Notice of Privacy Practices Policy

Policy Regarding Notice of Privacy Practices

Purpose:
To set forth INLAND CARDIOLOGY ASSOCIATES’s policy and procedures regarding the preparation and dissemination of INLAND CARDIOLOGY ASSOCIATES’s Notice of Privacy Practices (the “Notice”).

Standard:
Each individual patient has the right to receive adequate notice of the uses or disclosures of his/her protected health information (PHI) that may be made by INLAND CARDIOLOGY ASSOCIATES.  INLAND CARDIOLOGY ASSOCIATES shall obtain from each patient a written acknowledgement of receipt of the Notice or, if such written acknowledgement is unable to be obtained, INLAND CARDIOLOGY ASSOCIATES shall document in writing the attempts made to obtain the patient’s written acknowledgement.

Policy:
 INLAND CARDIOLOGY ASSOCIATES will develop, and provide to each individual who receives care and treatment from INLAND CARDIOLOGY ASSOCIATES, a Notice of Privacy Practices in accordance with the procedures set forth below.

Procedure:

1. Contents of INLAND CARDIOLOGY ASSOCIATES’s Notice of Privacy Practices

INLAND CARDIOLOGY ASSOCIATES’s Notice will be written in plain language and contain the elements listed below.

A. Header.  The Notice will contain the following statement as a header on the first page:  “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.”

B. Uses and Disclosures.  The Notice will contain:

i. A description of the types of uses and disclosures of PHI that may be made for treatment, payment, or health care operations, including at least one example of each type of use and disclosure. If INLAND CARDIOLOGY ASSOCIATES intends to engage in the following activities, INLAND CARDIOLOGY ASSOCIATES also will provide a separate statement that indicates —

  1. INLAND CARDIOLOGY ASSOCIATES may contact the individual to provide appointment reminders or provide information about treatment alternatives or other health-related benefits or services that may be of interest to the individual; or
  2. INLAND CARDIOLOGY ASSOCIATES may contact the individual to raise funds.

ii. A description of the types of uses and disclosures of PHI that may be made without the individual’s written consent or authorization, including those uses and disclosures permitted or required by HIPAA or other federal or state law.
iii. A statement that other uses or disclosures of PHI will be made with the individual’s written authorization only and that the individual may revoke the authorization at any time upon giving written notice of such revocation.
iv. Optional provision.  If INLAND CARDIOLOGY ASSOCIATES elects to limit the use or disclosure of PHI, INLAND CARDIOLOGY ASSOCIATES may describe such limitations in the notice, provided that INLAND CARDIOLOGY ASSOCIATES does not include any limitation that would affect its right to use or disclose PHI in any manner required by law.  If INLAND CARDIOLOGY ASSOCIATES elects to include a limitation provision in its Notice, then the Notice will contain a statement that allows INLAND CARDIOLOGY ASSOCIATES to reserve the right to change such limitations in the Notice, including a statement describing how INLAND CARDIOLOGY ASSOCIATES will provide individuals with the revised Notice.

C. Individual Rights.  The Notice will contain a statement of the individual’s rights regarding his/her PHI, including a brief description of how the resident may exercise these rights. An individual’s rights include:
i. The right to inspect and copy PHI;
ii. The right to request an amendment of PHI;
iii. The right to receive an accounting of PHI disclosures;
iv. The right to request restrictions on certain uses and disclosures of PHI, including a statement that INLAND CARDIOLOGY ASSOCIATES is not required to agree to a requested restriction;
v. The right to receive confidential communications of PHI; and
vi. The right to obtain a paper copy of the Notice upon request.

D. INLAND CARDIOLOGY ASSOCIATES’s duties.  The Notice will contain:
i. A statement that INLAND CARDIOLOGY ASSOCIATES is required by law to maintain the privacy of PHI and to provide individuals with notice of its legal duties and privacy practices regarding such PHI;
ii. A statement that INLAND CARDIOLOGY ASSOCIATES is required to abide by the terms of the Notice currently in effect; and
iii. A statement that INLAND CARDIOLOGY ASSOCIATES reserves the right to change the terms of its Notice and to make the new Notice provisions effective for all PHI that it maintains, including a statement describing how INLAND CARDIOLOGY ASSOCIATES will provide individuals with the revised Notice.

E. Complaints.  The Notice will contain:
i. A statement that individuals may complain to INLAND CARDIOLOGY ASSOCIATES and/or to the Secretary of the Department of Health and Human Services (“DHHS”) if they believe their privacy rights have been violated;
ii. A brief description of how individuals may file a complaint with INLAND CARDIOLOGY ASSOCIATES; and
iii. A statement that INLAND CARDIOLOGY ASSOCIATES will not retaliate against the individual for filing a complaint.

