NOTICE OF PRIVACY PRACTICES (NPP)
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.
USES AND DISCLOSURES
The following describes the ways ICAN may use and disclose individual’s Protected Health Information (PHI).
ICAN is permitted to use and disclose individual’s PHI without an individual’s written authorization for:
ICAN may use and disclose PHI for the individual’s treatment and to provide the individual with treatment‐related healthcare services. For example, ICAN may disclose PHI to doctors, nurses, technicians, or other personnel, including people outside ICAN’s office, who are involved in the individual’s medical care and need the information to provide the individual with medical care.
- For Payment;
ICAN may use and disclose PHI so that ICAN or others may bill and receive payment from the individual, an insurance company or a third party for the treatment and services the individual received. For example, ICAN may tell the individual’s insurance company about a treatment the individual is going to receive to determine whether the individual’s insurance company will cover the treatment.
- For Health Care Operations;
ICAN may use and disclose PHI for health care operations purposes. These uses and disclosures are necessary to make sure that all of ICAN’s patients receive quality care and to operate and manage ICAN’s office. For example, ICAN may share information with doctors, residents, nurses, technicians, clerks, and other personnel for quality assurance and educational purposes. ICAN also may share information with other entities that have a relationship with the individual, for example, the individual’s insurance company and anyone other than the individual who pays for the individual’s services.
Other purposes for which ICAN is permitted or required to use or disclose PHI without an individual’s written authorization:
- Appointment Reminders through 3rdparty;
ICAN may use and disclose PHI to contact the individual to remind them that they have an appointment with ICAN.
- Treatment Alternatives;
ICAN may use and disclose PHI to tell the individual about treatment alternatives.
- Health Related Benefits and Services;
ICAN may use and disclose PHI to tell the individual about health – related benefits and services that may be of interest to the individual.
Under certain circumstances, ICAN may use and disclose PHI for research. For example, a research project may involve comparing the health of patients who received one treatment to those who received another, for the same condition. ICAN will generally ask for the individual’s written authorization before using the individual’s PHI or sharing it with others to conduct research. Under limited circumstances, ICAN may use and disclose PHI for research purposes without the individual’s permission. Before ICAN uses or discloses PHI for research without the individual’s permission, the project will go through a special approval process to ensure that research conducted poses minimal risk to the individual’s privacy. The individual’s information will be de‐identified. Researchers may contact the individual to see if the individual is interested in or eligible to participate in a study.
- As required by Law;
ICAN will disclose PHI when required to do so by international, federal, state or local law.
- To avert a serious threat to health or safety;
ICAN may use and disclose PHI when necessary to prevent a serious threat to the individual’s health and safety or the health and safety of others. Disclosures, however, will be made only to someone who may be able to help prevent or respond to the threat, such as law enforcement or a potential victim. For example, ICAN may need to disclose information to law enforcement when a patient reveals participation in a violent crime.
- To Business Associates;
ICAN may disclose PHI to ICAN’s business associates that perform functions on ICAN’s behalf or provide ICAN with services if the information is necessary for such functions or services. For example, ICAN may use another company to perform billing services on ICAN’s behalf. All of ICAN’s business associates are obligated to protect the privacy of the individual’s information and are not allowed to use or disclose any information other than as specified in our contract.
- Organ and tissue donations;
If the individual is an organ donor, ICAN may use or release PHI to organizations that handle organ procurement or other entities engaged in procurement, banking or transportation or organs, eyes or tissues to facilitate organ, eye or tissue donation and transplantation.
- Military and Veterans;
If the individual is a member of the armed forces, ICAN may release PHI as required by military command authorities. ICAN also may release PHI to the appropriate foreign military authority if the individual is a member of a foreign military.
- Workers’ Compensation;
ICAN may release PHI for workers’ compensation or similar programs. These programs provide benefits for work-‐related injuries or illness.
- Public Health Risks;
ICAN may disclose PHI for public health risks or certain occurrences. These risks and occurrences generally include disclosures to prevent or control disease, injury or disability; report births and deaths; report child, elder or dependent adult abuse or neglect; report reactions to medications or problems with products; notify people of recalls of products they may be using; a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; and the appropriate government authority if we believe a patient has been the victim of abuse, neglect, or domestic violence (we will only make this disclosure when required or authorized by law).
