Dr Steven Alcuri I 198 Thomas Johnson Dr I Suite 14 I Frederick, MD 21702 I Telephone: (301) 846-0811
As Required by the Privacy Regulations Created as a Result of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) , amended.
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU AS A PATIENT OF THIS PRACTICE MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET ACCESS TO YOUR INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION. PLEASE REVIEW THIS NOTICE CAREFULLY. THE LANGUAGE OF THIS NOTICE IS PRESCRIBED BY LAW.
- OUR COMMITTMENT TO YOUR PRIVACY
Our practice is dedicated to maintaining the privacy of your individually identifiable health information (IHII). In conducting our business, we will create records regarding you and the treatment and services we provide to you. We are also required by law to provide you with this notice of our legal duties and the privacy practices that we maintain in our practice concerning your IHII. By federal and state law, we must follow the terms of this notice of privacy practices that we have in effect at this time. We realize that these laws are complicated, but we must provide you with the following important information:
*How we may use and disclose your IHII
*Your privacy rights in your IHII
*Our obligations concerning the use and disclosure of your IHII
The terms of this notice apply to all records containing your IHII that are created or retained by our practice. We reserve the right to amend this Notice of Privacy Practices. Any revision or amendment to this Notice will be effective for all of your records that our practice has created or maintained in the past, and for any of your records we may create or maintain in the future. Our practice will post a copy of our current Notice in our offices in a visible location at all times, and you may request a copy of our Notice at any time.
- IF YOU HAVE QUESTIONS ABOUT THIS NOTICE:
Please contact Dr. Alcuri, our designated Privacy Officer.
- WE MAY UE AND DISCLOSE YOUR INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION (IHII) IN THE FOLLOWING WAYS:
The following categories describe the different ways we may use and disclose your IHII.
1. Treatment. Our practice may use your IHII to treat you. For example, we may ask you to have laboratory tests (such as blood or urine tests) and we may use the results to help us reach a diagnosis. We might use your IHII in order to write a prescription for you, or we might disclose your IHII to a pharmacy when we order a prescription for you. The people who work in our practice - including, but not limited to, doctors and nurses - may use or disclose your IHII in order to treat you or to assist others in your treatment. Additionally, we may disclose your IHII to others who may assist in your care, such as a spouse, child or parent. Finally, we may also disclose your IHII to other health care providers for purposes related to your treatment.
2. Payment. Our practice may use and disclose your IHII in order to bill and collect payment for the services and items you receive from us. For example, we may contact your health insurer to certify that you are eligible for benefits (and for what range of benefits), and we may provide your insurer with details regarding your treatment to determine if your insurer will cover, or pay for, your treatment. We may also disclose your IHII to obtain payment from third parties that may be responsible for such costs, such as family members. Also, we may use your IHII to bill you directly for services and other items. We may disclose your IHII to other health care providers and entities to assist in their billing and collections efforts.
3. Health Care Operations. Our practice may use and disclose your IHII to operate our business. As examples of the ways in which we may use and disclose your information for our operations, our practice may use your IHII to evaluate the quality of care you receive from us, or to conduct cost-management and business planning activities for our practice. We may disclose your IHII to other health care providers and entities to assist in their health care operations.
4. Reminders. Our practice may use and disclose your IHII to contact and remind you of an appointment, or to inform you of health-related services that may be of interest to you, such as check-ups coming due or annual flu shots. We regard this use of IHII as treatment.
5. Release to Family/Friends. With your consent, our practice may release IHII to a friends or family that is involved in your care, or who assists in taking care of you. For example, a parent or guardian may ask that a friend, family member or babysitter take their child to our office for care. In this example, these individuals may have access to this child's medical information. We will use our best efforts to use and disclose the least possible information necessary for treatment. We will not compromise treatment in order to avoid disclosing information. We regard this use and disclosure of IHII as treatment.
6. Disclosures Required By Law. Our practice will use and disclose your IHII when we are required to do so by federal, state or local law.
D. USE AND DISCLOSURE OF YOUR IHII IN CERTAIN SPECIAL CIRCUMSTANCES.
The following categories describe unique scenarios in which we may use or disclose your IHII:
1. Public Health Risks. Our practice may disclose your IHII to public health authorities that are authorized by law to collect information for the purpose of:
*Maintaining vital records, such as births or deaths
*Reporting child abuse or neglect
*Preventing or controlling disease, injury or disability
*Notifying a person regarding potential exposure to a communicable disease
*Notifying a person regarding potential risk for spreading or contracting a disease or condition
*Reporting reactions to drugs or problems with products or devices
*Notifying individuals if a product or device they may use has been recalled
*Notifying appropriate government agency(ies) and authority (ies) regading the potential abuse or neglect of an adult patient (including domestic violence); however we will only disclose this information if the patient agrees or we are required or authorized by law to disclose this information
*Notifying your employer under limited circumstances related primarily to workplace injury or illness or medical surveillance
2. Health Oversight Activities. Our practice may disclose your IHII to a health oversight agency for activities authorized by law. Oversight activities can include, for example, investigations, inspections, audits, surveys, licensure and disciplinary actions; civil, administrative and criminal procedures or actions; or other activities necessary for the government to monitor government programs, compliance with civil rights laws and the health care system in general.
