RIGHT TO A COPY OF THIS NOTICE~
You or your representatives 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. You may print out the policy below or to obtain a separate paper copy, please contact firstname.lastname@example.org
MINNESOTA VISITING NURSE AGENCY
HIPAA NOTICE OF PRIVACY PRACTICES
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.
Protected health information as defined in the Privacy Rule of the Simplification Provisions of the Health Insurance Portability and Accountability Act of 1996, means any health information about you that identifies you or for which there is a reasonable basis to believe the information can be used to identify you. In this notice, we call all of that protected health information, “medical information.” This notice will tell you how we may use and disclose protected health information about you. This notice also will tell you about your rights and our duties with respect to medical information about you. In addition, it will tell you how to complain to us if you believe we have violated your privacy rights.
Minnesota Visiting Nurse Agency (MVNA) is required to abide by the terms of this Notice of Privacy Practices, but reserves the right to change the Notice at any time. Any change in the terms of this Notice will be effective for all medical information that we are maintaining at that time. If any change is made to this Notice, MVNA will provide you with a written revised notice as soon as practical by mail or hand delivery.
Permitted Uses and Disclosures
Once you give your written consent, we can use or disclose your medical information as necessary for purposes of treatment, payment, and health care operations. Examples of the uses and disclosures that we may make under each section are listed below:
Treatment. We may use medical information about you to provide, coordinate or manage your health care and related services by both us and other health care providers. We may disclose medical information about you to doctors, nurses, hospitals and other health facilities who are involved in your care. We may consult with other health care providers concerning you and as part of the consultation share your medical information with them.
Payment. We may use and disclose medical information about you so we can be paid for the services we provide to you. This can include billing you, your insurance company, or a third party payor. For example, we may need to give your insurance company information about the health care services we provide to you so your insurance company will pay us for those services or reimburse you for amounts you have paid. We also may need to provide your insurance company or a government program, such as Medicare or Medicaid, with information about your medical condition and the health care you need to receive to determine if you are covered by that insurance or program.
Health Care Operations. We may use and disclose medical information about you for our own health care operations. These are necessary for us to operate MVNA and to maintain quality health care for our patients. For example, we may use medical information about you to review the services we provide and the performance of our employees in caring for you. We may disclose medical information about you to train our staff, volunteers and students working in MVNA. We also may use the information to study ways to more efficiently manage our organization.
Other Uses and Disclosures Allowed
Federal law also allows us to use and disclose your medical information in the following ways:
Appointment/Visit Reminders. Unless you tell us otherwise in writing, we may contact you by either telephone or by mail at either your home or your workplace. At either location, we may leave messages for you on the answering machine or voice mail. .
Emergency Treatment. In emergency treatment situations, we may treat you as long as MVNA attempts to obtain consent as soon as practicable after treatment. In certain situations in which we are required by law to provide treatment, we may treat without consent.
Fundraising. We may use your name & address to contact you to raise funds. If you do not want MVNA to contact you for fundraising, you must notify the privacy officer in writing. MVNA will not share your medical information with any other entity that may contact you for fundraising or marketing purposes of its own.
Census Report/Directory. We may include information such as your name, your address, your physician, and your diagnosis in general terms on a census report used within the agency. This information is used primarily for scheduling, coordination, billing and health care oversight purposes.
Individuals Involved in Your Care. We may disclose to a family member, other relative, a close personal friend, or any other person identified by you, medical information about you that is directly relevant to that person’s involvement with your care or payment related to your care. If there is a family member, other relative, or close personal friend who you do not want us to disclose medical information about you to, please notify your case manager.
Business Associates. We may disclose medical information to a Business Associate as part of a contracted agreement to provide services for MVNA.
Special Situations also Allowed
Disaster Relief. We may use or disclose medical information about you to a public or private entity authorized by law or by its charter to assist in disaster relief efforts.
Required by Law. We may use or disclose medical information about you when we are required to do so by law.
Public Health Activities. We may disclose medical information about you for public health activities and purposes. This includes reporting medical information to a public health authority that is authorized by law to collect or receive the information for purposes of preventing or controlling disease. It also includes notifying a person who has been exposed to a communicable disease.
Victims of Abuse, Neglect or Domestic Violence. We may disclose medical information about you to a government authority authorized by law to receive reports of abuse, neglect, or domestic violence, if we believe you are a victim of abuse, neglect, or domestic violence.
Health Oversight Activities. We may disclose your medical information to a health oversight agency for activities including audits, investigations, inspections, licensure or disciplinary action.