- Health oversight activities;
ICAN may disclose PHI to a health oversight agency, such as the California Department of Health and Human Services or Center for Medicare and Medicaid Services, for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.
- Data breach notification purposes;
ICAN may use or disclose the individual’s PHI to provide legally required notices of unauthorized access to or disclosure of PHI.
- Lawsuits and disputes;
If the individual is involved in a lawsuit or a dispute, ICAN may disclose PHI in response to a court or administrative order. ICAN also may disclose PHI in response to a subpoena, discovery request, or other lawful request by someone else involved in the dispute, but only if efforts have been made to tell the individual about the request or to allow the individual to obtain an order protecting the information requested.
- Law enforcement;
ICAN may release PHI if asked by a law enforcement official if the information is: (1) in response to a court order, subpoena, warrant, summons or similar process; (2) limited information to identify or locate a suspect, fugitive, material witness, or missing person; (3) about the victim of a crime even if, under certain very limited circumstances, ICAN is unable to obtain the individual’s agreement; (4) about a death ICAN believes may be the result of criminal conduct; (5) about criminal conduct on ICAN’s premises; and (6) in an emergency to report a crime, the location of the crime or victims, or the identity, description or location of the person who committed the crime.
- Coroners, Medical examiners and Funeral directors;
ICAN may release PHI to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. ICAN also may release PHI to funeral directors as necessary for their duties.
- National Security and Intelligence Activities;
ICAN may release PHI to authorized federal officials for intelligence, counter-‐intelligence, and other national security activities authorized by law.
- Protective services for the President or others;
ICAN may disclose PHI to authorize federal officials so they may provide protection to the President, other authorized persons or foreign heads of state, or to conduct special investigations.
- Inmates or individuals in custody;
If the individual is an inmate of a correctional institution or under the custody of a law enforcement official, ICAN may release PHI to the correctional institution or law enforcement official. This release would be necessary if: (1) for the institution to provide the individual with health care; (2) to protect the individual’s health and safety or the health and safety of others; or (3) the safety and security of the correctional institution.
Uses and disclosures that require ICAN to give an individual an opportunity to object/opt out:
All objections must be made in writing:
- Third parties involved in individual’s care or payment for individual’s care.
When appropriate and unless the individual objects, ICAN may share PHI with a person who is involved in the individual’s medical care or payment for care, such as the individual’s family or a close friend. If the individual is unable to agree or object to such a disclosure, ICAN may disclose such information as necessary if ICAN determines that it is in the individual’s best interest based on ICAN’s professional judgment.
- Disaster relief
ICAN may disclose the individual’s PHI to disaster relief organizations that seek the individual’s PHI to coordinate the individual’s care, or notify family and friends of the individual’s location or condition in a disaster. ICAN will provide the individual with an opportunity to agree or object to such a disclosure whenever ICAN practically can do so.
ICAN may notify the individual about fundraising events that support ICAN.
Uses and disclosures that requires an individual’s written authorization:
- Uses and disclosures of PHI for marketing purposes;
- Disclosures that constitute a sale of the individual’s PHI;
- Disclosure of psychotherapy notes;
Other uses and disclosures of PHI not covered by this Notice of Privacy Practice or the laws that apply to ICAN will be made only with the individual’s written authorization. If the individual gives us authorization, the individual may revoke it at any time by submitting a written revocation to ICAN Compliance Officer and we will no longer disclose PHI under the authorization. But disclosure that ICAN made in reliance on an individual’s authorization before the individual revoked it will not be affected by the revocation.
With the respect to PHI, you have the right to:
- The right to inspect and copy PHI;
The individual has a right to inspect and copy PHI that may be used to make decisions about the individual’s care or payment for the individual’s care. This includes medical and billing records, other than therapy notes. To inspect and copy the individual’s PHI, the individual must make their request, in writing, to the Department in which their care was provided. ICAN has up to 30 days to make the individual PHI available to the individual. ICAN may charge the individual a reasonable fee for the costs of copying, mailing or other supplies associated with the individual’s request. ICAN may not charge the individual a fee if the individual needs the information for a claim for benefits under the Social Security Act or any other state or federal needs-‐based benefit program. ICAN may deny the individual’s request in certain limited circumstances. If the ICAN does deny the individual’s request, the individual has the right to have the denial reviewed by a licensed healthcare professional that was not directly involved in the denial of the individual’s request, and ICAN will comply with the outcome of the review.
