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.
Elderhealth is required by law to maintain the privacy of your medical information and to provide you with this notice, which explains our legal duties and privacy practices with respect to your medical information. Elderhealth is committed to protecting the privacy of the medical information you share with us as required by Arizona and federal laws. We must abide by the terms set forth in this Notice of Privacy Practices (Notice).
Uses and Disclosures of Your Protected Health Information
Treatment. We are permitted to use your medical information as necessary to provide you with medical treatment and services. For example, we may disclose information about you to physicians and providers of health, mental health or social and welfare services involved in your care or treatment.
Payment. We are permitted to use and disclose your medical information to get paid for the services you receive from ElderHealth. For example, we may disclose information about the services we have provided to you to your insurance company so that your insurance company will pay us. We also may tell your insurance company about treatment you are going to receive in order to obtain approval or to determine whether your insurance will cover the treatment. We may disclose your health information to other providers who are involved in your care for their payment purposes.
Health Care Operations. We are permitted to use your medical information for our business operations. Business operations include training of personnel, peer review, and quality improvement. For example, we may use your health information to assess the quality of care you received and to ensure that we continue providing the quality of care you and other patients deserve.
Business Associates. Outside people and entities provide some services for us. Examples of these “business associates” include our billing company, consultants, and attorneys. We may disclose your health information to our business associates so that they can perform the job we’ve asked them to do, such as bill for the services we have provided to you. We require our business associates to safeguard your information so that it is protected.
Appointment Reminders, Treatment Alternatives, and Health-related Benefits and Services. We may use and disclose your medical information to contact you to remind you that you have an appointment scheduled, to tell you about or recommend possible treatment options or alternatives that may be of interest to you, or to tell you about a product or service that may be of interest to you.
Family Members and Others Involved in Your Care. ElderHealth may disclose your medical information to your family members or friends who are involved in your care, treatment or supervision. If you do not want ElderHealth to disclose your medical information to family members or other individuals, please notify ElderHealth staff.
Health Oversight Activities. We may disclose your medical information to a health oversight agency or a human rights committee for activities authorized by law. These oversight activities include government audits, investigations, and inspections. We may also provide your medical information to a government agency that oversees licensing of healthcare professionals, such as the Arizona Medical Board or Arizona State Board of Nursing.
Incidental Disclosures. Incidental disclosures of your health information may occur as a byproduct of permitted uses and disclosures of your health information. These incidental disclosures are permitted if we have applied reasonable safeguards to protect the confidentiality of your health information.
Inmates. If you are an inmate of the state prison, we may release medical information about you to the state department of corrections.
Law Enforcement. We may disclose your health information to law enforcement officials as required by law or as directed by court order, warrant, criminal subpoena, or other lawful process and in other limited circumstances for purposes of securing the return of a patient who is on unauthorized absence from any agency where the patient was undergoing evaluation and treatment, to report a crime on ElderHealth’s premises or to avert a serious and imminent threat to an individual or the public.
Military, Veterans, National Security and Other Government Purposes. We may disclose health information about members of the armed forces, as required by military command authorities or to the Department of Veterans Affairs. If requested to do so, we may also provide information to federal officials for intelligence and national security purposes or for presidential protective services.
Legal Proceedings. We may disclose health information about you in response to a court order, grand jury subpoena or in any legal proceeding in which your records are subpoenaed in accordance with the law. In some cases you will receive advance notice about this disclosure so that you will have a chance to object to sharing your medical information.
Public Health Activities. We may disclose your medical information for public health activities as required or authorized by law. For example, such disclosures may include reporting of disease, injury, and vital events such as births and deaths, reporting of child and elder abuse, and reporting of reactions to medications and problems with products.
Research. Under certain circumstances, we may use and disclose your medical information for research purposes. All research projects are subject to your authorization or through a special approval process by an Institutional Review Board. This review process governs patient safety and welfare and the privacy of your medical information.
Marketing. We may use your medical information to provide you with certain refill reminders, for treatment, case management or care coordination, to direct or recommend alternative treatments, therapies, health care providers, or settings of care, or to describe a health-related product or service provided by ElderHealth. ElderHealth will obtain your authorization prior to using or disclosing your medical information for purposes of marketing items and services to you and where ElderHealth is paid to make the communication.
Fundraising. ElderHealth may contact you to raise funds for ElderHealth. You have the right to opt out of receiving such communications. To opt out of receiving such communications, send a written request to the ElderHealth Privacy Officer at 1846 E Innovation Park Dr, Oro Valley, AZ 85755.
Sale of PHI. ElderHealth may not sell your health information without your written
authorization.
Required by Law. We will disclose health information about you when required to do so by federal, state, or local law.
Workers' Compensation. We may release information about you for workers'
compensation or similar programs as required by law. These programs provide benefits for work related injuries or illness.
Information with Additional Protection. Certain types of medical information have additional protection under Arizona law. In some circumstances, ElderHealth will require your consent to disclose information about communicable disease and HIV/AIDS, drug and alcohol abuse treatment, and genetic testing.
Psychotherapy Notes. Elderhealth will only use or disclose your psychotherapy notes with your authorization, unless the use is by the person who wrote the notes for purposes of treatment, for ElderHealth to defend itself in a legal proceeding brought by you, the disclosure is required by law, for the health oversight of the practitioner that wrote the notes, or to avert a serious threat to the health or safety of a person or the public.
