Providing
Healthcare in the Farmington Valley Since 1908...
NOTICE OF PRIVACY PRACTICES -
USE AND DISCLOSURE OF PROTECTED HEALTH INFORMATION
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.
This notice is
effective beginning April 14, 2003.
Farmington Valley VNA is required by law to maintain the privacy
of protected health information and to provide you with notice of
its legal duties and privacy practices with respect to such information.
Farmington Valley VNA will abide by the terms of the notice currently
in effect; however, Farmington Valley VNA reserves the right to
change the terms of this notice as well as make the new provisions
effective for all protected health information maintained. If there
is a change, Farmington Valley VNA will inform you of this change
at your next scheduled appointment or upon your request. In addition,
a copy of the effective notice will be posted at all times in the
office, with a date notifying you of the most recent update.
As a patient of Farmington Valley VNA, information about you must
be used and disclosed to other parties for purposes of treatment,
payment, and health care operations. These uses and disclosures
do not require your consent, and include, but are not limited to,
a release of information contained in financial records, medical
records, laboratory test results, medical history, treatment progress
or any other related information to:
- Your insurance
company, self-funded or third-party health plan, Medicare, Medicaid,
or any other person or entity that may be responsible for paying
or processing for payment any portion of your bill for services;
- Any person
or entity affiliated with or representing for purposes of administration,
billing, and quality and risk management;
- Any hospital,
nursing home, or other health care facility to which you may
be admitted;
- Any assisted
living or personal care facility of which you are a resident;
- Any physician
providing you care;
- Any business
associate of Farmington Valley VNA that agrees to abide by the
privacy requirements regarding your protected health information;
and
- Licensing
and accrediting bodies, including the information contained
in the OASIS Data Set to the State agency acting as a representative
of the Medicare/Medicaid program.
In addition,
Farmington Valley VNA may contact you:
- To provide
appointment reminders or information about other health activities
we provide; and
- To raise
funds for Farmington Valley VNA
Farmington Valley VNA is also permitted to use or disclose information about you
without consent or authorization in the following circumstances:
- Where the
use or disclosure is required by another law, but only to the
extent that it is required and complies with such other law;
- For certain
health care activities;
- Where Farmington Valley VNA reasonably believes you are a victim of abuse,
neglect or domestic violence, but only to a government authority
authorized to receive reports of abuse, neglect or domestic
violence;
- Health
care oversight activities;
- Certain
judicial and administrative proceedings;
- Certain
law enforcement purposes;
- To coroners,
medical examiners and funeral directors, in certain circumstances;
- For cadaveric
organ, eye or tissue donation purposes;
- For certain
research purposes;
- To avert
a serious threat to health and safety;
- For specialized
government functions, including military and veterans' activities,
national security and intelligence activities, protective services
for the President and others, medical suitability determinations,
correctional institution and custodial situations; and
- For Workers'
Compensation purposes.
Farmington Valley VNA is permitted to use and disclose information about you without
consent or authorization provided you are informed in advance and
given the opportunity to agree to or prohibit or restrict the disclosure
in the following circumstances:
- For use
in a directory of individuals served by Farmington Valley VNA
(such information is limited to the individual's name, location
within the facility, condition in general terms, and religious
affiliation);
- To a family
member, other close relative, close personal friend, or other
identified person, the information relevant to such person's
involvement in your care or payment for care;
- To a public
or private entity authorized by law or charter to assist in
disaster relief efforts, but only for the purpose of coordinating
with such entities.
Other uses and
disclosures not specifically addressed earlier in this notice will
be made only with your written authorization. In addition, Connecticut
law requires an authorization to disclose highly sensitive information,
including communicable diseases such as Human Immune Deficiency
Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS), drug/alcohol
abuse, psychiatric diagnosis and treatment records, and genetic
testing information. Examples of when authorization is required
for Farmington Valley VNA to use or disclose your protected health
information include:
- Psychotherapy
notes (notwithstanding the provisions that allow the use and
disclosure of protected health information without consent and
authorization for treatment, payment and healthcare operations,
the law specifically requires an authorization to use or disclose
psychotherapy notes); and
- Marketing,
except if the communication is in the form of a face-to-face
communication made by Farmington Valley VNA to you or a promotional
gift of nominal value provided by Farmington Valley VNA;
These authorizations
may be revoked, in writing, at any time, except in limited situations.
YOUR
RIGHTS
The Health
Insurance Portability and Accountability Act gives you certain
rights with regard to your protected health information. Any of
these rights may be exercised by contacting Farmington Valley VNA
and in some situations, may require you to fill out a written
request. You have the right, subject to certain conditions, to:
- Request
restrictions on the use and disclosure of information about
you for treatment, payment and healthcare operations, and to
friends and family involved in the individual's care. However,
Farmington Valley VNA is not required to agree to the requested
restriction;
- Receive
confidential communication of protected health information;
- Inspect
and copy protected health information;
- Amend protected
health information;
- Receive
an accounting of disclosures of protected health information;
and
- Obtain
a paper copy of this notice, if you had agreed to receive this
notice electronically.
In addition,
Connecticut state law may provide you with greater protection than
the Health Insurance Portability and Accountability Act. In situations
where this is the case, Farmington Valley VNA will be in compliance
with the applicable Connecticut law.
COMPLAINTS
If you believe
that your privacy rights have been violated, you may complain
to both Farmington Valley VNA and the Office of the Secretary
at the U.S. Department of Health and Human Services. There will
be no retaliation against you for filing a complaint. Complaints
may be made to Incy S. Muir, Executive Director, at Farmington Valley VNA,(860) 651-3539. We recommend that complaints be given
in writing, stating the specific incident(s) in terms of subject,
date, and other relevant matters. Complaints to the Office of
the Secretary may be made in writing to the following address:
The U. S. Department of Health and Human Services, Office of the
Secretary, 200 Independence Avenue, S.W., Washington, D.C. 20201.
Complaints made also be made by phone to: (202) 619-0257 or Toll
Free: 1-877-696-6775.
If you would
like to have more information about our privacy practices or have
questions or concerns, please contact Incy S. Muir, Executive
Director, at (860) 651-3539.
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