NOTICE OF PRIVACY PRACTICES
REGARDING USE AND DISCLOSURE OF TREATMENT INFORMATION
1. PURPOSE OF THIS NOTICE
Your Protected Health Information (PHI) or treatment information includes but is not limited to the following:
Other personal identifying information;
Record of current, past or planned future treatment.
2. CONSENT AND AUTHORIZATION
COMHAR must obtain your written Consent prior to initiating treatment, payment or health care operations on your behalf. You will be required to read and give your Consent in writing before any treatment services are begun. This Consent will remain in effect until completion of your treatment services with COMHAR. However, you have the right to revoke your Consent, in writing, at any time during the course of your treatment services except to the extent that COMHAR has taken action in reliance on the Consent.
A written Authorization is required for the use and disclosure of all or part of your treatment information requested by a third party for purposes other than general treatment, payment and health care operations. For example, Progress Notes shall not be released without your specific Authorization, except when required by law. Only that information that is minimum and necessary to accomplish the purpose for which the
Progress Notes are being requested will be released. The Authorization will identify the specific information being requested, the purpose for which the requested information is to be used, and the party to whom the information will be released. The Authorization will be time restricted and contain a prohibition against the use of the information for any other purpose other that the purpose stated on the Authorization and against a re-release of the information for any purpose.
Please note that COMHAR cannot absolutely guarantee that once your treatment information has been released to the third party named in an Authorization, that the third party will abide by the rules stated in COMHAR’s Privacy Notice.
3. USE AND DISCLOSURE OF MEDICAL INFORMATION FOR TREATMENT, PAYMENT, HEALTH CARE OPERATIONS AND OTHERS INVOLVED IN YOUR HEALTHCARE
Laws governing treatment programs and procedures conducted by COMHAR allow COMHAR to use and disclose your personal information for the purpose of treatment, payment and health care operations once your written consent has been obtained by COMHAR.
Treatment means the provision, coordination or management of health care related and therapeutic services provided completely or in part by COMHAR.
Relevant portions or summaries of your protected health information may be used and disclosed to those actively engaged in treating you or to persons at other licensed facilities when you are referred to that facility and a summary or portion of the record is necessary to provide for continuity of proper care and treatment. Please note that relevant laws prohibit certain treatment information from being shared without your knowledge. COMHAR must obtain a written authorization, Authorization for Release Information, from you before all or any part of your treatment information can be used or released to parties outside COMHAR. Your signature on the Authorization to Release Information form will provide the necessary consent for the use or release of this information. Also, COMHAR may contact you by phone or other means to remind you about an appointment or to address a specific aspect of your care.
Within COMHAR, information regarding your treatment may be shared and disclosed to clinical staff responsible for your treatment. This may include, but is not limited to, psychiatrists, social workers, mental health professionals, mental health workers or other COMHAR personnel who are helping to care for you or are participating in your treatment. Outside of COMHAR, individuals such as intensive case managers or state and county officials may also be the recipients of information related to your treatment. When you begin treatment services at COMHAR, you are asked to sign a Consent for Treatment form that allows us to share treatment information with these individuals.
Your protected health information or treatment information will be used to obtain approval for and payment of your mental, behavioral and other health care services. This may include certain activities that your health insurance plan or government agency may undertake before it approves or pays for these services. For example, obtaining approval for your behavioral health care services requires that your relevant protected health care information may be disclosed to state or county officials in order to obtain prior approval for services. Making a determination for insurance eligibility or reviewing services to determine medical necessity or the appropriateness of specific services may also be cause to disclose health care information about you.
c. HEALTH CARE OPERATIONS
Health Care Operations cover a range of internal operations performed by COMHAR or its Business Associates to manage information, data, and services on behalf of COMHAR and its clients. These operations include but are not limited to, quality assessment and improvement activities, peer review, credentialing, licensing, training programs, legal and financial services, business planning and development, implementing and monitoring COMHAR’s Compliance Program and Privacy Practices, internal grievances, creating information for data aggregation and other purposes such as quality assurance, marketing, fund raising and due diligence activities. Examples of such operations are the evaluation of the performance of therapists to ensure that they meet COMHAR’s quality standards or engaging legal counsel to represent COMHAR’s interests when required.
d. OTHERS INVOLVED IN YOUR HEALTH CARE
With your written consent, we may disclose to a member of your family, a relative or a close friend or any other person you identify, your protected health information or treatment information that directly relates to that person’s involvement in your health care.
We may use or disclose your protected health information to notify or assist in notifying a family member, personal representative or any other person that is responsible for your care, general condition or death. Finally, we may use or disclose your protected health information to an authorized public or private entity to assist in disaster relief efforts and to coordinate uses and disclosures to family or other individuals involved in your health care.
4. THE USE AND DISCLOSURE OF TREATMENT INFORMATION WHEN YOUR CONSENT OR AUTHORIZATION ARE NOT REQUIRED
Under the following circumstances, COMHAR is permitted by law to use or disclose your treatment information without further Consent or Authorization:
To those caregivers actively engaged in your treatment at COMHAR or to providers who are actively coordinating with COMHAR in your care or treatment plan
To insurers and those third party payers or co-payers whom you have identified to COMHAR as being responsible for payment for your treatment services and who require information to verify that services were actually provided. Information to be released hereunder is limited to the staff names, the dates, types and costs of therapies or services, and a short description of the general purpose of each treatment session or service;
To reviewers and inspectors, including accrediting agencies, the Commonwealth licensure or certification, when necessary to obtain certification as an eligible provider of service;
To those participating in Utilization Reviews and internal audits;
To the administrator(s) under required duties pursuant to applicable statutes and regulations;
To a court or Mental Health Review Officer in the course of legal proceedings authorized by statute or regulations;
In response to a Court Order when the Production of Documents is properly ordered by law;
To appropriate regulatory agencies responsible for addressing client or child abuse;
In response to an emergency medical situation when release of information is necessary to prevent serious risk of bodily harm or death (only that specific information minimum and necessary to the relief of the emergency may be released on a non-consensual basis);
To parents, guardians or other verified personal representatives when necessary to obtain consent to medical treatment; and
Attorneys assigned to represent the subject of a commitment hearing.
