Notice of Privacy Practices
Your information, legally referred to as your medical information, is kept private by Dr. Simpson. What you say in your sessions with her, stays in the room, with certain exceptions. HIPAA requires that a medical establishment declare what those exceptions are in a Notice of Privacy Practices, and the State of New York requires that the Notice be published on the office's website and made available to you on paper if you'd iike a copy. This is Dr. Simpson's Notice.
DR. CATHIE SIMPSON'S HIPAA NOTICE OF PRIVACY PRACTICES
Effective Date: 01 January 2013
This Notice describes how medical information about you may be used and disclosed and how you can access this information.
I, Dr. Cathie Simpson, make a record of the mental-health care I provide, and I may receive such medical records from others. I use these records to provide quality medical care, to obtain payment for services provided to you as allowed by your health plan, and to enable me to meet my professional and legal obligations to operate my medical practice properly. I am required by law to maintain the privacy of protected health information, to provide you with notice of my legal duties and privacy practices with respect to protecting your health information, and to notify you following a breach of unsecured protected health information.
How I May Use and Disclose Your Medical Information.
This notice describes your rights and my legal obligations with respect to your medical information. If you have any questions about this notice, please ask.
My practice collects health information about you. This is your medical record. I store it in a folder in a locked cabinet. The medical record is the property of my psychotherapy practice, but the information in the record belongs to you. The law permits me to use or disclose your health information for the following purposes:
1. Treatment. I use medical information about you to provide you with medical care. I do not disclose your medical information to anyone with the possible exception of other health-care providers who offer services that I do not provide, like a person who might prescribe psychotropic medication to you. I always clear it with you before I share.
2. Payment. If you use insurance to pay for our work together, I will use and disclose your DSM-5 diagnosis to your insurance company to obtain payment. In other words, I give your health plan the information it requires before it will pay me. Sometimes in this legal document, your insurance company will be referred to as an “organized health care arrangement” (OHCA).
3. Health Care Operations. In some far stretch of the imagination, I may use and disclose your information for medical reviews, legal services, and audits, including fraud and abuse detection and compliance programs (all such are usually OHCA generated).
4. Appointment Reminders. When we agree that I will give you a reminder call, text, or email, I’m disclosing your medical information, because I’m calling about a medical appointment. If you’re not home, but you’ve given me permission, I’ll leave this reminder on your answering machine, or with the person answering the phone, or in your email in-box, or in a text. This is considered shared medical information.
5. Notification and Communication With Family. In the case of disaster or death, unless you have instructed me otherwise, I may disclose your health information so that I may notify, or assist in notifying, a family member; the person responsible for your care, or paying for your care; or a relief organization about your location and your general condition if I believe such disclosure is necessary in response to the emergency circumstances.
6. Sale of Health Information. I will not sell your health information without your prior written authorization.
7. Required by Law. As required by law, I will use and disclose your health information, but I will limit my disclosures to the relevant requirements of the law. The law requires me to report abuse, neglect, or domestic violence, and to respond to judicial or administrative proceedings and law enforcement officials. I will further comply with the requirements set forth below concerning those activities:
a. Public Health. I may be required by law to disclose your health information to public health authorities for purposes related to reporting child, elder, or dependent-adult abuse or neglect, or domestic violence. When I report suspected elder or dependent-adult abuse or domestic violence, I will inform you promptly unless in my best professional judgment I believe the notification would place you at risk of serious harm.
b. Judicial and Administrative Proceedings. I may be required by law to disclose your health information in the course of a judicial proceeding to the extent expressly authorized by a court order. I may also disclose information about you in response to a subpoena, discovery request, or other lawful process if reasonable efforts have been made to notify you of the request and you have not objected, or if your objections have been resolved by a court order. The sole persuasion in these circumstances is the court order. Nothing less will move me to hand over your file.
c. Law Enforcement. I may be required by law to disclose your health information to a law enforcement official for purposes such as identifying or locating a suspect, fugitive, material witness, or missing person, complying with a court order.
d. Public Safety. I may be required by law to disclose your health information to appropriate persons in order to prevent or lessen a serious and imminent threat to the health or safety of a particular person, or the general public.
e. Workers’ Compensation. I may disclose your health information as necessary to comply with workers’ compensation laws when they are paying for my services. For example, to the extent your care is covered by workers' compensation, I will make periodic reports to your employer about your condition. I am also required by law to report cases of occupational injury or occupational illness to the employer or workers’ compensation insurer.
