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- NEWS
- November 16, 2020
NOTICE OF PRIVACY PRACTICES
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.
We are required by law to maintain the privacy of your protected health information, to notify you of our legal duties and privacy practices with respect to your health information, and to notify affected individuals following a breach of unsecured health information. This Notice summarizes our duties and your rights concerning your information. Our duties and your rights are set forth more fully in 45 CFR Part 164. We are required to abide by the terms of our Notice that is currently in effect.
1.Uses And Disclosures We May Make Without Written Authorization.
We may use or disclose your health information for certain purposes without your written authorization, including the following:
Treatment: We may use or disclose your information for purposes of treating you. For example, we may disclose your information to another health care provider so they may treat you; to provide appointment reminders; or to provide information about treatment alternatives or services we offer.
Payment: We may use or disclose your information to obtain payment for services provided to you. For example, we may disclose information to your health insurance company or other payer to obtain pre-authorization or payment for treatment.
Healthcare Operations: We may use or disclose your information for certain activities that are necessary to operate our practice and ensure that our patients receive quality care. For example, we may use information to train or review the performance of our staff or make decisions affecting the practice.
Other Uses or Disclosures: We may also use or disclose your information for certain other purposes allowed by 45 CFR § 164.512 or other applicable laws and regulations, including the following:
2. Disclosures We May Make Unless You Object.
Unless you instruct us otherwise, we may disclose your information as described below:
3. Uses and Disclosures With Your Written Authorization. Other uses and disclosures not described in this Notice will be made only with your written authorization, including most uses or disclosures of psychotherapy notes; for most marketing purposes; or if we seek to sell your information. You may revoke your authorization by submitting a written notice to the Privacy Contact identified below. The revocation will not be effective to the extent we have already taken action in reliance on the authorization.
4. Health Information Exchange (HIE). Madison Memorial Hospital, Madison Memorial Rexburg Medical Clinic, Madison Memorial Orthopedics, Madison Surgery Center, and Seasons Medical by Madison Memorial currently participate in health information exchanges (HIE’s), which ultimately help enhance the quality of your care. The goal of the HIE’s is to help participating physicians and providers give better, more efficient care to their patients by the sharing of health information across secure systems. This means that wherever a patient goes, the patient’s health information may be available to all doctors who use the HIE’s, which helps to provide safer, more coordinated patient care.
MMH, MMRMC, MMO, MSC, and SMMM currently utilize Idaho Health Data Exchange (IHDE) and CommonWell Health Alliance to access and share your health information with other participants of these HIE’s for treatment purposes and for payment of treatment services. These HIE’s allow any health information organization that participates in the HIE’s to have secure electronic access to patients’ records. You may opt out of the Health Information Exchange by doing one or both of the following:
Idaho Health Data Exchange: Complete and sign IHDE’s “Request to Restrict Disclosure of Health Information” form and mail or fax it to IHDE. You can find the form here: https://www.idahohde.org/restrictdisclosure.
CommonWell Health Alliance: Complete and sign MMH’s “Request to Restrict Disclosure of Health Information” form and mail or fax it to MMH. You can find the form here: https://madisonmemorial.org/restrict-disclosure.
5. Your Rights Concerning Your Protected Health Information. You have the following rights concerning your health information. To exercise any of these rights, you must submit a written request to the Privacy Officer identified below.
6. Changes To This Notice. We reserve the right to change the terms of this Notice at any time, and to make the new Notice effective for all protected health information that we maintain. If we materially change our privacy practices, we will post a copy of the current Notice in our reception area and on our website. You may obtain a copy of the operative Notice from our receptionist or Privacy Officer.
7. Complaints. You may complain to us or to the Secretary of Health and Human Services if you believe your privacy rights have been violated. You may file a complaint with us by notifying our Privacy Officer. All complaints must be in writing. We will not retaliate against you for filing a complaint.
8. Contact Information. If you have any questions about this Notice, or if you want to object to or complain about any use or disclosure or exercise any right as explained above, please contact the Privacy Officer: 208-359-6539 | PO Box 310, Rexburg, ID 83440-0310 | HIMDirector@mmhnet.org
9. Effective Date. This Notice is effective October 28, 2019.
PURPOSE: Practitioners and staff affiliated with Seasons Medical shall comply with the requirements of applicable state and federal laws concerning the privacy and security of protected health information concerning Practice’s patients, including but not limited to the Health Insurance Portability and Accountability Act of 1996 and its implementing regulations, 45 CFR part 164 (hereafter “the HIPAA privacy and security rules”).