Judicial and Administrative Proceedings. We may disclose medical information about you in response to a subpoena, court order, or other legal process but only if efforts have been made to tell you about the request or to obtain an order protecting the information to be disclosed.
Disclosures for Law Enforcement Purposes. We may disclose medical information about you to a law enforcement official for law enforcement purpose such as responding to a subpoena or court order, or to notify authorities of a criminal act.
Coroners and Medical Examiners. We may disclose medical information about you to a coroner or medical examiner for purposes such as identifying a deceased person and determining cause of death.
Funeral Directors. We may disclose medical information about you to funeral directors as necessary for them to carry out their duties.
National Security and Military Functions. We may disclose medical information to facilitate specified government functions relating to military and veteran activities, national security and intelligence activities, protective services for the president and others, correctional institutions and custodial situations.
Workers Compensation. We may disclose medical information about you to the extent necessary to comply with workers’ compensation and similar laws that provide benefits for work-related injuries or illness without regard to fault.
Other Uses and Disclosures
Other uses and disclosures of medical information will be made only with your written authorization. That authorization may be revoked, in writing, at any time. However, should you revoke such an authorization, you should understand that we are unable to take back any disclosures we have already made with your permission and that we are required to retain our records as proof of the care that we provided you.
Your Rights With Respect to Medical Information About You
All following requests must be in writing.
- Right to request restrictions on certain uses and disclosures of information about you. However, MVNA is not required to agree to the requested restriction. You must submit your request in writing. You have the right to request that we restrict the uses or disclosures of medical information about you to carry out treatment, payment, or health care operations. You also have the right to request that we restrict the uses or disclosures we make to: (a) a family member, other relative, a close personal friend or any other person identified by you; or, (b) to public or private entities for disaster relief efforts. For example, you could ask that we not disclose medical information about you to your brother or sister. To request a restriction, you may do so at any time in writing. We are not required to agree to any requested restriction. However, if we do agree, we will follow that restriction unless the information is needed to provide emergency treatment. Even if we agree to a restriction, either you or we can later terminate the restriction.
- Right to receive confidential communication of protected health information. For example, you can ask that we only contact you by mail or at work. We will not require you to tell us why you are asking for the confidential communication. If you want to request confidential communication, you must do so in writing.
- Right to inspect and copy protected health information.
With a few very limited exceptions, such as psychotherapy notes, you have the right to inspect and obtain a copy of medical information about you. To inspect or copy medical information about you, you must submit your request in writing to MVNA’s Privacy Officer. Your request should state specifically what medical information you want to inspect or copy. If you request a copy of the information, we may charge a fee for the costs of copying and, if you ask that it be mailed to you, the cost of mailing.
- Right to amend protected health information. You
have the right to request in writing that your medical information be amended.
If we grant the request, in whole or in part, we will seek your identification of and agreement to share the amendment with relevant other persons. We also will make the appropriate amendment to the medical information by appending or otherwise providing a link to the amendment. Under the law, we may deny your request to amend medical information if we determine that the information: 1) Was not created by us 2) Is not part of the medical information maintained by us; 3) Would not be available for you to inspect or copy; or, 4) is accurate and complete.
- Right to an accounting of disclosures of your protected health information. The request must be in writing and it should specify the time period for the accounting starting on or after April 14, 2003.
Our Duties to you
We are required by law to maintain the privacy of medical information about you and to provide individuals with notice of our legal duties and privacy practices with respect to medical information. We are required to abide by the terms of our Notice of Privacy Practices in effect at the time.
We reserve the right to change this Notice of Privacy Practices. We reserve the right to make the new notice’s provisions effective for all medical information that we are maintaining at the time. MVNA will provide you with a written revised notice as soon as practical by mail or hand delivery.
If you have any questions or want more information concerning this Notice of Privacy Practices, please contact Minnesota Visiting Nurse Agency’s Privacy Officer at 612-617-4600.
You may complain to us and to the United States Secretary of Health and Human Services if you believe your privacy rights have been violated by us.
To file a complaint with us, contact Minnesota Visiting Nurse Agency’s Privacy Officer at 3433 Broadway Street NE, Suite 300, Minneapolis, MN 55413. All complaints should be submitted in writing.
To file a complaint with the United States Secretary of Health and Human Services, send your complaint to him or her in care of: Office for Civil Rights, U.S. Department of Health and Human Services, 200 Independence Avenue SW, Washington, D.C. 20201.
You will not be retaliated against for filing a complaint.
Effective Date of Notice
This notice becomes effective on April 14, 2003