11. Breach Notification. In the case of a breach of unsecured protected health information, I will notify you. I will use your mailing address to communicate information related to the breach.
12. Psychotherapy Notes. I will not use or disclose your psychotherapy notes without your prior written authorization except for the following: 1) if a court order requires me to disclose the information, 2) in response to health-oversight activities, 3) to avert a serious and imminent threat to health or safety, or 4) to defend myself if you sue me or bring some other legal proceeding. To the extent you revoke authorization to use or disclose your psychotherapy notes, I won’t share them.
When I May Not Use or Disclose Your Health Information.
Except as described in this Notice of Privacy Practices, I will, consistent with my legal obligations, not use or disclose health information that identifies you without your written authorization. If you do authorize me to use or disclose your health information for another purpose, you may revoke your authorization in writing at any time.
Your Health Information Rights.
Right to Request Special Privacy Protections. You have the right to request restrictions on certain uses and disclosures of your health information by a written request specifying what information you want to limit, and what limitations on my use or disclosure of that information you wish to have imposed. I reserve the right to accept or reject your request, and will discuss my decision with you.
Right to Inspect and Copy. You have the right to inspect and copy your health information, with limited exceptions. To access your medical information, you must submit a written request detailing what information you want access to and whether or not you want to inspect it or get a copy of it. I will give you a hard copy and also send a copy to any other person you designate in writing. I will charge a reasonable fee to cover my costs for labor, supplies, postage, and, if requested and agreed to in advance, the cost of preparing an explanation or summary. I may deny your request under limited circumstances. If I deny your request to access your child’s records or the records of an incapacitated adult you are representing because I believe allowing access would be reasonably likely to cause substantial harm to the patient, you will have the right to appeal my decision. If I deny your request to access your psychotherapy notes, you will have the right to have them transferred to another mental health professional.
Right to Amend or Supplement. You have the right to request that I amend your health information that you believe is incorrect or incomplete. You must make a request to amend in writing and include the reasons you believe the information is inaccurate or incomplete. I am not required to change your health information and will provide you with information about my denial and how you can disagree with the denial. I may deny your request if I do not have the information, if I did not create the information (unless the person or entity that created the information is no longer available to make the amendment), if you would not be permitted to inspect or copy the information at issue, or if the information is accurate and complete as is. If I deny your request, you may submit a written statement of your disagreement with that decision, and I may, in turn, prepare a written rebuttal. All information related to any request to amend will be maintained and disclosed in conjunction with any subsequent disclosure of the disputed information.
Right to an Accounting of Disclosures. You have a right to receive an accounting of the disclosures I have made of your health information, except for the disclosures provided to you or pursuant to your written authorization, or as described in paragraphs 1 (treatment), 2 (payment), 3 (health-care operations), and 5 (notification and communication with family) of Section A of this Notice of Privacy Practices, or which are incident to a use or disclosure otherwise permitted or authorized by law.
Right to a Paper Copy of this Notice. You have a right to this Notice of my legal duties and privacy practices with respect to your health information, including a right to a paper copy of this Notice of Privacy Practices.
If you would like to have a more detailed explanation of these rights, or if you would like to exercise one or more of these rights, contact me.
Changes to this Notice of Privacy Practices.
I reserve the right to amend this Notice of Privacy Practices at any time in the future. Until such amendment is made, I am required by law to comply with the terms of this Notice currently in effect. After an amendment is made, the revised Notice of Privacy Protections will apply to all protected health information that I maintain, regardless of when it was created or received. I will keep a copy of the current notice on my website, and a copy will be available at each appointment.
Complaints.
Complaints about this Notice of Privacy Practices or how I handle your health information should be directed to me.
If you are not satisfied with the manner in which I handle a complaint, you may submit a formal complaint to:
Office for Civil Rights, DHHS OCRMail@hhs.gov
26 Federal Plaza - Suite 3313
New York, NY 10278
(212) 264-3313; (212) 264-2355 (TDD); (212) 264-3039 (FAX)
The complaint form may be found at www.hhs.gov/ocr/privacy/hipaa/complaints/hipcomplaint.pdf
You will not be penalized in any way for filing a complaint.