The unauthorized access of information outside the scope of such person’s duties will subject Practice personnel to appropriate sanctions as provided below. (See 45 CFR § 164.514(d)).
The limits and process for exercising and responding to a patient’s or personal representative’s exercise of rights are more fully described in the HIPAA privacy rules, 45 C.F.R. § 164.522 et seq. Practice personnel should consult with the Privacy Officer in responding to a patient’s request.
Notwithstanding the foregoing, Practice personnel are only required to utilize safeguards that are reasonable under the circumstances. Practice personnel should use reasonable judgment to ensure that privacy concerns do not interfere with effective patient care.
Seasons Medical complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Seasons Medical does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
Seasons Medical:
If you need these services, contact Jen Harris.
If you believe that Seasons Medical has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Jen Harris, 37th South 2nd East Rexburg, ID 83401, (phone) 208-356-0234, (fax) 208-656-8877, jharris@seasonsmedical.com. You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Jen Harris is available to help you.
You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C. 20201 1-800-368-1019, 800-537-7697 (TDD) Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.
Information about nondiscrimination and accessibility requirements can be read in 15 different languages by visiting: http://www.hhs.gov/civil-rights/for-individuals/section-1557/translated-resources/
At the very least, know that language assistance services, free of charge, are available to you. Please call us at (208) 356-0234.
Spanish: ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al (1-208-356-0234)
Chinese: 注意:如果您使用繁體中文,您可以免費獲得語言援助服務。請致電 (1-208-356-0234)
Serbo Croation: OBAVJEŠTENJE: Ako govorite srpsko-hrvatski, usluge jezičke pomoći dostupne su vam besplatno. Nazovite (1-208-356-0234)
Korean: 주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다 (1-208-356-0234) 번으로 전화해 주십시오.
Nepali: ध्यान दिनुहोस्: तपार्इंले नेपाली बोल्नुहुन्छ भने तपार्इंको निम्ति भाषा सहायता सेवाहरू निःशुल्क रूपमा उपलब्ध छ । फोन गर्नुहोस् (1-208-356-0234)
Vietnamese: CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số (1-208-356-0234)
Arabic: تنبيه: إذا كنت تتكلم العربية، وخدمات المساعدة اللغوية، مجانا، تتوفر لك. دعوة 1-208-356-0234.
German: ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: (1-208-356-0234)
Tagalog: PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa (1-208-356-0234)
Russian: ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните (1-208-356-0234)
French: ATTENTION : Si vous parlez français, des services d’aide linguistique vous sont proposés gratuitement. Appelez le (1-208-356-0234)
Japanese: 注意事項:日本語を話される場合、無料の言語支援をご利用いただけます。(1-208-356-0234)まで、お電話にてご連絡ください。
Romanian: ATENȚIE: Dacă vorbiți limba română, vă stau la dispoziție servicii de asistență lingvistică, gratuit. Sunați la (1-208-356-0234)
Bantu (Swahili): KUMBUKA: Ikiwa unazungumza Kiswahili, unaweza kupata, huduma za lugha, bila malipo. Piga simu (1-208-356-0234)
Persian (Farsi): توجه: اگر به زبان فارسی گفتگو می کنید، تسهیلات زبانی بصورت رایگان برای شما فراهم می باشد. با 1–208-356-0234 تماس بگیرید.
REFERENCES
HIPAA Privacy Rules, 45 CFR § 164.501 et seq.
HIPAA Breach Notification Rules, 45 CFR § 164.401 et seq.
HIPAA Security Rules, 45 CFR § 164.301 et seq.
Idaho Code § 39-4504 (identifying “personal representatives” under Idaho law)
RELATED DOCUMENTS AND POLICIES
HIPAA Security Policy
Privacy Breach Notification Policy
Notice of Privacy Practices
Accounting of Disclosure Log
Sample Business Associate Agreement
Sample Authorization for Disclosure of Protected Health Information
Last Modified August 28, 2018