NOTICE OF PRIVACY PRACTICES THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED BY CPGA AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. This notice is effective September 1, 2011. It is provided to you under the Health Insurance Portability and Accountability Act of 1996 and related federal regulations (HIPAA).
If you have questions about this Notice please contact CarePartners of Georgia Privacy Officer, Kathy Durden, at the address below.
CarePartners of Georgia
243 West Main Street PO Box 1094 Swainsboro, GA 30401
office: (478) 237-2484 | fax: (478) 237-7541
CarePartners of Georgia (CPGA) is an agency of the State of Georgia responsible for certain programs which deal with medical and other confidential information. Both federal and state laws establish strict requirements regarding the disclosure of confidential information, and CPGA must comply with those laws. For situations where stricter disclosure requirements do not apply, this Notice of Privacy Practices describes how CPGA may use and disclose your “protected health information” for treatment, payment, health care operations, and for certain other purposes. This notice also describes your rights regarding your protected health information. Protected health information is information that may personally identify you and relates to your past, present or future physical or mental health or condition and related health care services. CPGA is required to provide you this Notice of Privacy Practices, and to abide by its terms, and may change the terms of this notice at any time. A new notice will be effective for all protected health information that CPGA maintains at the time of issuance. CPGA will provide you with any revised Notice of Privacy Practices by posting copies at its facilities, publication on CPGA''s website, in response to a telephone or facsimile request to the Privacy Officer, or in person at any facility where you receive services from CPGA.
1. Uses and Disclosures of Protected Health Information: Your protected health information may be used and disclosed by CPGA, its administrative and clinical staff and others involved in your care and treatment for the purpose of providing health care services to you, and to assist in obtaining payment of your health care bills. a. Treatment: Your protected health information may be used to provide, coordinate, or manage your health care and any related services, including coordination of your health care with a third party that has your permission to have access to your protected health information, such as, for example, a health care professional who may be treating you, or to another health care provider such as a specialist or laboratory. b. Payment: Your protected health information may be used to obtain payment for your health care services. For example, this may include activities that a health insurance plan requires before it approves or pays for health care services such as: making a determination of eligibility or coverage, reviewing services provided to you for medical necessity, and undertaking utilization review activities. c. Health Care Operations: CPGA may use or disclose your protected health information to support the business activities of CPGA, including, for example, but not limited to, quality assessment activities, employee review activities, training, licensing, and other business activities. Your protected health information may be used to contact you about appointments or for other operational reasons. Your protected health information may be shared with third party “business associates” who perform various activities that assist us in the provision of your services.
2. Other Permitted or Required Uses and Disclosures with Your Authorization or Opportunity to Object: a. Confidentiality of Alcohol and Drug Abuse Patient Records: The confidentiality of patient records which disclose any information identifying you as an alcohol or drug abuser is protected by federal law and regulations. This information generally will not be disclosed unless you consent in writing, the disclosure is allowed by a court order, or the disclosure is made to medical personnel in a medical emergency or to qualified personnel for research, audit, or program evaluation. Violation of these federal laws and regulations by the facility, treatment or service provider, or CPGA, is a crime. You may report violations to appropriate authorities in accordance with the federal regulations. Federal regulations do not protect any information about a crime committed by you either at a facility or program or against any person who works at a facility or program or about any threat to commit such a crime. Federal regulations do not protect any information about suspected child abuse or neglect from being reported under State law to appropriate State or local authorities. Other uses and disclosures of your protected health information will be made only with your written authorization, which you may revoke at any time to the extent that CPGA has not acted upon your authorization, except as permitted or required by law as described below. CPGA may use and disclose your protected health information when you authorize in writing such use or disclosure of all or part of your protected health information. If you are hospitalized, CPGA may use and disclose certain protected health information to your representative, as that term is defined in the Georgia Mental Health Code, upon your admission or discharge; you may be given a chance to object to certain other disclosures to your representative. b. AIDS confidential information: AIDS confidential information, including HIV status or testing information, confidential under state law. Generally, CPGA will not disclose AIDS confidential information without your authorization. CPGA may disclose this information in certain circumstances to protect persons at risk of infection by you, including your family and health care providers. CPGA may disclose AIDS confidential information in certain circumstances as part of your mental health commitment or by other legal procedures.