Notification. ElderHealth may use or disclose information to notify or assist in notifying a family member, personal representative or another person responsible for your care, of your location and general condition. This may include disclosures to a public or private entity assisting in disaster relief efforts.
Organ Procurement Organizations. Consistent with applicable law, we may disclose your health information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of facilitating organ, eye, or tissue donation and transplant.
Uses and Disclosures about Decedents. We may disclose your health information to funeral directors, coroners or medical examiners to carry out their duties consistent with applicable law.
Food and Drug Administration (FDA). We may disclose to the FDA, or to a person or entity subject to jurisdiction of the FDA, health information relative to adverse events with respect to food, supplements, product and product defects, or post marketing surveillance information to enable product recall, repairs or replacement.
Disclosure by Whistleblowers. An ElderHealth employee or contractor (business associate) who in good faith believes that we have engaged in conduct that is unlawful or otherwise violates clinical and professional standards, or that the care or services provided by us has the potential of endangering one or more patients or members of the workplace or the public, may disclose your information to an appropriate government agency and/or to an attorney to determine his or her legal options.
Disclosure by Workforce Member Crime Victim. Under certain circumstances, an ElderHealth workforce member who is a victim of a crime on or outside the ElderHealth premises may disclose limited information about the suspect to law enforcement officials.
Other Uses and Disclosures. Uses and disclosures of your information not described in this notice require your written authorization. If you provide ElderHealth with an authorization to use or disclose your medical information, you may revoke that authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose your medical information for the reasons covered by your written authorization. You understand that we cannot take back any disclosures we have already made with your authorization, and that we are required to retain our records of the care we provided to you. To revoke your authorization, please write to ElderHealth Privacy Officer at 1846 E Innovation Park Dr, Oro Valley, AZ 85755.
Your Health Information Rights
Copy of This Notice. You have the right to receive a paper copy of this notice and any revisions to it upon request. You may obtain a copy by asking our receptionist or your provider at your next visit or by calling and asking us to mail you a copy.
Inspect and Copy. You have the right to inspect and copy the medical information we maintain about you for as long as we maintain that information. You may not inspect or copy psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding; medical information that is subject to a law that prohibits access to the medical information; or in circumstances where a professional member of our staff has determined that release may cause harm to you or another individual or where a promise of confidentiality may be breached. In some circumstances, you may have a right to review our denial, if any, of your request to inspect or copy your medical information.
If you wish to inspect or copy your medical information, you must submit your request in writing to the attention of our Privacy Officer, 1846 E Innovation Park Dr, Oro Valley, AZ 85755. We may charge you a fee for the costs of copying, mailing, or other supplies used in fulfilling your request. You may mail your request or bring it to our office. We have 30 days to respond to your request for information that we maintain at our practice sites, although we may extend the time an additional 30 days, but must inform you of this delay.
Request Amendment. You have the right to request that we amend your medical information. You must make this request in writing to our Privacy Officer. The request must state the reason for the amendment. We may deny your request if it is not in writing or does not state the reason for the amendment. We may also deny your request if the information: was not created by us, unless you provide reasonable information that the person who created it is no longer available to make the amendment; is not part of the record which you are permitted to inspect and copy; the information is not part of our designated record set; or is accurate and complete, in our opinion.
Request Restrictions. You may request that ElderHealth restrict or limit the health information it uses or discloses about you for treatment, payment or health care operations. ElderHealth is not required to agree to your request for a restriction, unless you request that we not share your medical information with your health insurer about a service for which you (or someone other than your insurer) has paid ElderHealth in full and the disclosure is for the purpose of carrying out payment or health care operations and is not otherwise required by law.
Accounting of Disclosures. You have the right to request a list of certain disclosures of your medical information. Your request must be in writing and must state the time period for the requested information. Your first request for a list of disclosures within a 12 month period will be free. If you request an additional list within 12 months of the first request, we may charge you a fee for the costs of providing the subsequent list. We will notify you of such costs and afford you the opportunity to withdraw your request before any costs are incurred.
Request Confidential Communications. You have the right to request how we communicate with you to preserve your privacy. We may condition the accommodation by asking you for information as to how payment will be handled or specification of an alternative address or other method of contact. You must submit your request in writing to our Privacy Officer. The request must specify how or where we are to contact you. We will accommodate all reasonable requests.
File a Complaint. You have the right to file a complaint with our Privacy Officer or with the Secretary of the Department of Health and Human Services if you believe we have violated your privacy rights.
Complaints to our Privacy Officer must be in writing and submitted to the address listed below. Complaints to the Secretary of the Department of Health and Human Services may be submitted on line at http://www.hhs.gov/ocr/privacy/hipaa/complaints/ or by mail to:
Regional Manager, Office for Civil Rights, U.S. Department of Health and Human Services, 90 7th Street, Suite 4-100, San Francisco, CA 94103. We will not retaliate against you for filing a complaint.
Notification if Confidentiality is Breached. We are required to notify you if we learn that your unsecured medical information has been breached.
Changes to this Notice. ElderHealth reserves the right to change the terms of this notice and to make the new notice provisions effective for all medical information we maintain. You may receive a copy of any revised notice at the ElderHealth facility after it becomes effective.
For More Information
If you have questions or would like additional information, you may contact our Privacy Officer by phone at 520-829-9987 or by mail at:
1846 E Innovation Park Dr, Oro Valley, AZ 85755
Effective Date: 01/01/2021.