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.

MedCare Susquehanna Valley is dedicated to maintaining the privacy of your identifiable health information. In conducting our business, we will create records regarding you and the treatment and services we provide to you. We are required by law to maintain the confidentiality of health information that identifies you. We also are required by law to provide you with this notice of our legal duties and privacy practices concerning your identifiable health information. By law, we must follow the terms of the notice of privacy practices that we have in effect at the time. 

To summarize, this notice provides you with the following important information:

• How we may use and disclose your identifiable health
  information
• Your privacy rights in your identifiable health information
• Our obligations concerning the use and disclosure of your
  identifiable health information.

WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION IN THE FOLLOWING WAYS
 

The following categories describe the different ways in which 
we may use and disclose your identifiable health information:

1. Treatment. MedCare may use your identifiable health information to treat you. For example, we may perform a follow-up interview and we may use the results to help us modify your treatment plan. Many of the people who work for MedCare may use or disclose your identifiable health information in order to treat you or to assist others in your treatment. Additionally, we may disclose your identifiable health information to others who may assist in your care, such as your physician, therapists, spouse, children, or parents.

2. Payment. MedCare may use and disclose your identifiable health information in order to bill and collect payment for the services and items you may receive from
us. For example, we may contact your health insurer to certify that you are eligible for benefits (and for what  range of benefits), and we may provide your insurer with 
details regarding your treatment to determine if your insurer will cover, or pay for, your treatment. We also may use and disclose your identifiable health information 
to obtain payment from third parties who may be responsible for such costs, such as family members. Also, we may use your identifiable health information to bill you 
directly for services and items.

3. Health Care Operations. Examples: We may review health information in an effort to maintain or improve quality, comply with health care regulations and/or
insurance provisions, review or approve doctor privileges, coordinate your continued care needs, or seek legal representation regarding potential claims.

4. Appointment Reminders. MedCare may use and disclose your identifiable health information to contact you and remind you of visits/deliveries. MedCare may leave a
message on your answering machine or voicemail, if necessary.

5. Health-Related Benefits and Services. MedCare may use and disclose your identifiable health information to inform you of health-related benefits or services that may be of interest to you.

6. Fundraising. We may contact you for our fundraising activities. You have a right to opt out of receiving fundraising communications.

7. Release of Information to Family/Friends. MedCare may release your identifiable health information to a friend or family member with your documented consent.

8. Disclosures Required By Law. MedCare will use and disclose your identifiable health information when we are required to do so by federal, state, or local law.

USE AND DISCLOSURE OF YOUR IDENTIFIABLE HEALTH INFORMATION IN CERTAIN CIRCUMSTANCES

The following categories describe certain circumstances in which we may use or disclose your identifiable health information:

1. Public Health Risks. MedCare may disclose your identifiable health information to public health authorities who are authorized by law to collect information for the
purpose of :

• Maintaining vital records, such as births and deaths
• Reporting child abuse or neglect
• Preventing or controlling disease, injury, or disability
• Notifying a person regarding potential exposure to a communicable disease
• Notifying a person regarding a potential risk for spreading or contracting a disease or condition
• Reporting reactions to drugs or problems with products or devices
• Notifying individuals if a product or device they may be using has been recalled
• Notifying appropriate government agency(ies) and authority(ies) regarding the potential abuse or neglect of an adult patient (including domestic violence);
  however, we will only disclose this information if the patient agrees or we are required or authorized by law to disclose this information
• Notifying your employer under limited circumstances related primarily to workplace injury or illness or medical surveillance.

2. Health Oversight Activities. MedCare may disclose your identifiable health information to a health oversight agency for activities authorized by law. Oversight activities can include, for example, investigations, inspections, audits, surveys, licensure, and disciplinary actions; civil, administrative, and criminal procedures or actions; or other activities necessary for the government to monitor government programs, compliance with civil rights laws, and the health care system in general.

3. Lawsuits and Similar Proceedings. MedCare may use and disclose your identifiable health information in response to a court or administrative order if you are involved in a lawsuit or similar proceeding. We also may disclose your identifiable health information in response to a discovery request, subpoena, or other lawful process by another party involved in the dispute, but only if we have made an effort to inform you of the request or to obtain an order protecting the information the party has requested.

4. Law Enforcement. We may release identifiable health
information if asked to do so by a law enforcement
official:

• Regarding a crime victim in certain situations, if we are unable to obtain the person’s agreement
• Concerning a death we believe might have resulted from criminal conduct
• Regarding criminal conduct at our offices
• In response to a warrant, summons, court order, subpoena, or similar legal process
• To identify/locate a suspect, material witness, fugitive, or missing person
• In an emergency, to report a crime (including the location or victim(s) of the crime, or the description, identity or location of the perpetrator)

5. Serious Threats to Health or Safety. MedCare may use and disclose your identifiable health information when necessary to reduce or prevent a serious threat to your health and safety or the health and safety of another individual or the public. Under these circumstances, we will only make disclosures to a person or organization able to help prevent the threat.

6. Military. MedCare may disclose your identifiable health information if you are a member of U.S. or foreign military forces (including veterans) and if required by the appropriate military command authorities.

7. National Security. MedCare may disclose your identifiable health information to federal officials for intelligence and national security activities authorized by law. We also may disclose your identifiable health information to federal officials in order to protect the President, other officials or foreign heads of state, or to conduct investigations. 