3. Lawsuits and Similar Proceedings. Our practice may use and disclose your IHII in response to a court or administrative order, if you are involved in a lawsuit or similar proceedings. We may also disclose your IHII in response to a discovery request, subpoena, or other lawful process by another party involved in a dispute, but only if we have made an effort to inform you of the request or to obtain an order protecting the information the party has requested.
4. Law Enforcement. We may release IHII if asked to do wo by a law enforcement official:
*Regarding a crime victim in certain circumstances, if we are unable to obtain the person's agreement
*Concerning a death we believe has resulted from criminal conduct
*Regarding criminal conduct at our offices
*In response to a warrant, summons, court order, subpoena or similar legal process
*To identify/locate a suspect, material witness, fugitive or missing person
*In an emergency, to report a crime (including the location or victim(s) of the crime, or the description, identity or location of the perpetrator)
5. Deceased Patients. Our practice may release IHII to a medical examiner or coroner to identify a deceased individual or to identify the cause of death. If necessary, we may also release information in order for funeral directors to perform their jobs.
6. Organ and Tissue Donation. If you are an organ donor, our practice may release your IHII to organizations that handle organ, eye or tissue procurement and transplantation, including organ donation banks, as necessary to facilitate organ or tissue transplantation.
7. Serious Threats to Health or Safety. Our practice may use and disclose your IHII when necessary to reduce or prevent a serious threat to your health and safety or the health and safety of another individual or the public. Under these circumstances, we will only make disclosures to a person or organization able to help prevent the threat.
8. Military. Our practice may disclose your IHII if you are a member of U.S. or foreign military forces (including veterans) and if required by the appropriate authorities.
9. National Security. Our practice may disclose your IHII to federal officials for intelligence and national security activities as authorized by law. We may also disclose your IHII to federal officials in order to protect the President, other officials or foreign heads of state, or conduct investigations.
10. Inmates. Our practice may disclose your IHII to correctional institutions or law enforcement officials if you are an inmate or under the custody of a law enforcement official. Disclosure for these purposes would be necessary; (a) for the institution to provide health care services to you, (b) for the safety and security of the institution, and/or (c) to protect your health and safety or the health and safety of other individuals.
11. Workers' Compensation. Our practice may release your IHII for workers' compensation and similar programs.
- YOUR RIGHTS REGARDING YOUR IHII
You have the following rights regarding your IHII that we maintain about you:
1. Confidential Communications. You have the right to request that our practice communicate with you about health related issues in a particular manner or at a certain location. For instance, you may ask that we contact you at home, rather than at work. In order to request a type of confidential communication, you must make a written request to Dr. Alcuri, our designated Privacy Officer, at the practice address, specifying the requested method of contact, or the location where you wish to be contacted. Our practice will accomodate reasonable requests. You do not need to give a reason for your request.
2. Requesting Restrictions. You have the right to request a restriction in our use or disclosure of your IHII for treatment, payment or health care operations. Additionally, you have the right to request that we restrict our disclosure of your IHII only to certain individuals involved in your care or the payment for your care, such as family or friends. We are not required to, and generally will not, agree to your request. If we do agree, we are bound to our agreement except when otherwise required by law, in emergencies, or when the information is required to treat you. In order to request a restriction in our use or disclosure of your IHII, you must make your request to Dr. Alcuri, our designated Privacy Officer, at the practice address. Your request must describe in a clear and concise fashion: (a) the information you wish restricted; (b) whether you are requesting to limit our practice's use, disclosure or both; and (c) to whom you want the limits to apply.
3. Inspection and Copies. You have the right to inspect and obtain a copy of the IHII that may be used to make a decision about you, including patient medical records and billing records, but not including psychotherapy notes. You must submit your request in writing to Dr. Alcuri, our designated Privacy Officer, at the practice address, in order to inspect and/or obtain a copy of your IHII. Our practice may charge a fee for the costs of copying mailing, labor and supplies associated with your request. Our practice may deny your request to inspect and/or copy in limited circumstances; however, you may request a review of our denial. Another licensed health care professional chosen by us will conduct reviews.
4. Amendment. You may ask us to amend your health information if you believe it is incorrect or incomplete, and you may request an amendment for as long as the information is kept by or for our practice. To request an amendment, your request must be made in writing to Dr. Alcuri, our designated Privacy Officer, at the practice address. You must provide us with a reason that supports your request for amendment. Our practice will deny your request if you fail to submit your request (and the reason supporting your request) in writing. Also, we may deny your request if you ask us to amend information that is in our opinion: (a) accurate and complete; (b) not part of the IHII kept by or for the practice; (c) not part of the IHII which you would be permitted to inspect and copy; or (d) not created by our practice; unless the individual or entity that created the information is not available to amend the information.
