Notice of Privacy Practices

NOTICE OF 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 this document carefully.

We understand that information about your health is personal and private. Cascade Health Solutions is committed to maintaining the privacy of your protected health information. This notice describes the privacy practices followed by our employees, volunteers, students, and independent members of the medical community who provide services to you through our organization.

Your health information, that we have in our possession, may include information created or received by this organization, and may be in written, printed, electronic, or spoken word format. This information may include your medical history, current health status, symptoms, examinations, test results, diagnoses, treatments, procedures, prescriptions, other health-related services, or billing activity records.

We are required by law to maintain the privacy of your protected health information, to provide you with this notice, and to abide by the terms of this notice. This document will tell you about the ways in which Cascade Health Solutions may use and disclose health information about you and describes your rights and our obligations regarding the use and disclosure of this information.

HOW WE MAY USE AND DISCLOSE HEALTH AND BILLING INFORMATION ABOUT YOU
We may use and disclose your information for the following purposes without requesting or obtaining your consent or authorization.

TREATMENT: We may use and disclose your health information as necessary within Cascade Health Solutions and with other outside health care providers to provide you with medical treatment or services.

For example, health care professionals treating you will document information about services you receive. This record will be released to other health professionals assisting in your treatment to ensure that they are fully informed about your medical condition and treatment needs.

PAYMENT: We may use and disclose your health information so the treatment and services you receive from our organization may be billed to and payment collected from you, an insurance company, or other third party.

For example, we may need to give your insurance company information about a service you received so they will reimburse you or pay us for the service. We may also tell your insurance company about a treatment you are going to receive to obtain their prior approval or to determine whether they will cover the treatment.

HEALTH CARE OPERATIONS: We may use and disclose your health information for purposes of maintaining and improving the quality and performance of Cascade Health Solutions or that of another health care provider or health plan you have a relationship with. For example, health information may be used to help organizations provide or improve care, reduce costs, coordinate or manage health care, train staff, and comply with the law.

APPOINTMENT REMINDERS: We may contact you as a reminder that you have an appointment for treatment or medical care at our organization.

DISASTER OR MAJOR EMERGENCY: We may disclose health information to other health care providers and to an entity assisting in a disaster relief effort to coordinate care so that your family can be notified about your condition and location.

TREATMENT ALTERNATIVES: We may tell you about or recommend possible treatment options or alternatives that may be of interest to you.

HEALTH-RELATED PRODUCTS AND SERVICES: We may tell you about health-related products or services that may be of interest to you.

Please notify the Privacy Officer, in writing, if you do not wish to be contacted regarding appointment reminders, disasters, treatment alternatives, or health-related products and services. When your request is received, we will not use or disclose your information for the purposes you specify.

SPECIAL SITUATIONS
We may use or disclose your health information for the following purposes, or in the following situations, subject to all applicable legal requirements and limitations:

Avert a serious threat to your health or safety or the health and safety of the public or another person.
Required by federal, state, or local law.
Research purposes, all of which are subject to a special approval process. We will ask your 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.
Organ and tissue donation organizations involved with organ procurement; organ, eye, or tissue transplantation; or to an organ donation bank, as necessary to facilitate donation or transplantation activities.
Military, veterans, national security, and intelligence. If you are or were a member of the armed forces or part of the national security or intelligence communities, as required by military command or other government authorities. We may also release information about foreign military personnel to the appropriate foreign military authority.
Protective services for the President and others to authorized federal officials so they may provide protection to the President, other authorized persons, and foreign heads of state, or to conduct special investigations.
Workers' compensation or similar programs that provide benefits for work-related injuries or illness.
Public health risks in order to prevent or control disease, injury or disability; or report births, deaths, suspected abuse or neglect, non-accidental physical injuries, reactions to medications or problems with products.
Health oversight activities for audits, investigations, inspections, or licensing purposes. This is necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.
Lawsuits and disputes. If you are involved in litigation, or a dispute, we may provide information in response to a court order, administrative order, subpoena, discovery request, or other lawful process.
Law enforcement in response to court order, criminal subpoena, warrant, or similar process. In other limited circumstances for purposes of reporting a crime, identifying or locating suspects, fugitives, material witnesses, missing persons, or crime victims.
Coroners, medical examiners, and funeral directors to identify a deceased person or determine the cause of death or to perform other legally required duties.
Information not personally identifiable may be disclosed if it does not reveal who you are.
Incidental disclosure of your health information may occur as a by-product of lawful and permitted use and disclosure of your health information. Reasonable safeguards are in place to protect your health information.
Individuals involved in your care or payment for your care may receive information unless you tell us otherwise. Using their best judgment, health professionals will disclose your health information to a family member, close personal friend, or anyone else you identify, if the information is relevant to that person's involvement with your care. We may also give information to someone who helps pay for your care.
Business associates. There are some services provided in our organization through contracts with business associates. Examples may include laboratory, medical transcription, or record storage services. We may disclose your health information to our business associates so they can perform the jobs we've asked them to do and they are required to safeguard your information appropriately.

