HIPPA Privacy Information

PACE,
INC.

Notice of Privacy
Practices

(Federal Health
Insurance and Portability Act)
 
 

Purpose.  We are
required by law to maintain the confidentiality and privacy of your
protected health information.  “Protected
health information” is information about you that may identify you and
that relates to your past, present or future physical or mental health or
condition and related health care services. 
This Notice describes how we may use and disclose your protected
health information to carry out treatment, payment or health care
operations and for other purposes that are permitted or required by law.[2] 
It also describes your rights to access and control you protected
health information.

We are required to abide by the terms of this Notice, which is effective
April 14, 2003
. 
We reserve the right to change the terms of our Notice at any time
as permitted b law.  The new
Notice will be effective for all protected health information that we
maintain at that time and for information we receive in the future. 
We will post a current copy of the policy and will have copies of
our current policy available each time you are here for health care
services.  We will also provide
you with any revised Notice of Privacy Practices upon a request made by
you via phone or in person.
 

Uses and
Disclosures of Protected Health Information for Treatment, Payment and/or
Operations.

The
following categories describe different ways that we may use and disclose
health information for treatment, payment and operations. 
At least one example is given for each category. 
Please be aware that not every possible use of disclosure is
listed.

Treatment:  We may
use and disclose your protected health information to provide you with
treatment and services and to coordinate your care. 
For example, we may disclose your protected health information to
other agency clinical staff that are involved in your care as well as
different departments of the agency in order to coordinate the various
services you might need, such as prescriptions.[3]

Payment:  Your
protected health information may be used to obtain approval for and
payment for services you receive.  For
example, we may confirm your eligibility with insurance plans,
governmental agencies, or Medicaid in order to obtain approval and/or
payment of services.

Operations: 
We
may use or disclose your protected health information as necessary for our
regular business activities such as health oversight, accreditation,
licensing, and quality assurance.  For
example, members of the quality assurance team may use information in your
health record to assess the care in your case in an effort to continually
improve the quality and effectiveness of the healthcare services we
provide.

As part of operations, we may contact you to provide appointment
reminders.

We may share your protected health information with third party
“business associates” that perform various activities for us involving
protected health information (e.g., auditors, attorneys), but only when we
have a written contract with the business associate that fully protects
the privacy of your protected health information.
 

 Other
Permitted and/or Required Uses and Disclosures

According
to Federal Privacy Regulations, we may make the following uses disclosures
without obtaining consent or written authorization from you.

Unless
you object, under federal law we may disclose health information about you
to a member of your family, a relative, a close friend or any other person
you identify as involved in your case.[4]

We
may use or disclose your protected health information in an emergency
situation when use and disclosure of the protected health information is
necessary to prevent serious risk of bodily harm or death.[5]

We
may use or disclose your protected health information if and to the extent
we are required by federal or state law. 
You will be notified, if required by law, or any such uses or
disclosures.

We
may disclose to a court when ordered by the court.

We
may disclose to a public health authority that is authorized by law to
receive reports of child abuse or neglect. 
In addition, if we believe that you have been a victim of abuse,
neglect or domestic violence, we may disclose your protected health
information to the governmental entity or agency authorized to receive
such information.  Any
disclosure of suspected abuse will be made consistent with the
requirements of applicable state law.

We
may disclose to governmental agencies or private entities responsible for
overseeing health care activities through audits, investigations,
inspections and licensure.  Oversight
agencies include government and/or private agencies that oversee the
health care systems, government benefit programs, government regulatory
programs and civil rights laws.

Required
Uses and Disclosures:  Under
federal law, we must make disclosures when required by the Secretary of
the United States Department of health and Human Services to investigate
or determine our compliance with the requirements of 45 C.F.R. Part
164.308 et. seq.

We
may disclose for public health purposes such as notifying public health
authorities regarding specific communicable diseases, but only to the
extent authorized by state law.

We
may disclose to federal, state or local agencies engaged in disaster
relief to the extent that such information is required to enable them to
carry out their responsibilities in specific disaster situations.
 

Uses and
Disclosures of Protected Health Information Based Upon Your Written
Authorization.
 

Other
uses and disclosures of you protected health information not covered by
this Notice or by laws that apply to us will be made only with your
written authorization.  You may
revoke this authorization, at any time, in writing. 
If you revoke this authorization, we will no longer use or disclose
your protected health information for the reasons covered by the
authorization.  However, we
cannot undo any disclosure we have already made with the authorization and
are required to retain our records of the care that we provided to your.
 

Your
rights Regarding Your Protected Health Information.

 You have the following rights with respect to your protected health
information:

You Have
the Right to Request Restrictions:  You
have the right to request a limitation or restriction on the protected
health information we use or disclose about you for treatment, payment or
healthcare operations.  We are
not required to agree to restriction that you may request. 
If we agree to the requested restriction, we may not use or
disclose your protected health information in violation of the restriction
unless it is needed to provide emergency treatment. 
You must make this request in writing to our Privacy Contact at the
address listed below.

Right to
Request Confidential Communication:  You
have the right to request to receive confidential communications from us
in a certain way or at an alternative location. 
For example, you can ask that we only contact you at home or by
mail.  We will accommodate
reasonable requests.  We may
also condition this accommodation by asking you for specification of an
alternative address or other method of contact. 
The request must be made in writing to our Privacy Contact at the
address listed below specifying how or where you wish to be contacted.

Right to
Inspect and Copy:  You
have the right to inspect and obtain a copy of protected health
information about you that we maintain. 
To inspect and/or obtain a copy of protected health information,
you must submit your request in writing to our Privacy Contact. 
If you request a copy of the information, we may charge a
reasonable fee for the costs of copying, mailing, or other related costs.

We may deny your request to inspect a copy in certain limited
circumstances.  Under federal
law, for example, you may not inspect or copy the following records;
psychotherapy notes; information compiled in reasonable anticipation of,
or use in, a civil, criminal, or administrative action or proceeding. 
  We are also permitted to deny your request to inspect
and copy if the protected health information was obtained from someone
under a promise of confidentiality.  Please
contact our Privacy Contact if you have questions about access to your
records.

Right to
Amend:    If
you believe that health information we have about you is incorrect or
incomplete, you may request that we amend it. 
  Your request must be in writing, submitted to the
address listed below, and must state the reason you are seeking an
amendment.  If we deny your
request for amendment, you have the right to file a statement of
disagreement with us which will be made a part of your record. 
We may prepare a rebuttal to your statement and will provide you
with a copy of such rebuttal.  Please
contact our Privacy Contact if you have questions about amending your
record.

Right to
Receive an Accounting of Disclosure:  You
have the right to an accounting of disclosures for purposes other than
treatment, payment or healthcare operations as described in this Notice. 
You have the right to receive specific information regarding these
disclosures that occurred after
April 14, 2003
. 
You must submit your request in writing to the addresses listed at
the end of this Notice.  The
right to receive this information is subject to certain exceptions,
restrictions and limitations.

Right to
Receive a Copy: 
You have aright to receive a paper copy of the notice of Privacy
Practices upon request.

Complaints

If you
believe we have violated your privacy rights, you may complain to us or to
the Secretary of Health and Human Services. 
You may file a complaint with us by notifying our Privacy Contact. 
We will not retaliate against you for filing a complaint.
 

Contacting
Privacy Officer

You
may contact our Privacy Contact, Bruce Johnson, by phone at 302-999-9812
or submit written requests to him at:
 

PACE,
Inc.

Attn:  
Bruce Johnson

Woodmill
Corporate Center

5171 West Woodmill
Road, Suite 9

Wilmington
,  

DE
 
19808