Treatment information made available shall be limited to that information which is minimum and necessary to the purpose for which the information is sought.
Treatment information may not be released to additional parties or entities or used for additional purposes without your consent.
5. YOUR RIGHTS REGARDING YOUR PROTECTED HEALTH INFORMATION
a. RIGHT TO REQUEST RESTRICTIONS
You may request restrictions on the use and disclosure of your treatment information for treatment, payment, and operational purposes. COMHAR will honor and be bound by all reasonable and appropriate requests for such restrictions that it agrees with in writing, except in emergency circumstances. COMHAR reserves the right to request the withdrawal of certain restrictions at any time during treatment. However, COMHAR is not bound to accept your requested restrictions if the treatment team does not believe that it can or should comply with the requested restrictions. COMHAR reserves the right to exercise discretion and give a written refusal in response to your request for restrictions.
Please address any written requests for restrictions to COMHAR Privacy Officer at 100 West Lehigh Avenue, Philadelphia, PA 19133.
b. RIGHT TO REQUEST CONFIDENTIAL COMMUNICATION
You have the right to receive confidential communications from us regarding how COMHAR communicates information regarding your treatment, health care services, and payment for services. For example, you may request that all communication be directed to your home and not to your place of work. COMHAR will do its best to reasonable accommodate such requests. These requests must be made in writing and addressed to COMHAR’s Privacy Officer at 100 West Lehigh Avenue, Philadelphia, PA 19133.
c. RIGHT TO ACCESS RECORDS
A client of appropriate age and legal capacity, who understands the nature of treatment information and the purpose for which treatment information may be used or disclosed, shall control access to his or her personal treatment information. Access refers to the physical examination of treatment information but does not include physical possession of this information. A person who has received or is receiving treatment may request access to treatment information including records, but shall be denied such access to all or part of the treatment information if:
1. It is determined by COMHAR’s Medical Director that granting such access will constitute a substantial detriment to the treatment process; and/or when disclosure of specific treatment information will reveal the identity of persons, or breach the trust or confidentiality of persons who have provided information upon an agreement to maintain their confidentiality.
2. The limitations on access to treatment information are applicable to parents, guardians, and others who may otherwise have the right to control access over treatment records, except that the possibility of substantial detriment to the parent, guardian, or other person may also be considered.
3. COMHAR’s Medical Director retains discretion in receiving and reviewing the treatment information requested in writing in advance of granting access to the treatment information, and may be present or designate an appropriate party to be present when the treatment information is being reviewed.
d. RIGHT TO AMEND
If you believe that we have protected health information about you in a designated record that is incorrect or misleading, you may prepare a statement for inclusion as part of your record. Your statement shall accompany all released records.
Amendments to your documented treatment information may also be requested in writing. Amendments agreed to by COMHAR shall be documented with sixty (60) days of your written request. However, COMHAR reserves the right to deny requests for amendments when the treatment team finds that: (1) the existing documented treatment information is accurate; (2) COMHAR is not the author of the treatment information requested to be amended; or (3) the request to amend changes or alters the accuracy of the treatment information. You may appeal any denial of your request for amendments within thirty (30) days of receipt of COMHAR’s denial of your requested amendment. All appeals must be made in writing.
Please direct any requests for amendments and appeals to COMHAR’s Privacy Officer at 100 West Lehigh Avenue, Philadelphia, PA 19133.
e. RIGHT TO RECEIVE AN ACCOUNTING OF DISCLOSURES
An accounting of any and all disclosures made of your treatment information for the six (6) years prior to the date of your request shall be made available to you within sixty (60) days of your written request. These disclosures do not include those made for certain treatment payment, or operational purposes. The right to an accounting is subject to the effective date of regulatory laws and statutes.
Please direct requests for accountings to COMHAR’s Privacy Officer at 100 West Lehigh Ave., Philadelphia, PA 19133.
If you believe COMHAR has violated your privacy rights by inappropriate use or disclosure of your treatment information by COMHAR employees or agents, you may direct the complaint to COMHAR’s Privacy Officer at 100 West Lehigh Ave., Philadelphia PA. 19133, or to the Secretary of the federal Department of Health and Human Services. Under no circumstances shall COMHAR retaliate against you for filing a complaint.
7. COMHAR has the un-delegable duty to maintain the privacy of your documented treatment information and to provide you with Notice of its legal obligations and Privacy Practices with respect to your treatment information. COMHAR must date and comply with the Privacy Notice currently in effect. COMHAR reserves the right to amend and/or update its Privacy Notice from time to time upon change of practices or revision of laws.
If its Privacy Notice is revised, copies of the revised and dated Privacy Notice shall be posted in the COMHAR service areas or be made available through COMHAR’s Privacy Officer at 100 West Lehigh Ave., Philadelphia, PA 19133.
COMHAR reserves the right to implement the changes prior to issuing the revised Privacy Notice.
November 6, 2019