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.
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, Spearhead Lodge may not say to a person outside Spearhead Lodge that you attend the program, nor may Spearhead Lodge disclose any information except as permitted by federal law.
Spearhead Lodge must obtain your written consent before it can disclose information about you for payment process. For example, Spearhead Lodge 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 Spearhead Lodge can share information for treatment purposes or for health care operations. However, federal law permits Spearhead Lodge to disclose information without your written permission:
Pursuant to an agreement with a Qualified Service Organization; For research, audit or evaluations; To report a crime committed on Spearhead Lodge’s premises or against Spearhead Lodge personnel; To medical personnel in a medical emergency; To appropriate authorities to report suspected child abuse or neglect; As allowed by a court order. For example, Spearhead Lodge 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 Spearhead Lodge 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.
Under HIPAA you have the right to request restrictions on certain uses and disclosures of your health information. Spearhead Lodge 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. Spearhead Lodge 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 Spearhead Lodge, 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 Spearhead Lodge’s records, and to request and receive an accounting of disclosures of your health related information made by Spearhead Lodge during the six years prior to your request. You also have the right to receive a paper copy of this notice.
Spearhead Lodge’s Duties:
Spearhead Lodge 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. Spearhead Lodge is required by law to abide by the terms of this notice. Spearhead Lodge 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 Spearhead Lodge 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.
For further information contact us at 888-483-0528