8. Inmates. MedCare may disclose your identifiable health information to correctional institutions or law enforcement officials if you are an inmate or under the custody of a law enforcement official. Disclosure for these purposes would be necessary: (a) for the institution to provide health care services to you; (b) for the safety and security of the institution; and/or (c) to protect your health and safety or the health and safety of other individuals.

9. Workers’ Compensation. MedCare may release your identifiable health information for workers’ compensation and similar programs.

YOUR RIGHTS REGARDING YOUR IDENTIFIABLE 
HEALTH INFORMATION

You have the following rights regarding the identifiable health 
information that we maintain about you:

1. Confidential Communications. You have the right to specify other ways or locations you receive confidential communications from MedCare about your health 
information. For instance, you may ask that we contact you at home, rather than work. In order to request a type of confidential communication, you must make a written request to MedCare specifying the requested method of contact or the location where you wish to be contacted. MedCare will accommodate reasonable requests. You do not need to give a reason for your request. 

2. Requesting Restrictions. You have the right to request a restriction in our use or disclosure of your identifiable health information for the treatment, payment, or health care operations. We are not required to agree to your request; however, if we do agree, we are bound by our agreement except when otherwise required by law, in emergencies, or when the information is necessary to treat you. In order to request a restriction in our use of disclosure of your identifiable health information, you must make your request in writing to MedCare. Your request must describe in a clear and concise fashion: (a) the information you wish restricted; (b) whether you are requesting to limit our practice’s use, disclosure, or both; and (c) to whom you want the limits to apply.

3. Requesting Privacy About the Items and Services for 
Which You Paid in Full. You have the right to request that we restrict certain disclosures to a health plan for items and services for which you paid out of pocket and in full.

4. Inspection and Copies. You have the right to inspect and obtain a copy of the identifiable health information that may be used to make decisions about you, including patient medical records and billing records, but not including psychotherapy notes. You must submit your request in writing to MedCare in order to inspect and/or obtain a copy of your identifiable health information. MedCare may charge a fee for the costs of copying, mailing, labor, and supplies associated with your request. Our practice may deny your request to inspect and/or copy in certain limited circumstances; however, you may request a review of our denial. Reviews will be conducted by another licensed health care professional chosen by us. 

5. Amendment. You may ask us to amend your health information if you believe it is incorrect or incomplete, and you may request an amendment for as long as the information is kept by or for MedCare. To request an amendment, your request must be made in writing and submitted to MedCare. You must provide us with a reason that supports your request for amendment. MedCare will deny your request if you fail to submit your request (and the reason supporting your request) in writing. Also, we may deny your request if you ask us to amend information that is: (a) accurate and complete; (b) not part of the identifiable health information kept by or for the organization; (c) not part of the identifiable health information which you would be permitted to inspect and copy; or (d) not created by MedCare, unless the individual or entity that created the information is not available to amend the information. 

6. Accounting of Disclosures. All of our patients have the right to requests an “accounting of disclosures.” An “accounting of disclosures” is a list of certain disclosures MedCare has made of your identifiable health information. In order to obtain an accounting of disclosures, you must submit your request in writing to MedCare. All requests for an “accounting of disclosures” must state a time period 
which may not be longer than six years. The first list you request within a 12-month period is free of charge, but our practice may charge you for additional lists within the same 12-month period. MedCare will notify you of the costs involved with additional requests, and you may withdraw your request before you incur any costs.

7. Receiving Notice that Your Health Information was Breached. If your health information was accessed, used or disclosed due to a breach of unsecured protected health information, we will notify you promptly of the occurrence and provide you with details regarding the information that was breached.

8. Right to a Paper Copy of This Notice. You are entitled to receive a paper copy of our notice of privacy practices. You may ask us to give you a copy of this notice at any time. To obtain a paper copy of this notice, contact MedCare.

9. Right to File a Complaint. You will not be retaliated against for filing a complaint. If you wish to file a complaint with: 

1. MedCare Susquehanna Valley: 1-833-297-2905 or in writing to Compliance Officer, 381 Independence Avenue, Suite 106, Mechanicsburg, PA 17055.
2. The Compliance Team: 888-291-5353
3. Department of HHS: 1-877-696-6775

10. Right to Provide an Authorization for Other Uses and 
Disclosures. MedCare will obtain your written authorization for uses and disclosures including for marketing purposes, or the sale of your protected health information or otherwise not identified by this notice or permitted by applicable law. Any authorization you provide to us regarding the use and disclosure of your identifiable health information may be revoked at any time in writing. After you revoke your authorization, we will no longer use or disclose your identifiable health information for the reasons described in the authorization. Please note that we are required to retain records of your care.

The terms of this notice apply to all records containing your identifiable health information that are created or retained by MedCare. We reserve the right to revise or amend our notice of privacy practices. Any revision or amendment to this notice will be effective for all of your records our practice has created or maintained in the past, and for any of your records we may create or maintain in the future. MedCare will post a copy of our current notice in our offices in a prominent location, on our website, and you may request a copy of our most current notice to be mailed to you by contacting Customer Service at 1-833-297-2905.

If you have any questions about this notice, please contact MedCare Susquehanna Valley at 1-833-297-2905 or in writing to: 381 Independence Avenue, Suite 106, Mechanicsburg, PA 17055.

NPP Effective 9-20-2017

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