THIS NOTICE DESCRIBES HOW MEDICAL AND DRUG AND ALCOHOL RELATED INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

General Information:

Information regarding your health care, including payment for health care, is protected by two federal laws: the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), 42 U.S.C. & 1320d et seq., 45 C.F.R. Parts 160 & 164, and the Confidentiality Law, 42 U.S.C & 290dd-2, 42 C.F.R. Part 2. Under these laws, Comprehensive Addiction Program (CAP) may not say to a person outside Comprehensive Addiction Program that you attend the program, nor may Comprehensive Addiction Program disclose any information except as permitted by federal law.

Comprehensive Addiction Program must obtain your written consent before it can disclose information about you for payment process. For example, Comprehensive Addiction Program must obtain your written consent before it can disclose information to your health insurer in order to be paid for services. Generally, you must also sign a written consent before Comprehensive Addiction Program can share information for treatment purposes or for health care operations. However, federal law permits Comprehensive Addiction Program to disclose information without your written permission:

1. Pursuant to an agreement with a Qualified Service Organization;

2. For research, audit or evaluations;

3. To report a crime committed on CAP’s premises or against Comprehensive Addiction Program personnel;

4. To medical personnel in a medical emergency;

5. To appropriate authorities to report suspected child abuse or neglect;

6. As allowed by a court order.

For example, Comprehensive Addiction Program can disclose information without your consent to obtain legal or financial services, or to another medical facility to provide health care to you, as long as there is a Qualified Service Organization Agreement in place.

Before Comprehensive Addiction Program can use or disclose any information about your health in a manner which is not described above, it must obtain your specific written consent allowing it to make the disclosure. Any such written consent may be revoked by you in writing.

Your Rights:

Under HIPAA you have the right to request restrictions on certain uses and disclosures of your health information. Comprehensive Addiction Program is not required to agree to any restrictions you request, but if it does agree then it is bound by that agreement and may not use or disclose any information which you have restricted except as necessary in a medical emergency. You have the right to request that we communicate with you by alternative means or at an alternative location. Comprehensive Addiction Program will accommodate such requests that are reasonable and will not request an explanation from you. Under HIPAA you also have the right to inspect and copy your own health information maintained by Comprehensive Addiction Program, except to the extent that the information contains psychotherapy notes or information compiled for use in a civil, criminal or administrative proceeding or in other limited circumstances. Under HIPAA you also have the right, with some exceptions, to amend health care information maintained in CAP’s records, and to request and receive an accounting of disclosures of your health related information made by Comprehensive Addiction Program during the six years prior to your request. You also have the right to receive a paper copy of this notice.

CAP’sDuties:

Comprehensive Addiction Program is required by law to maintain the privacy of your health information and to provide you with notice of its legal duties and privacy practices with respect to your health information. Comprehensive Addiction Program is required by law to abide by the terms of this notice. Comprehensive Addiction Program reserves the right to change the terms of this notice and to make new notice provisions effective for all protected health information it maintains.

Complaints and Reporting Violations:

You may complain to Comprehensive Addiction Program and the Secretary of the United States Department of Health and Human Services if you believe that your privacy rights have been violated under HIPAA. You will not be retaliated against for filing such a complaint.

Violation of the Confidentiality Law by a program is a crime. Suspected violations of the Confidentiality Law may be reported to the United States Attorney in the district where the violation occurs.

Contact:

For further information contact our HIPAA Privacy/Compliance Officer, at 559-264-5096.