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Planned Parenthood of Austin Surgical & Sexual Health Services

HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU

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The following categories describe different ways that we may use or disclose health information about you.

For Treatment: We may use health information to provide you with healthcare treatment and services. For example, we may share your information with other specialists to whom you are referred for treatment purposes.

For Payment: We may use and disclose health information so that the treatment and services you receive from us may be billed to, and payment collected from, you or a state Medicaid agency. For example, we may need to disclose Protected Health information to a health plan in order for the health plan to pay us for the services rendered to you. We may also tell your health plan about a treatment or procedure you are going to receive in order to obtain prior approval or to determine whether your plan will cover the services.

For Healthcare Operations: We may use and disclose health information for operations of our healthcare practice. These uses and disclosures are necessary to run our practice and make sure that all of our clients receive quality care. For example, your medical records and health information may be used in the evaluation of health care services and the appropriateness and quality of health care treatment. In addition, medical records are audited for timely documentation and correct billing.

For Appointment Reminders: We may use and disclose health information to contact you in writing or by telephone, as a reminder that you have an appointment.

Fund Raising Activities: With your authorization we may use and disclose your health information to contact you in an effort to raise money for our not-for-profit operations.

Research: There may be situations where we want to use and disclose health information for research purposes. For example, a research project may involve comparing the health and recovery of all patients who received one medication to those who received another medication for the same condition. All research projects, however, are subject to a special approval process. Prior to using or disclosing any medical information, the project must be approved through this research approval process. We will ask for your specific permission if the researcher will have access to your name, address, or other information that reveals who you are, or will be involved in your care.

As Required by Law: We will disclose health information when required by federal, state, or local law.

To Avert a Serious Threat to Health or Safety: We may use or disclose health information when necessary to prevent a serious threat to your health and safety or the health and safety of another person.

Military and Veterans: If you are a member of the armed services or are separated/discharged from military services, we may release health information as required by military command authorities or Veterans Affairs, as applicable.

Workers Compensation: We may release health information for workers' compensation or similar programs.

Public Health Risks: We may disclose health information for public health activities. You may request a list of such activities. These activities generally include the following:

  • To prevent or control disease, injury, or disability;
  • To report births and deaths;
  • To report child abuse or neglect;
  • To report reactions to medications or problems with products;
  • To notify people of recalls of products they may be using;
  • To notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition;
  • To notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect, or domestic violence.

All such disclosures will be made in accordance with the requirements of Texas and federal laws and regulations. You may request a list of such activities.

Health Oversight Activities: We may disclose health information to a health oversight agency for activities authorized by law, such as audits, investigations, inspections, or licensure.

Lawsuits and Disputes: If you are involved in a lawsuit or a dispute, we may disclose health information in response to a court order or subpoena.

Law Enforcement: We may release health information if asked to do so by law enforcement. A list of examples may be provided on request.

Coroners, Health Examiners, and Funeral Directors: We may release health information to a coroner or health examiner, when authorized by law (e.g. to determine the cause of death). We may also release your information to funeral directors.

Inmates: If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release information to the correctional or law enforcement official for treatment purposes

YOUR RIGHTS REGARDING HEALTH INFORMATION DISCLOSURE

You have the following rights regarding health information we maintain about you:

Right to Inspect and Copy: You have the right to inspect and copy health information used to make decisions about your care. You must make your request in writing to the Privacy Official of Planned Parenthood of the Texas Capital Region. We may charge a fee for copying, mailing, or summarizing your medical records. Texas law requires that we provide copies or a narrative within fifteen (15) days of your request. We will inform you of when the records are ready.

We may deny your request in certain very limited circumstances. If you are denied access to health information, we will inform you in writing. You may, in certain circumstances, request that the denial be reviewed.

Right to Amend: If you feel that your health information is incorrect or incomplete, you may ask us to amend the information. Your request to amend must be made in writing to the Privacy Official at Planned Parenthood of the Texas Capital Region. You must provide a reason that supports your request. If we refuse to allow an amendment, you are permitted to include a patient statement about the information at issue in your medical records. If we approve the amendment, we will inform you in writing, allow the amendment to be made, and tell others that we know we have the correct information.

