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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.
Effective 1/1/03
CMHS, Inc. is required by law to maintain the
privacy of protected health information and to provide individuals with notice
of its legal duties and privacy practices with respect to protected health
information.
CMHS, Inc. is required to abide by the terms
of the notice currently in effect; and
CMHS, Inc. reserves the right to change the
terms of its notice and to make the new notice provisions effective for all
protected health information that it maintains and provide all individuals with
the revised notice either by mail or in person.
Complaints: Individuals may request
further information or make a complaint of any alleged violations of privacy
rights to the Privacy Officer at CMHS, Inc. 254-3652 or file a complaint in
writing and within 180 days of occurrence to the Secretary of DHHS, Office of
Civil Rights, Washington, D.C. 20201.
Individuals will not be retaliated against for filing a complaint.
Uses and disclosures
With
consent: Protected health information (PHI) may be disclosed as authorized by you,
the client/resident. Only information
requested on the written authorization will be disclosed unless limited by law.
This includes the following:
·
Other healthcare facilities responsible for providing health care
services to you. e.g. your primary care physician.
·
Insurance carriers for the purpose of reimbursement
·
Attorney
·
Employers
·
School referrals
Without
consent: PHI shall
be disclosed upon request to:
·
the parent of a minor client or resident (exception minor requesting
drug or alcohol services)
·
the guardian or other person having legal custody of same
·
The attorney of a client/resident who is a ward of the juvenile court,
an alleged incompetent person as evidenced by court orders of an attorney’s
appointment.
·
The courts upon receipt of an official court order
·
The appropriate local authorities of a threat of harm to self or others
·
Government agencies for purpose of audits, licensure, etc.
·
MO Advocacy agency authorized to protect the rights of persons with a
mental illness.
·
Medicare and Medicaid recipients as authorized by Federal law
·
Worker’s Compensation claims (MO law)
·
Public Health Laws pertaining to certain vital statistics, public
health safety
·
Internal Revenue audits by qualified personnel
·
Medical personnel in a life-threatening situation
NOTE: Federal law and regulations do NOT
protect any information about a crime
committed by a client either at the program or against any person who works
for the program or about any threat to commit such a crime. Federal laws and regulations
do not protect any information about suspected child abuse or neglect from
being reported under State law to appropriate State or local authorities. See 42USC 290dd-3 and 290ee-3 for Federal laws and 42 CFR Part 2
for Federal regulations. Also 9 CSR
40-2.035 (6) (State)
Your
Rights: Federal law 45 CFR Parts 160 and 164 give you
the right to privacy of your personal
health information maintained by
CMHS, Inc., with some exceptions mandated by law. You may exercise your rights as follows:
·
Request restrictions on certain uses and disclosures of PHI, however,
CMHS is not required to agree to a requested restriction.
·
Inspect and copy PHI
·
Amend PHI
·
Receive an acknowledgement of disclosures of PHI
·
To obtain a paper copy of this Notice, upon request, if you agreed to
receive the notice electronically.
H:\WPDATA\HIPAA\Privacy
Notice 02.doc