How ICAN may use and disclose PHI:
The following describes the ways ICAN may use and disclose PHI. Except for the purposes described below, ICAN will use and disclose PHI only with the individual’s written permission. The individual may revoke such permission at any time by writing to ICAN’s Compliance Officer.
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.
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) for the individual’s healthcare operation activities.
Appointment Reminders, Treatment Alternatives, and Health Related Benefits and Services:
ICAN may use and disclose PHI to contact the individual to remind them that they have an appointment with ICAN. ICAN also may use and disclose PHI to tell the individual about treatment alternatives or health-‐related benefits and services that may be of interest to the individual.
Third Parties Involved in an Individual’s Care or Payment for an Individual’s Care:
When appropriate, ICAN may share PHI with a person who is involved in the individual’s medical care or payment for the individual’s care, such as the individual’s family or a close friend. ICAN also may notify the individual’s family about the individual’s location or general condition or disclose such information to an entity (such as the Red Cross) assisting in a disaster relief effort.
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.
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 Donation:
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.
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 Medical 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.
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 and Others:
ICAN may disclose PHI to authorized 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 REQUIRES ICAN TO GIVE THE INDIVIDUAL AN OPPORTUNITY TO OBJECT/OPTOUT:
Third Parties Involved in the Individual’s Care or Payment for Individual’sCare:
Unless the individual objects, ICAN may disclose to a member of the individual’s family, a relative, a close friend or any other person the individual identifies, the individual’s PHI that directly relates to that third party’s involvement in the individual’s health care. 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.
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.
INDIVIDUAL’S WRITTEN AUTHORIZATION IS REQUIRED FOR OTHER USES AND DISCLOSURES:
The following uses and disclosures of the individual’s PHI will be made only with the individual’s written authorization:
- Uses and disclosures of PHI for marketing purposes;
- Disclosures that constitute a sale of the individual’s PHI;and
- Disclosures of therapy 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.
INDIVIDUAL’S RIGHTS REGARDING PHI:
Right to Inspect and Copy:
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 and 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.
Right to Get Notice of a Breach:
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.
Right to Amend, Correct or Add an Addendum:
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. In the case of claims that the information is incorrect, incomplete, or if the record was not created by ICAN, ICAN may deny the individual’s request. However, if ICAN denies any part of 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.
Right to an Accounting of Disclosures:
Individuals have the right to request a list of certain disclosures ICAN made of PHI for purposes other than treatment, payment, health care operations, 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.
Right to Request Restrictions:
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 also 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. ICAN is not required to agree to the individual’s request unless the individual is asking us to restrict the use and disclosure of the individual’s PHI to a health plan for payment or healthcare operation purposes and such information the individual wishes to restrict pertains solely to a health care item or service for which the individual has paid ICAN out-‐of-‐pocket in full. 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.
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.
Right to Request Confidential Communications:
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.
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.
Right to a Paper Copy of This Notice of Privacy Practices:
Individuals have the right to a paper copy of this Notice of Privacy Practices. Individuals may ask ICAN to give the individual a copy of this Notice of Privacy Practices at anytime. 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.
CHANGES TO THIS NOTICE OF PRIVACY PRACTICES:
ICAN reserves the right to change this Notice of Privacy Practices and make the new Notice of Privacy Practices apply to PHI ICAN already has as well as any information ICAN receives in the future. ICAN will post a copy of ICAN’s current Notice of Privacy Practice at our office. The Notice of Privacy Practices will contain the effective date on the first page, in the top right-‐hand corner. Individuals will be sent information regarding the changes via e-‐mail or via mail on how they can obtain a new copy. Individuals will be asked to sign off on the new Notice of Privacy Practices at the individual’s next scheduled appointment.
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. Please contact ICAN Compliance Officer if an individual needs assistance locating current contact information. Individuals will not be penalized or retaliated against for filing a complaint.