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.
USE AND DISCLOSURE OF HEALTH INFORMATION
The Arkansas Association of Area Agencies on Aging (5A) may use and disclose your health information, information that constitutes protected health information (PHI) as defined in the Privacy Rule of the Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996, for purposes of providing you services, obtaining payment for you care and conducting health care operations. 5A has established policies to guard against unnecessary disclosure of your health information.
THE FOLLOWING IS A SUMMARY OF THE CIRCUMSTANCES UNDER WHICH AND PURPOSES FOR WHICH YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED:
To Provide Services. 5A may use and disclose your health information to coordinate care within 5A and with others involved in your care, such as your attending physician and other health care professionals who have agreed to assist 5A in coordinating care. For example, physicians involved in your care will need information about your symptoms in order to prescribe appropriate medications. 5A also may disclose your health care information to individuals outside of 5A involved in your care including family members, pharmacists, suppliers of medical equipment or other health care professionals.
To Obtain Payment. 5A may include your health information in invoices to collect payment from third parties for the care you receive from 5A. For example, 5A may be required to provide information to a payer regarding your health care status in order to receive payment.
To Conduct Health Care Operations. 5A may use and disclose health information for its own operations in order to facilitate the function of 5A and as necessary to provide quality care to all of 5A clients. For example, 5A may use your health information to evaluate its staff performance, combine your health information with other 5A clients in evaluating how to more effectively serve all 5A clients, or disclose your health information to 5A staff and contracted personnel for training purposes.
For Fundraising Activities. 5A may use information about you including your name, address, phone number and the dates you received care in order to contact you to raise money for 5A. 5A may also release this information to a related 5A foundation. If you do not want 5A to contact you, notify the 5A Privacy Official at (866) 292-7165 and indicate that you do not wish to be contacted.
For Appointment Reminders and Service Alternatives. 5A may use and disclose your health information to contact you as a reminder that you have an appointment for a home visit, or tell you about or recommend possible treatment options or alternatives that may be of interest to you.
THE FOLLOWING IS A SUMMARY OF ADDITIONAL CIRCUMSTANCES UNDER WHICH YOUR HEALTH INFORMATION MAY ALSO BE USED AND DISCLOSED:
- When there are risks to public health
- To report abuse, neglect or domestic violence
- To conduct health oversight activities
- In connection with judicial and administrative proceedings
- For law enforcement purposes
- To coroners, medical examiners and funeral directors about decedents
- For organ, eye or tissue donation
- For research purposes after an approval process
- To avert a serious threat to health or safety
- For specified government functions
- For worker’s compensation purposes
- To release immunization records to schools
- When legally required
AUTHORIZATION TO OTHER USES OR DISCLOSURES OF HEALTH INFORMATION
Other than stated above, 5A will not disclose your health information without your written authorization. Written authorization is required for purposes of marketing, underwriting, and in the event that 5A were to ever sell health information. If you or your representative authorizes 5A to use or disclose your health information, you may revoke that authorization in writing at any time, unless 5A has taken action in reliance thereon.
DUTIES OF 5A
5A is required by law to maintain the privacy of your health information and to provide to you or your representative this Notice of its duties and privacy practices. 5A is required to abide by the terms of this Notice as may be amended from time to time. 5A reserves the right to change the terms of its Notice and to make the new Notice provisions effective for all health information that it maintains. If 5A changes its Notice, 5A will post a copy of the Notice at its offices and on its website.
YOUR RIGHTS WITH RESPECT TO YOUR HEALTH INFORMATION
You or your representative have the following rights regarding your health information that 5A maintains:
To request restrictions. You may request restrictions on certain uses and disclosures of your health information. You also have the right to request a limit on 5A’s disclosure of your health information to someone who is involved in your care or the payment of your care. However, 5A is not required to agree to your request. If you pay for an item or service out of pocket, you have the right to request that PHI pertaining to that item or service not be disclosed to your health plan. 5A must abide by this request.
To receive alternative communications. You have the right to request that your protected health information be provided by alternative means or at alternative locations.
To inspect and copy your health information. You have the right to inspect and copy your health information, including billing records. If you request a copy of your health information, 5A may charge a reasonable fee for copying and assembling costs associated with your request.
To request amendment of your health care information. You have the right to request that 5A amend your records, if you believe that your health information maintained by 5A is incorrect or incomplete. 5A may deny the request if it does not include a reason for the amendment. The request also may be denied if your health information records were not created by 5A, if the records you are requesting are not part of 5A’s records, if the health information you wish to amend is not part of the health information you are permitted to inspect and copy, or if, in the opinion of 5A, the records containing your health information are accurate and complete.
To accounting. You have the right to request an accounting of disclosures of your health information made by 5A for certain reasons, including reasons related to public purposes authorized by law and certain research. 5A will provide the first accounting you request during any 12-month period without charge. Subsequent accounting requests may be subject to a reasonable cost-based fee.
For a paper copy of this notice. You have a right to a separate paper copy of this notice at any time even if you have received this Notice previously. You may also obtain a copy of the current version of 5A’s Notice of Privacy Practices at its website, www.agingarkansas.org.
To express complaints. You have the right to express complaints to 5A and to the Secretary of Department of Health and Human Services if you or your representative believe that your privacy rights have been violated. You will not be retaliated against in any way for filing a complaint.
To be notified of a breach of PHI. You have the right to be notified in the event of a breach of your unsecured PHI.
5A has designated the 5A Privacy Official as its contact person for all issues regarding client privacy and your rights under the Federal privacy standards. To exercise any of the rights listed above, you may contact this person at (866) 292-7165 or 600 E. Capitol #2815, Little Rock, Arkansas, 72203. Requests to receive alternative communications, to inspect and copy, to amend and to an accounting, as well as any complaints must be in writing.
This Notice is effective August 21, 2020.
IF YOU HAVE ANY QUESTIONS REGARDING THIS NOTICE, PLEASE CONTACT THE 5A PRIVACY OFFICIAL, Arkansas Association of Area Agencies on Aging, 600 E. CAPITOL #2815, LITTLE ROCK, AR 72203, (866) 292-7165.