3. Permitted or Required Uses and Disclosures without Your Authorization or Opportunity to Object: CPGA may use or disclose your protected health information without your authorization for continuity of your care or for your treatment in an emergency or when clinically required; when required to do so by law; for public health purposes; to a person who may be at risk of contracting a communicable disease; to a health oversight agency; to an authority authorized to receive reports of abuse or neglect; in certain legal proceedings, such as hearings regarding your hospitalization or commitment or to comply with workers'' compensation laws; and for certain law enforcement purposes. Protected health information may also be disclosed without your authorization to a coroner or medical examiner, and to the legal representativeof your estate.
4. Required Uses and Disclosures: Under the law, CPGA must make certain disclosures to you, and to the Secretary of the United States Department of Health and Human Services when required to investigate or determine CPGA''s compliance with the requirements of HIPAA regulations beginning at 45 CFR Section 164.500.
5. Your Rights: The following is a statement of your rights with respect to your protected health information and a brief description of how you may exercise these rights. a. You have the right to inspect and copy your protected health information: You may inspect and obtain a copy of protected health information about you for as long as CPGA maintains the protected health information. This information includes medical and billing records and other records CPGA uses for making medical and other decisions about you. A reasonable, cost-based fee for copying, postage and labor expense may apply. Under federal law you may not inspect or copy psychotherapy notes; information compiled in anticipation of, or for use in, a civil, criminal, or administrative proceeding, or protected health information that is subject to a federal or state law prohibiting access to such information. While you are hospitalized, your physician may restrict your right to review your records if it would be harmful to your physical or mental health. b. You have the right to request restriction of your protected health information: You may ask CPGA not to use or disclose any part of your protected health information for the purposes of treatment, payment or healthcare operations, and not to disclose protected health information to family members or friends who may be involved in your care. Such a request must state the specific restriction requested and to whom you want the restriction to apply. CPGA is not required to agree to a restriction you request, and if CPGA believes it is in your best interest to permit use and disclosure of your protected health information, your protected health information will not be restricted, except as required by law. If CPGA does agree to the requested restriction, CPGA may not use or disclose your protected health information in violation of that restriction unless it is needed to provide emergency treatment. c. You have the right to request to receive confidential communications from us by alternative means or at an alternative location: Upon written request to a person listed in section 6 below, CPGA will accommodate reasonable requests for alternative means for the communication of confidential information with you, but may condition this accommodation upon your provision of an alternative address or other method of contact. CPGA will not request an explanation from you as to the basis for the request. d. You may have the right to request amendment of your protected health information: If CPGA created your protected health information, you may request an amendment of that information for as long as it is maintained by CPGA. CPGA may deny your request for an amendment, and if it does so will provide information as to any further rights you may have with respect to such denial. Please contact one of the persons listed in section 6 below if you have questions about amending your protected health information. e. You have the right to receive an accounting of certain disclosures CPGA has made of your protected health information: This right applies only to disclosures for purposes other than treatment, payment or healthcare operations, and does not apply to any disclosures CPGA made to you, to family members or friends or representatives, as defined in the Georgia Mental Health Code, who are involved in your care, or for national security, intelligence or notification purposes. You have the right to receive legally specified information regarding disclosures occurring in the six (6) years before your request, subject to certain exceptions, restrictions and limitations. f. You have the right to obtain a paper copy of this notice from CPGA, upon request.
6. Complaints: You may complain to us and to the United States Secretary of Health and Human Services if you believe your privacy rights have been violated. You may file a complaint in writing with CPGA providing your treatment or services, or your treatment provider or services provider under contract or agreement with the CPGA which maintains your protected health information at telephone (478) 237-2484, facsimile (478) 237-7541, or by mail to PO Box 1094, Swainsboro, GA 30401.