F. Contact Information.   The Notice will contain the name, or title, and telephone number of a person or office to contact for further information.

G. Effective Date.  The Notice will contain the date on which the Notice is first in effect, which will not be earlier than the date on which the Notice is printed or otherwise published.

2. Revision, Dissemination, and Publication of the Notice

A. Revision.  INLAND CARDIOLOGY ASSOCIATES will promptly revise and distribute its Notice whenever there is a material change to the uses and disclosures of PHI, the individual’s rights, INLAND CARDIOLOGY ASSOCIATES’s duties, or other privacy practices stated in the Notice.

B. Dissemination and Publication. 
i. For those individuals with whom INLAND CARDIOLOGY ASSOCIATES has a direct treatment relationship, INLAND CARDIOLOGY ASSOCIATES will –

  1. Provide the Notice to the individual no later than the date of the first service delivery (including services delivered electronically) after the compliance deadline date of April 14, 2003;
  2. Make the Notice available at INLAND CARDIOLOGY ASSOCIATES’s physical location for individuals to take with them, and post the Notice in a clear and prominent location where there is a reasonable expectation that individuals will be able to read the Notice; and 
  3. Upon revision, make the Notice available upon request on or after the effective date of the revision.

ii. For those individuals with whom INLAND CARDIOLOGY ASSOCIATES has an indirect treatment relationship (if any), INLAND CARDIOLOGY ASSOCIATES will make its Notice available to individuals upon request only.  INLAND CARDIOLOGY ASSOCIATES may also distribute its Notice through other health care Inland Cardiology Associates who have direct treatment relationships or through participation in an organized health care arrangement that produces a joint Notice.
iii. If INLAND CARDIOLOGY ASSOCIATES maintains a Web site, INLAND CARDIOLOGY ASSOCIATES will prominently post its Notice (and any revisions) on the site and make it available electronically through the site.
iv. INLAND CARDIOLOGY ASSOCIATES may provide its Notice to an individual by email, if the individual verbally agrees to such electronic notice.  If, after sending the Notice by email, INLAND CARDIOLOGY ASSOCIATES becomes aware that the electronic transmission failed, INLAND CARDIOLOGY ASSOCIATES will provide the individual with a hard paper copy of the Notice.  Any individual who receives the Notice electronically retains the right to obtain, upon request, a paper copy of the Notice from INLAND CARDIOLOGY ASSOCIATES.
v. If INLAND CARDIOLOGY ASSOCIATES is a recipient of federal financial assistance, INLAND CARDIOLOGY ASSOCIATES is generally obligated under Title VI of the Civil Rights Act of 1964 to provide material ordinarily distributed to the public in the primary languages of persons with limited English proficiency in INLAND CARDIOLOGY ASSOCIATES’s service areas. 
vi. INLAND CARDIOLOGY ASSOCIATES may distribute its Notice in a newsletter or other communication as long as the Notice is sufficiently separate from other documents contained in the newsletter or other communication.

3. Written Acknowledgement from Patient of Receipt of Notice

  1. Except in an emergency situation, INLAND CARDIOLOGY ASSOCIATES shall make a good faith effort to obtain an individual’s written acknowledgement of receipt of the Notice on the form prescribed by INLAND CARDIOLOGY ASSOCIATES.  Such written acknowledgement shall be maintained in the individual’s medical file for the minimum period described in Section 5 of this Policy.

 

  1. In the event INLAND CARDIOLOGY ASSOCIATES is unable to obtain an individual’s written acknowledgement, then INLAND CARDIOLOGY ASSOCIATES shall document in the individual’s medical record the good faith attempts made by INLAND CARDIOLOGY ASSOCIATES to obtain such written acknowledgement.

4. Joint Notice of Entities Participating in an Organized Health Care Arrangement
If INLAND CARDIOLOGY ASSOCIATES participates in an organized health care arrangement (“OHCA”), then INLAND CARDIOLOGY ASSOCIATES may submit a Joint Notice prepared by the OHCA if:

  1. INLAND CARDIOLOGY ASSOCIATES agrees to abide by the terms of the Joint Notice as part of its participation in the OHCA;
  2. The Joint Notice meets the above-stated requirements and reflects that it covers more than one entity;
  3. The Joint Notice describes, with reasonable specificity, the covered entities and the service delivery sites to which the Notice applies; and 
  4. States, if applicable, that the covered entities participating in the OHCA will share information with each other as necessary to carry out treatment, payment, and health care operations relating to the OHCA.

5. Documentation
INLAND CARDIOLOGY ASSOCIATES will document its compliance with the Notice requirements as set forth in this policy and procedure by retaining copies of its Notice, including any revisions thereto, and any individually signed written acknowledgements for a period of at least six (6) years from the date that the Notice or acknowledgement was created or was last in effect, whichever is later.