NOTICE OF HEALTH INFORMATION 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.

Understanding Your Health Record/Information
Each time you visit a hospital, physician, or other healthcare provider, a record of your visit is made. Typically, this record contains your symptoms, examinations and test results, diagnoses, treatment. It is often referred to as your health or medical record, and it serves as:

• A basis for planning your care and treatment;
• A means of communication among the many health professionals who contribute to your care;
• A legal document describing the care you received;
• A means by which you or a third-party can verify that services were actually provided;
• A tool in educating health professionals and students;
• A source of data for facility planning and marketing;
• A tool which we can assess and use to continually work to improve the care we render and the outcomes we achieve.
• Enrolling individuals into medications assistance programs.

An understanding of what is in your record and how your health information is used helps you to:

• Ensure its accuracy;
• Better understand who, what, when, where and why others may access your health information;
• Make more informed decisions when authorizing disclosure to others.

Your Health Information Rights
Although your health record is the physical property of the healthcare practitioner or facility that compiled it, the information belongs to you. Federal Law provides you the right to:

• request a restriction on certain uses and disclosures of your information. MAP is not required to agree to a restriction, except in limited circumstances, such as for psychotherapy notes or information gathered for judicial proceedings,
• upon your request, at any time receive a paper copy of this notice, even if you earlier agreed to receive this notice electronically,
• inspect and obtain a copy of health records,
• amend your health record if you believe it is incorrect or incomplete. However, MAP is not required to amend your health information and if your request is denied, MAP will provide you with information about our denial and how you can disagree with our denial,
• obtain an account of disclosures of your health information. In some limited instances, you have the right to ask for a list of the disclosures of your health information we have made, but the request cannot include dates before April 14, 2003. This list must include the date of each disclosure, who received the disclosed health information, a brief description of health information disclosed, why the disclosures was made.
  The list will not include disclosures made for the purposes of treatment, healthcare operations, pharmaceutical patient assistance programs, our directory, national security, law enforcement/corrections, and certain health oversight activities. We must comply with your request for a list within 60 days, unless you agree to a 30-day extension. The first request in any 12 month period is provided free of charge. We may charge for subsequent requests.
• receive communications of protected health information from MAP by alternative means or at alternative locations. MAP must accommodate reasonable requests,
• authorize use or disclosure of any of your protected health information by using the Authorization for Use & Disclosure Health Information Form,
• revoke your authorization to use or disclose health information except to the extent that action has already been taken.

• maintain the privacy of your health information as required by law,
• provide you with a notice as to our legal duties and privacy practice with respect to information we collect and maintain about you,
• abide by the terms of this notice
• notify you if we are unable to agree to a requested restriction,
• accommodate reasonable requests you may have to communicate health information by alternative means.

Uses and/or Disclosures for Treatment, Payment, and Health Care Operations Without Your Written Authorization

The following area describes the way MAP may use or disclose your health information. An example is given. Not every use or disclosure in the respective area will be listed. However, the way MAP is permitted to use and disclose information is described in this example.

We will use your health information for enrollment into medication patient assistance programs

For example: Information obtained from you or your physician by the MAP team will be recorded in your record and used to determine your eligibility for the medication patient assistance program;
ie., pharmaceutical companies, medicare, medicaid.

We will also provide your physician with a list of medications that we are assisting you in the enrollment application process.

Other Uses and Disclosures of Your Health Information Made without Your Authorization

Marketing: We may contact you to provide information related to health-related benefits and services that may be of interest to you. We may contact you to discuss updates in your medication regimen or surveys to evaluate our quality of service.

Correctional Institution: Should you be an inmate of a correctional institution, we may disclose to the institution or agents thereof health information necessary for your health and the health safety of other individuals.

Required by Law: We may disclose health information for law enforcement purposes, as required by law, or in response to a valid subpoena. Federal Law makes provision for your health information to be a released to an appropriate health oversight agency, public health authority or attorney, provided that a work force member or business associate believes in good faith that we have engaged in unlawful conduct or have otherwise violated professional or clinical standards and are potentially endangering one or more patients, workers or the public.

For More Information or to Report a Problem
If you believe your privacy rights have been violated, you can file a compliant in writing with the MAP Privacy Officer. There will be no retaliation for filing a compliant.

If you would like to act upon any of your health information rights, as provided herein, have any questions or would like additional information, please contact the MAP Privacy Officer at 706-721-0131, Mon-Fri 9am - 5pm.