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The Health Insurance Portability and
Accountability Act of 1996 (HIPAA) requires Criterion, Inc. provide all
patients with a Notice of Privacy. Please contact our HIPAA Compliance
Manager (800) 743-0093
if you have any questions about this notice.
Please read the following material carefully.
PATIENT PROTECTIONS
The new privacy regulations ensure a national floor of privacy
protections for patients by limiting the ways that health plans,
pharmacies, hospitals and other covered entities can use patients'
personal medical information. The regulations protect medical records and
other individually identifiable health information, whether it is on
paper, in computers or communicated orally. Key provisions of these new
standards include:
- Access To Medical Records. Patients generally should
be able to see and obtain copies of their medical records and request
corrections if they identify errors and mistakes. Health plans, doctors,
hospitals, clinics, nursing homes and other covered entities generally
should provide access these records within 30 days and may charge patients
for the cost of copying and sending the records.
- Notice of Privacy Practices. Covered health plans,
doctors and other health care providers must provide a notice to their
patients how they may use personal medical information and their rights
under the new privacy regulation. Doctors, hospitals and other direct-care
providers generally will provide the notice on the patient's first visit
following the April 14, 2003, compliance date and upon request. Patients
generally will be asked to sign, initial or otherwise acknowledge that
they received this notice. Health plans generally must mail the notice to
their enrollees by April 14 and again if the notice changes significantly.
Patients also may ask covered entities to restrict the use or disclosure
of their information beyond the practices included in the notice, but the
covered entities would not have to agree to the changes.
- Limits on Use of Personal Medical Information. The
privacy rule sets limits on how health plans and covered providers may use
individually identifiable health information. To promote the best quality
care for patients, the rule does not restrict the ability of doctors,
nurses and other providers to share information needed to treat their
patients. In other situations, though, personal health information
generally may not be used for purposes not related to health care, and
covered entities may use or share only the minimum amount of protected
information needed for a particular purpose. In addition, patients would
have to sign a specific authorization before a covered entity could
release their medical information to a life insurer, a bank, a marketing
firm or another outside business for purposes not related to their health
care.
- Prohibition on Marketing. The final privacy rule sets
new restrictions and limits on the use of patient information for
marketing purposes. Pharmacies, health plans and other covered entities
must first obtain an individual's specific authorization before disclosing
their patient information for marketing. At the same time, the rule
permits doctors and other covered entities to communicate freely with
patients about treatment options and other health-related information,
including disease-management programs.
- Stronger State Laws. The new federal privacy
standards do not affect state laws that provide additional privacy
protections for patients. The confidentiality protections are cumulative;
the privacy rule will set a national "floor" of privacy standards that
protect all Americans, and any state law providing additional protections
would continue to apply. When a state law requires a certain disclosure --
such as reporting an infectious disease outbreak to the public health
authorities -- the federal privacy regulations would not preempt the state
law.
- Confidential communications. Under the privacy rule,
patients can request that their doctors, health plans and other covered
entities take reasonable steps to ensure that their communications with
the patient are confidential. For example, a patient could ask a doctor to
call his or her office rather than home, and the doctor's office should
comply with that request if it can be reasonably accommodated.
- Complaints. If you believe your privacy
rights have been violated, you may file a complaint with us or with the
Secretary of the Department of Health and Human Services. To file a
complaint with us, contact our HIPAA Compliance Manager, (800) 743-0093. All complaints must be
submitted in writing:
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HIPPA Compliance Manager, 5190 Neil Road, Suite
430, Reno, NV 89502 |
| HEALTH
PLANS AND PROVIDERS The privacy rule requires health plans,
pharmacies, doctors and other covered entities to establish policies and
procedures to protect the confidentiality of protected health information
about their patients. These requirements are flexible and scalable to
allow different covered entities to implement them as appropriate for
their businesses or practices. Covered entities must provide all the
protections for patients cited above, such as providing a notice of their
privacy practices and limiting the use and disclosure of information as
required under the rule. In addition, covered entities must take some
additional steps to protect patient privacy:
- Written Privacy Procedures. The rule requires
covered entities to have written privacy procedures, including a
description of staff that has access to protected information, how it
will be used and when it may be disclosed. Covered entities generally
must take steps to ensure that any business associates who have access
to protected information agree to the same limitations on the use and
disclosure of that information.
