• Treatment: HIPAA defines treatment as "the provision, coordination, or management of health care and related services by one or more health care providers, including the coordination or management of health care by a health care provider with a third party; consultation between health care providers relating to a patient; or the referral of a patient for health care from one health care provider to another." We will use and/or disclosure your PHI for the purpose of providing you with care/services, treatment and health care products relating to your care. As a patient, we may use and/or disclose your PHI on your medical record. This will include your medical condition, treatments, services, medications, health care products which you may receive and any health insurance information. We may use or disclose PHI to employees, contractors, care givers, and your physicians and health care professionals that are providing care/services to you.
• Payment: HIPAA defines payment, in relation to health care providers, as activities to obtain reimbursement for the health care services and products that we provide to you. A.C.H.C. may use and/or disclose your PHI for the purpose to secure payment for the health care services and products provided to you. The agency may inform your health insurance company or patient/family that is responsible for the paying the home health care bill of your diagnosis, treatment, services and health care products rendered to you.
  Activities related to billing may include claims management, collections, and related health care data processing. Other activities may include determination of eligibility of coverage, medical necessity, including precertification and recertification process, appropriateness of care, or justification of charges; Utilization Review & Performance Improvement activities.
  A.C.H.C. will use and disclose your PHI to carry out the above activities only as necessary or required to obtain payment for care, services and health care products we provide to you. Also, health care insurance programs that may provide or pay for your health care can conduct audits and surveys of the agency in regard to our activities and your activities and we may be required to disclose your PHI to them.
• Business Associates: A.C.H.C. may need to provide care, services, and health care products to you with other contracted persons and/or businesses through written agreements or contracts with the agency. They are defined by HIPAA as "Business Associates". It may be necessary for A.C.H.C. to disclose your PHI to these Business Associates so that you may receive the necessary care, services and health care products needed for your treatment. Whenever a Business Associate agreement involves the use or disclose of your PHI, A.C.H.C. will have a written agreement with the Business Associate that assures us they will protect the privacy of your PHI and maintain standards of the privacy law.
• Healthcare Operations: HIPAA defines health care operations as those activities and functions necessary and related to providing care, services and health care products to you.
  A.C.H.C. may use or disclose your PHI for the day to day operations and functions. They include, but not limited to the following
  • Purposes of care, services and health care products.
  • Performing Utilization Review and Performance Improvement activities, case management and related functions to access and improve the quality of care and services, provided to you.
  • Management and administrative activities and also activities relating to implementation and compliance with the regulations of HIPPA.
  • Performing health oversight activities such as audits, auditing functions, surveys, administrative or criminal investigations
• Communication with Individuals Involved in Your Care: In providing care, services, and health care products to you, A.C.H.C. may find it necessary to communicate with you, a family member, relative, close personal friend, caregivers, and businesses your PHI relevant to that person's involvement in your care or payment related to care. Most of these disclosures will be related to providing care, services and health care products or payment related to your care. A.C.H.C. will only use and disclose your PHI as mentioned above, only as necessary and appropriate for your health care.
• State and Federal Government Agencies: A.C.H.C. may use and disclose your PHI to state and federal government agencies for a variety of purposes, most of which are directed at monitoring health care quality, safety and government programs related to health care and our compliance with laws, regulations and standards applicable to health care. We may disclose your PHI to such organizations when they require it, so they can perform its required activities and functions.
• State and Federal Government Healthcare Insurance Programs: If you receive benefits from state and federal healthcare programs, such as Medicaid or Medicare, your PHI may be used and disclosed to the programs. These programs have the right to conduct audits, surveys and investigations related to our functions and activities and your activities and when required, we will disclose your PHI for these activities.
• Workers Compensation: A.C.H.C. may disclose your PHI to the extent authorized by and as necessary to comply with relating to workman's compensation or other similar programs established by law.
• Public Health and Safety: There are state and federal laws that require healthcare providers to report to various government agencies issues related to public health. If your illness is of a nature that it is required by law to be reported, then we will disclose your PHI appropriately. In addition, we may also disclose your PHI to state/government agencies in situations where there is domestic, child and elder abuse or neglect, as required by law.
• To Avert a Serious Threat to Health or Safety: In accordance with State/Federal laws, A.C.H.C. may use and disclose your PHI when necessary to prevent a serious threat to your health and safety and also the health and safety of others.
• Health Oversight Activities: There are state, federal and accrediting agencies which mandate laws, regulations and standards for the home health program. A.C.H.C. must comply with these laws. These agencies may mandate activities and functions to assess, monitor and improve home health programs. These activities include surveys, licensure surveys, audits, and investigations of our care, services that we provide to you and agency activities and functions. At any time if we are required by state or federal agencies to disclose your PHI we will do so as necessary.
• Law Enforcement: A.C.H.C. will disclose your PHI as necessary when required by the following: State and federal law, law enforcement official as part of a law enforcement activities, investigations of criminal conduct, by court orders, subpoena, or in emergency circumstances.
• Lawsuits and Legal Disputes: In the event that you are involved in a lawsuit or other legal proceeding, A.C.H.C. will disclose your PHI in response to a subpoena, court order, discovery request or other legal mandate from a court.
• Funeral Directors, Coroners and Medical Examiners: A.C.H.C. may release health information to a coroner or medical examiner. This may be necessary, for example; to identify a deceased person or determine the cause of death. We may also release information to funeral directors as necessary for their duties.
• Disclosures for the Benefit of you and Others: A.C.H.C. would use or disclose your PHI for your benefit and to prevent or reduce the risk of harm to you in a situation that would involve Emergency Care such as if you become unconscious in the Ambulance or Emergency Room and if staff request your PHI, we may disclose it for the purpose of assisting prompt treatment. Also, when necessary to protect the health and safety of others, your PHI may be disclosed.
• Protective Services for the President, National Security and Intelligence: A.C.H.C. is legally required to use or disclose your PHI to authorized federal or government officials so they may provide protection to the President, other authorized persons or foreign heads of state or conduct special investigations, or for intelligence, counterintelligence and other national security activities authorized by law.
• Military and Veterans: If you are a member of the armed forces, whether on active or reserve status, A.C.H.C. may disclose your PHI as required by the U.S.M. also, we may disclose your PHI if you are a veteran and if you are receiving health services and products from the Veterans Service. Any disclosures for these purposes would be made only to authorized government officials.
• Miscellaneous Natures: This includes various uses and disclosure that A.C.H.C. may be required to make in compliance with HIPAA. We may use and disclose PHI about an inmate of a correctional institution or under the custody of a law enforcement official to the correctional institution or law enforcement official. Other instances include research or research projects, organ transplantation for organ donations.

YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION

HIPAA provides you with rights regarding the PHI information we maintain, use and/or disclose about you. The following describes your rights. If you would like more information about any of these, please submit your request in writing to:

Privacy Officer
All Care Home Care Inc.
472 S. Poplar St.
Hazleton, Pa. 18201

• Right to Reqeust Restrictions on Uses and Disclosures: You have the right to request that A.C.H.C. restrict uses or disclosures of your PHI to provide care, services, healthcare products, healthcare operations or communication with family or friends. We are not required to agree to your requested restriction. All requests for limitation on the use and disclosure of your PHI must be submitted to our Privacy Officer in writing.
• Right to Inspect and Obtain a Copy of your PHI: You have the right to review or receive copies of our medical records that contain your PHI. We must accommodate your request if it is reasonable. You may review your records during normal business hours at no charge. However, if you request copies of your medical records, you may be charged a reasonable cost-based fee for the cost of copying, mailing, faxing, supplies and labor costs necessary in providing you with your request.
  If A.C.H.C. is unable to carry out your request, we will provide you a written explanation of why we denied your request. Depending on the circumstances, you may submit in writing a request for us to reconsider the denial. All requests to review or receive copies of our records that contain your PHI must be submitted to our Privacy Officer in writing.
• Right to Receive Confidential Communications: You have the right to request that we send communications that contain your PHI by alternate means or to alternative locations only as specified by you. All requests for confidential PHI must be submitted in writing to our Privacy Officer.
• Right to Request and Amendment of PHI: You have the right to have us amend your PHI contained in our records for as long as we maintain such records as required by law. You must submit a written request that includes the reason or reasons for your request. We may not be able to agree to your requested change if it would cause your PHI to become inaccurate or if we no longer maintain the records. If A.C.H.C. does not agree to your requested change, we will notify you in writing as to why we are not able to agree. You have the right to submit to us a written statement of disagreement, to which we may respond to you in writing. All requests for amendments must be written and submitted to our Privacy Officer.
• Right to Receive an Accounting of Disclosures of PHI: You have the right to receive an accounting of disclosures of your PHI made after April 14, 2003. By accounting, we mean a written record of these disclosures. This does not include disclosures made to provide care, services, and healthcare products; healthcare operations; disclosures made to you; communications with family and friends; for national security or intelligence purposes; to correctional institutions or law enforcement officials; and disclosures made prior to the HIPAA compliance date April 14, 2003. Please refer to agencies Privacy Officer for more information on the disclosures not required to be included in the accounting.
  The time period for which we are required to provide the accounting is the six (6) years prior to the date of your request (or shorter period of time requested) but no earlier than April 14, 2003.
  Your first request for one accounting in any 12-month period shall be provided without a charge. If you request additional accounting during the same 12-month period, we may charge a reasonable, cost-based fee for printing, copying, with any expenses for mailing, courier services and supplies necessary in fulfilling your request. All requests for an accounting must be submitted in writing to our Privacy Officer.
• Right to a Paper Copy of this Notice: You have the right to a paper copy of this notice, you may ask us to give you a copy of this notice at any time. You may obtain a copy of this notice upon request.

USES AND DISCLOSURES NOT CONTAINED IN THIS NOTICE

If a use and/or disclosure of your PHI is not revealed in this Notice, we will then obtain from you a written authorization before the use and/or disclosure. You may have the right to refuse to authorize the use and/or disclosure, or if you agree to the authorization, to revoke the authorization at any time. If such authorization is requested, we will provide you with a form that describes your rights, and the use and/or disclosure to the requested authorization.

CONCLUSION

A.C.H.C. has made every effort in this Notice to comply with HIPAA requirements. In this Notice, HIPAA requires us to cover the three important areas as follows:

• How A.C.H.C. will use and disclose your PHI
• Your rights to your PHI.
• A.C.H.C. legal duties to protect the confidentiality of your PHI.

If you have any questions regarding your PHI and privacy rights, our privacy practices under HIPAA laws, please contact our Privacy Officer Cindy Plitnick at A.C.H.C. at (570) 459-3002.

You have a right to file a complaint about our privacy practices or if you believe that we have violated your rights as described above and to not fear retaliation or adverse action against you for exersizing your right.

You can file the complaint with A.C.H.C. directly, or with the United States Department of Health and Human Services, (HHS), 200 Independance Avenue, S.W. Room 509 HHH Building, Washington, D.C., 20201.All complaints must be submitted in writing.

HIPAA requires that we give you this (Notice of Privacy Practices) and obtain your written Acknowledgment that you received this Notice. Again, any questions regarding this Notice or Privacy Practices please contact the Privacy Officer at A.C.H.C.