Right to an Accounting of Disclosures: You have the right to request a list or accounting of any disclosures of your health information we have made, except for disclosures for treatment, payment, and health care operations, or made via an authorization signed by you or your representative. You must make your request for this list of disclosures in writing to the Privacy Official of Planned Parenthood of the Texas Capital Region. Your first accounting (within a twelve [12] month period) will be free. For additional requests within that period, we will charge for the cost of providing the list. We will notify you of the costs and you may choose to withdraw or modify your request.

Right to Request Restrictions: You have the right to request a restriction or limitation on the health information we use or disclose for treatment, payment, healthcare operations, or that information released to someone involved in your care.

While you have the right to request restrictions, we are not required to restrict the information if it is not feasible for us to ensure our compliance with the law or it will negatively impact your healthcare. If we agree to your request, we will comply with your request unless the information is needed to provide you emergency treatment.

Right to Request Confidential Communications: You have the right to request that we communicate with you about health matters in a confidential manner or confidential location. To do so, contact the privacy official of PPTCR. We will accommodate reasonable requests.

Right to a Paper Copy of this Notice: You have a right to obtain a paper copy of this Notice at any time.

Right to Receive Notice of a Breach: We are required to notify you by first class mail or by e-mail (if you have indicated a preference to receive information by e-mail), of any breaches of Unsecured Protected Health Information as soon as possible, but in any event, no later than 60 days following the discovery of the breach. “Unsecured Protected Health Information” is information that is not secured through the use of a technology or methodology identified by the Secretary of the U.S. Department of Health and Human Services to render the Protected Health Information unusable, unreadable, and undecipherable to unauthorized users. The notice is required to include the following information:

• A brief description of the breach, including the date of the breach and the date of its discovery, if known;
• A description of the type of Unsecured Protected Health Information involved in the breach;
• Steps you should take to protect yourself from potential harm resulting from the breach;
• A brief description of actions we are taking to investigate the breach, mitigate losses, and protect against further breaches;
• Contact information, including a toll-free telephone number, e-mail address, Web site or postal address to permit you to ask questions or obtain additional information.

In the event the breach involves 10 or more patients whose contact information is insufficient or out of date, we will post a notice of the breach on the home page of our Web site or in a major print or broadcast media. If the breach involves more than 500 patients in a state or jurisdiction, we will send notices to prominent media outlets, and to the Secretary of the U.S. Department of Health and Human Services. We also are required to submit an annual report to the Secretary of a breach that involved less than 500 patients during the year and will maintain a written log of breaches involving less than 500 patients.

MINORS AND PERSONS WITH GUARDIANS
Minors have all the rights outlined in this Notice with respect to health information relating to reproductive healthcare, except for abortion, emergency situations, or when law requires reporting of abuse and neglect. If a parent provides consent for an abortion the parent has the rights outlined in this notice. However, if you obtain a judicial bypass of the consent requirement, you have the same rights as an adult.

CHANGES TO THIS NOTICE
We reserve the right to change this Notice. We reserve the right to make the revised or changed Notice effective for health information we already have about you or any future health information we may receive. We will post a copy of the current Notice in our facility.

COMPLAINTS
If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Department of Health and Human Services. To file a complaint with us contact the Privacy Official of Planned Parenthood of the Texas Capital Region. All complaints must be in writing. You will not be penalized for filing a complaint. To file a complaint with the office of Civil Rights, U.S. Department of Health and Human Services, contact:

Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Room 509F, HHH Building
Washington, D.C. 20201

To file a complaint with PPASSHS, contact:
Kasia White
Privacy Official
201 E. Ben White Blvd.
Austin, Texas 78704

OTHER USES OF HEALTH INFORMATION
Other uses and disclosures of health information not covered by this Notice or the laws that apply to us will be made only with your written permission. If you provide permission to use or disclose health information, you may revoke that permission, in writing, at any time. You understand we cannot take back any disclosure we have already made with your permission, and that we are required to retain the records of the care provided to you.

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