5. Accounting of Disclosures. All of our patients have the right to an "accounting of disclosures." An "accounting of disclosures" is a list of certain non- routine disclosures our practice has made of your IHII for non-treatment, non-payment, or non-operations purposes. Use of your IHII as part of the routine patient care in our practice is not required to be documented. For example, the doctor sharing information with the nurse; or the billing department using your information to file your insurance claim. In order to obtain an accounting of disclosures, you must submit your request in writing to Dr. Alcuri, our designated Privacy Officer, at the practice address. All requests for an accounting of disclosure must state a time period, which may not be longer than six (6) years from the date of the disclosure and may not include dates before April 14, 2003. The first list you request within a 12-month period is free of charge, but our practice may charge you for additional lists within the same 12-month period. Our practice will notify you of the costs involved with additional requests, and you may withdraw your request before you incur any costs. Please note that this practice makes no routine disclosures of IHII for non-treatment, non-payment, or non-operations purposes (an example would be sale of a patient list to a marketing company). You must authorize us in writing for any such disclosures (see Section 8), so you will always be aware of them.
6. Right to a paper Copy of This Notice. You are entitled to receive a paper copy of our Notice of Privacy Practices. You may ask us to give you a copy of this Notice at any time. To obtain a paper copy of this notice, contact Dr. Alcuri, our designated privacy Officer, at the practice address. The practice will not object to your printing a copy of our Notice from this web page.
7. Right to File a Complaint. If you believe your privacy rights have been violated, you may file a complaint with our practice or with the Secretary of the Department of Health and Human Services. To file a complaint with our practice, contact Dr. Alcuri, our designated Privacy Officer, at the practice address. All complaints must be submitted in writing. You will not be penalized for filing a complaint.
8. Right to Provide an Authorization for Other Uses and Disclosures. Our practice will obtain your written authorization for uses and disclosures that are not identified in this Notice or permitted by applicable law. Any authorization you provide to us regarding the use and disclosure of your IHII may be revoked at any time, in writing. After you revoke your authorization, we will no longer use or disclose your IHII for the reasons describes in the authorization. Please note, we are required to maintain records of your care.
- BREACH NOTIFICATION
1. We are required to provide notification following a breach of unsecured protected health information. Definition of Breach: A breach is, generally, an impermissible use or disclosure under the Privacy Rule that compromises the security or privacy of the protected health information. An impermissible use or disclosure of protected health information is presumed to be a breach unless we can demonstrate that there is a low probability that the protected health information has been compromised based on a risk assessment of at least the following factors:
- The nature and extent of the protected health information involved, including the types of identifiers and the likelihood of re-identification;
- The unauthorized person who used the protected health information or to whom the disclosure was made;
- Whether the protected health information was actually acquired or viewed; and
d. The extent to which the risk to the protected health information has been mitigated.
2. We have discretion to provide the required breach notifications following an impermissible use or disclosure without performing a risk assessment to determine the probability that the protected health information has been compromised.
3. There are three exceptions to the definition of "breach." unintentional acquisition, access, or use of protected health information by a workforce member if such acquisition, access, or use was made in good faith and within the scope of authority; inadvertent disclosure of protected health information by one workforce member to another, or to an organized health care arrangement in which we participate; or if we have a good faith belief that the unauthorized person to whom the impermissible disclosure was made, would not have been able to retain the information.
- HEALTH INFORMATION EXCHANGE
1. The Practice participates in the Chesapeake Regional Information Service for Patients, a.k.a. "CRISP," a regional Health Information Exchange serving Maryland, DC, and West Virginia.
2. A Health Information Exchange, or HIE, is a way of sharing your health information among participating doctors' offices, hospitals, care coordinators, labs, radiology centers, and other health care providers through secure, electronic means. The purpose is so that each of your participating healthcare providers can have the benefit of the most recent information available from your other participating providers when taking care of you. Information flowing through the HIE can also be made available to researchers with appropriate consent through a careful review and approval process.
3. The Exchange includes a Prescription Drug Monitoring Program. The Maryland Prescription Drug Monitoring Program (PDMP) was created to support providers and their patients in the safe and effective use of prescription drugs. The PDMP is part of Maryland's response to the epidemic of opioid addiction and overdose deaths.
4. You can opt out of participation in the HIE. If you do opt out, doctors and nurses will not be able to search for your health information through the HIE to use while treating you and your information will not be available for research. In accordance with the law, Public health reporting, such as the reporting of infectious diseases to public health officials, will still occur through the HIE after you decide to opt out. You cannot opt out of the Maryland Prescription Drug Monitoring Program: Controlled Dangerous Substances (CDS) information, as part of the Maryland Prescription Drug Monitoring Program, will continue to be available through the HIE to licensed providers. You can learn about the various methods of opting out at: https://crisphealth.org/for-patients.
If you have any questions regarding this Notice or our health information privacy policies, please contact Dr. Alcuri, our designated Privacy Officer, at the practice address.