in notifying a family member, personal representative, or any other person who is responsible for your care, of your location, general condition, or death. You have the right to object to such a disclosure, and we may allow you to do so unless there is an emergency or you are unable to function or are incapacitated. Finally, we may use or disclose your protected health information to an authorized public or private entity to assist in disaster relief efforts and to coordinate uses and disclosures to family or other individuals involved in your health care.
Access To Protected Health Information By Parents, Guardians, Or Other Legally Authorized Personal Representatives State of Maine law permits or requires disclosure of protected health information under most circumstances to parents of minor children, guardians of children or adults, and to other persons acting in a similar legal capacity on behalf of an individual. We will act consistently with state law with respect to treatment and disclosure.
Authorization To Disclose
Other uses and disclosures of your protected health information will be made only with your written authorization. You may revoke your authorization at any time by submitting a request in writing to Northeast Occupational Exchange, Inc.
Your Rights Regarding Health Information
Right To Inspect And Copy You may inspect and obtain a copy of your protected health information for as long as we maintain your records. This right does not include inspection and copying of the following records:
¨ Psychotherapy notes;
¨ Information compiled in reasonable anticipation of or use in a civil, criminal, or administrative action or proceeding;
¨ Protected health information that is subject to law that prohibits access to it.
We will charge you a fee for copies of your records as permitted by law and agency policy.
Right To Request Restrictions You may ask us not to use or disclose any part of your protected health information for treatment, payment, or health care operations. Your request must be in writing to Northeast Occupational Exchange. We are not required to agree to a requested restriction. However, we will attempt to accommodate reasonable requests, whenever possible. If the restriction is mutually agreed upon, we will not use or disclose your protected health information in violation of that restriction, unless it is needed to provide emergency treatment.
Right To Request Confidential Communications You may request that we communicate with you using alternative means or at an alternative location. We will accommodate reasonable requests.
Right To Request An Amendment If you believe that the information we have about you is incorrect or incomplete, you may request an amendment to your protected health information as long as we maintain it. While we will accept reasonable requests for an amendment, we are not required to agree to the amendment.
Right To And Accounting Of Disclosures You may request that we provide you with an accounting of the disclosures we have made of your protected health information, except disclosures made prior to November 07, 2014, and no more than six years from the date of request. This right excludes disclosures made to carry out treatment, payment, and health care operations, and excludes certain other types of disclosures as outlined by law.
Right To Obtain A Copy Of This Notice You may obtain a paper copy of this notice from Northeast Occupational Exchange, Inc. or Northeast Occupational Exchange, Inc.’s web site at www.noemaine.org.
State And Other Privacy Laws This Notice of Privacy Practices is provided to you as a requirement of the Health Insurance Portability and Accountability Act (HIPAA). There are numerous other federal and state laws concerning the confidentiality of client/patient information. These laws shall be followed by Northeast Occupational Exchange and have been taken into consideration in developing our policies and this notice.
Complaints If you believe your privacy rights have been violated, you may file a complaint with Northeast Occupational Exchange, Inc.’s Assistant Director. You may also file a complaint with the Secretary of the federal Department of Health and Social Services. No retaliation against you will occur for filing a complaint.
Contact For Additional Information You may contact the agency Intake Worker or Assistant Director for further information about this document or to file a complaint at: Northeast Occupational Exchange, Inc., PO Box 1189 Bangor, ME 04402 1-800-857-0500
This notice is effective November 07, 2014