- Employee Training and Privacy Officer. Covered
entities must train their employees in their privacy procedures and must
designate an individual to be responsible for ensuring the procedures
are followed. If covered entities learn an employee failed to follow
these procedures, they must take appropriate disciplinary action.
- Public Responsibilities. In limited circumstances,
the final rule permits -- but does not require --covered entities to
continue certain existing disclosures of health information for specific
public responsibilities. These permitted disclosures include: emergency
circumstances; identification of the body of a deceased person, or the
cause of death; public health needs; research that involves limited data
or has been independently approved by an Institutional Review Board or
privacy board; oversight of the health care system; judicial and
administrative proceedings; limited law enforcement activities; and
activities related to national defense and security. The privacy rule
generally establishes new safeguards and limits on these disclosures.
Where no other law requires disclosures in these situations, covered
entities may continue to use their professional judgment to decide
whether to make such disclosures based on their own policies and ethical
principles.
- Equivalent Requirements For Government. The
provisions of the final rule generally apply equally to private sector
and public sector covered entities. For example, private hospitals and
government-run hospitals covered by the rule have to comply with the
full range of requirements.
OUTREACH AND ENFORCEMENT
HHS' Office for Civil Rights (OCR) oversees and enforces the new
federal privacy regulations. Led by OCR, HHS has issued extensive guidance
and technical assistance materials to make it as easy as possible for
covered entities to comply with the new requirements. Key elements of
OCR's outreach and enforcement efforts include:
- Guidance and technical assistance materials. HHS
has issued extensive guidance and technical materials to explain the
privacy rule, including an extensive, searchable collection of
frequently asked questions that address major aspects of the rule. HHS
will continue to expand and update these materials to further assist
covered entities in complying. These materials are available at
http://www.hhs.gov/ocr/hipaa/assist.html.
- Conferences and seminars. HHS has participated in
hundreds of conferences, trade association meetings and conference calls
to explain and clarify the provisions of the privacy regulation. These
included a series of regional conferences sponsored by HHS, as well as
many held by professional associations and trade groups. HHS will
continue these outreach efforts to encourage compliance with the privacy
requirements.
- Information line. To help covered entities find out
information about the privacy regulation and other administrative
simplification provisions of the Health Insurance Portability and
Accountability Act of 1996, OCR and HHS' Centers for Medicare & Medicaid
Services have established a toll-free information line. The number is
(866) 627-7748.
- Complaint investigations. Enforcement will be
primarily complaint-driven. OCR will investigate complaints and work to
make sure that consumers receive the privacy rights and protections
required under the new regulations. When appropriate, OCR can impose
civil monetary penalties for violations of the privacy rule provisions.
Potential criminal violations of the law would be referred to the U.S.
Department of Justice for further investigation and appropriate action.
- Civil and Criminal Penalties. Congress provided
civil and criminal penalties for covered entities that misuse personal
health information. For civil violations of the standards, OCR may
impose monetary penalties up to $100 per violation, up to $25,000 per
year, for each requirement or prohibition violated. Criminal penalties
apply for certain actions such as knowingly obtaining protected health
information in violation of the law. Criminal penalties can range up to
$50,000 and one year in prison for certain offenses; up to $100,000 and
up to five years in prison if the offenses are committed under "false
pretenses"; and up to $250,000 and up to 10 years in prison if the
offenses are committed with the intent to sell, transfer or use
protected health information for commercial advantage, personal gain or
malicious harm.
*Reference:
United States Department of Health and Human Services.
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