OTHER USES AND DISCLOSURES OF HEALTH INFORMATION
All other uses and disclosures of health information not covered by this notice or the laws that apply to use will be made only with your written authorization. If you provide us authorization to use or disclose health information about you, you may revoke that authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose health information about you for the reason covered by your written authorization, but we cannot take back any uses or disclosures already made with your authorization.

In some instances we may need specific, written authorization from you in order to disclose certain types of specially protected information such as HIV tests, substance abuse, mental health, and genetic tests.

YOUR RIGHTS REGARDING HEALTH AND BILLING INFORMATION ABOUT YOU

RIGHT TO INSPECT AND COPY: You have the right to inspect and copy health or billing information that may be used to make decisions about your care. You may submit a written request to the Privacy Officer, and an appointment will be scheduled for this review. If you request a copy of the information, we may charge a copying and mailing fee that covers the costs associated with this request.

We may deny your request to inspect and/or copy this information in certain limited circumstances. If you are denied access to your health or billing information, you may submit a written request to the Privacy Officer that our denial be reviewed. Another licensed health care professional chosen by our organization will review your request and the denial. We will comply with the outcome of the review.

RIGHT TO AMEND: You have the right to request an amendment if you believe health information we have about you is incorrect or incomplete. The request must be made in writing to the Privacy Officer and must include a reason for the amendment. We may deny your request if:

The request is not in writing or does not include a reason to support the request.
The information was not created by us, unless the person or entity that created the information is no longer available to make the amendment.
The information is not part of the health or billing information that we keep.
You would not be permitted to inspect and copy this part of the information.
The information is accurate and complete.

RIGHT TO AN ACCOUNTING OF DISCLOSURES: You have the right to request an accounting of disclosures. This is a list of the disclosures we made of health information about you for purposes other than treatment, payment, health care operations, and a limited number of special circumstances. The list will also exclude any disclosures we made to you or based on your written authorization.

To obtain this printed list, you must submit a written request to the Privacy Officer. It must state a time period, which may not be longer than six years and may not include dates before April 14, 2003. The first list you request within a 12-month period will be free. For additional lists requested, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.

RIGHT TO REQUEST RESTRICTIONS: You have the right to request a restriction or limitation on the health information we use or disclose about you for treatment, payment, or health care operations. You also have the right to request a limit on the health information we disclose about you to someone who is involved in your care or the payment for services you receive, such as a family member or friend.

We are not required to agree to your request. If we cannot agree to your requested restriction, you will be notified. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment or we are required by law to use or disclose this information. To request restrictions, you must submit a written request to the Privacy Officer.

RIGHT TO REQUEST CONFIDENTIAL COMMUNICATIONS: You have the right to request that we communicate with you about health matters in a certain way or at a certain location. Your request should be submitted in writing to the Privacy Officer and must specify how or where you wish to be contacted. We will accommodate all reasonable requests. We will not ask you the reason for your request.

RIGHT TO A PAPER COPY OF THIS NOTICE: You have the right to a paper copy of this notice at any time. A copy can be requested from your health care provider or the Privacy Officer.

CHANGES TO THIS NOTICE
We reserve the right to change this notice at any time, and to make the revised notice effective for health and billing information we already have about you, as well as any information we receive in the future. The current notice will be posted in our various service areas and will be made available to you at your request. The effective date of the notice will be on the first page, in the top right-hand corner.

COMPLAINTS
If you have any questions or concerns about this notice or our privacy practices, please contact our Privacy Officer at 541-228-3009. If you believe your privacy rights have been violated, you may file a complaint with Cascade Health Solutions at the following address:

Privacy Officer
Cascade Health Solutions
2650 Suzanne Way, Suite 200
Eugene, OR 97408

You may also contact the Secretary of the Department of Health and Human Services at their toll-free telephone number (1-877-696-6775) or at the following address:

Department of Health and Human Services
200 Independence Avenue, SW
Washington, D.C. 20201

There will be no retaliation for filing a complaint.