- The right to be notified of a breach to PHI;
ICAN is committed to safeguarding the individual’s PHI. If a breach of the individual’s PHI occurs, ICAN will notify the individual in accordance with state and federal law.
- The right to amend PHI;
If the individual feels that the PHI ICAN has is incorrect, incomplete, or the individual wishes to add an addendum to the individual’s records, the individual has the right to make such request for as long as the information is kept by or for ICAN’s office. The individual must make their request in writing to the Department in which their care was provided. ICAN may deny the individual’s request if the information is incorrect, incomplete, or if the record was not created by ICAN. If ICAN denies the the individual’s request, ICAN will provide the individual with a written explanation of the reasons for doing so within 60 days of the individual’s request.
- The right to receive an accounting of disclosures of PHI;
Individuals have the right to request a list of certain disclosures ICAN made of PHI for purposes other than treatment, payment, health care operations, and certain other purposes consistent with law, or for which the individual provided written authorization. To request an accounting of disclosure, individuals must make their request, in writing, to the Department in which the individual’s care was provided. The individual may request an accounting of disclosures for up to the previous six years of services provided before the date of the individual’s request. If more than one request is made during a 12 month period, ICAN may charge a cost based fee.
- Request limitation on certain uses and disclosures of PHI. Covered entity is not required to agree to requested restriction;
Individuals have the right to request a restriction or limitation on the PHI ICAN uses or disclose for treatment, payment, or health care operations. Individuals have the right to request a limit on the PHI we disclose to someone involved in the individual’s care or the payment for the individual’s care, like a family member or friend. For example, the individual could ask that ICAN not share information about a particular diagnosis or treatment with the individual’s spouse. To request a restriction, the individual must make their request, in writing, to the Department in which their care was provided. If ICAN agrees, ICAN will comply with the individual’s request unless the information is needed to provide the individual with emergency treatment or to comply with law. If ICAN does not agree, ICAN will provide an explanation in writing.
- The right to restrict certain disclosures of PHI to health plan when the individual pays out of pocket in full for a healthcare item or service;
If the individual pays out‐of‐pocket (or in other words, the individual has requested that ICAN not bill the individual’s health plan) in full for a specific item or service, the individual has the right to ask that the individual’s PHI with respect to that item or service not be disclosed to a health plan for purposes of payment or health care operations, and ICAN will honor that request.
- The right to receive confidential communications of PHI, as applicable;
Individuals have the right to request that ICAN communicate with them about medical matters in a certain way or at a certain location. For example, the individual can ask that ICAN only contact individuals by mail or at work. To request confidential communications, individuals must make their request, in writing, to the Department in which their care was provided. The individual’s request must specify how or where the individual wishes to be contacted. ICAN will accommodate reasonable requests.
- The right to choose someone to act for the individual;
If the individual gives someone medical power of attorney or if someone is the individual’s legal guardian, that person can exercise the individual’s rights and make choices about the individual’s PHI. ICAN will use our best efforts to verify that person has authority to act for the individual before ICAN takes any action.
- The right to request a paper copy of the Notice of Privacy Practices;
Individuals have the right to a paper copy of this Notice of Privacy Practices. Even if the individual has agreed to receive this Notice of Privacy Practices electronically, individuals are still entitled to a paper copy of this Notice of Privacy Practices. To obtain a paper copy of this Notice of Privacy Practices, contact the Department in which the individual’s care was provided.
ICAN is required by Law to:
- Maintain the privacy of PHI and provide individuals with notice of its legal duties and privacy practices with the respect to PHI;
- Abide by the terms of the notice currently in effect;
- Reserve the right to change the terms of its notice and make the new notice provisions effective for all PHI that it maintains;
Individuals will be notified of the new NPP via email. New notice will be available upon request, in our office, and on our website.
If an individual believes their privacy rights have been violated, the individual may file a complaint with ANNA PAVLUSHINA, HIPAA Compliance Officer, 5150 VILLAGE PARK DR SE BELLEVUE, WA 98006 425.657.0620. All complaints must be made in writing. Individuals may also contact the Secretary of the Department of Health and Human Services or Director, Office of Civil Rights of the U.S. Department of Health and Human Services. Individuals will not be penalized or retaliated against for filing a complaint.