Notice of Privacy Practices
January 1, 2017
January 1, 2017
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.
This Notice describes the ways that CATAPULT HEALTH may use and disclose health information about our patients. The Health Insurance Portability and Accountability Act of 1996, as amended by the Health Information Technology for Economic and Clinical Health Act (collectively, “HIPAA”) requires that CATAPULT HEALTH protect the privacy and security of health information that identifies a patient, or where there is a reasonable basis to believe the information could be used to identify a patient. This information is called “protected health information,” which we refer to in this Notice as “health information.” This Notice describes how CATAPULT HEALTH may use and disclose your health information, your rights as our patient, and our obligations regarding the use and disclosure of your health information.
CATAPULT HEALTH is required by law to maintain the privacy of your health information as set forth in this Notice and to provide you this Notice of its duties and privacy practices with respect to your health information. CATAPULT HEALTH is required to abide by the terms of this Notice, which may be amended from time to time. CATAPULT HEALTH reserves the right to change the terms of this Notice and to make the new Notice provisions effective for all health information that it maintains. If CATAPULT HEALTH changes the Notice, we will provide a copy of the revised Notice upon request on or after the effective date of the revision. We will also have available a copy of the current Notice onsite when we see you, as well as on our website at www.CatapultHealth.com.
CATAPULT HEALTH may use or disclose your health information to provide, coordinate or manage your health care and related services. We may consult with other health care providers regarding your treatment and coordinate and manage your health care with others. For example, we may use and disclose your health information when you need a prescription, lab work, an x-ray, or other health care services. In addition, we may use and disclose your health information when referring you to and/or for treatment by another health care provider. For example, if you are referred to another physician, we may disclose your health information and send a report about your care from CATAPULT HEALTH to the physician so that the other physician may treat you.
CATAPULT HEALTH may use or disclose your health information to make payment to or collect payment from third parties, such as your employer, health plans, or providers, for the care you receive. Before providing treatment or services, we may share details with your health plan concerning the services you are scheduled to receive. For example, we may ask for payment approval from your health plan before we provide care or services. We may use and disclose your health information to find out if your health plan will cover the cost of care and services we provide. We may use and disclose your health information for billing, claims management, and collection activities. We may disclose your limited health information to consumer reporting agencies relating to collection of payments owed to us. For example, CATAPULT HEALTH may provide information regarding your coverage or health care treatment to other third parties to coordinate payment of benefits.
We may also disclose your health information to another health care provider or to a company or health plan required to comply with HIPAA for the payment activities of that health care provider, company, or health plan. For example, we may allow a health insurance company to review your health information for the insurance company’s activities to determine the insurance benefits to be paid for your care.
CATAPULT HEALTH may use or disclose health information for its own operations to facilitate the administration of CATAPULT HEALTH and, as necessary, to provide coverage and services to all of CATAPULT HEALTH’s participants. For example, CATAPULT HEALTH may use your health information to conduct case management, quality improvement and utilization review, and provider credentialing activities or to engage in customer service and grievance resolution activities. Health care operations include such activities as:
CATAPULT HEALTH may also disclose your health information to another provider or a health plan that also has a relationship with you for certain health care operations, such as quality assessment and improvement or population-based activities to improve health care.
CATAPULT HEALTH may disclose health information about you to your family member, close friend, or any other person identified by you if that information is directly relevant to the person’s involvement in your care or payment for your care. If you are present and able to consent or object (or if you are available in advance), then CATAPULT HEALTH may disclose your health information if you do not object after you have been informed of your opportunity to object.
If you are not present or you are unable to consent or object, CATAPULT HEALTH may exercise professional judgment in determining whether the use or disclosure of your health information is in your best interests. For example, if you are brought in to see a CATAPULT HEALTH health care provider and are unable to communicate normally with your health care provider for some reason, we may find it is in your best interest to give your prescription and other medical supplies to the friend or relative who brought you in for treatment. CATAPULT HEALTH may also use and disclose your health information to notify such persons of your location, general condition, or death. CATAPULT HEALTH may coordinate with disaster relief agencies to make this type of notification. CATAPULT HEALTH also may use professional judgment and our experience with common practice to make reasonable decisions about your best interests in allowing a person to act on your behalf to pick up filled prescriptions, medical supplies, x-rays, or other things that contain health information about you.
CATAPULT HEALTH will disclose your health information when it is required to do so by any federal, state or local law.
CATAPULT HEALTH may disclose your health information to a health oversight agency for authorized activities including audits, civil administrative or criminal investigations, inspections, licensure or disciplinary action.
CATAPULT HEALTH may disclose your health information in the course of any judicial or administrative proceeding in response to an order of a court or administrative tribunal as expressly authorized by such order. CATAPULT HEALTH may also disclose your health information in response to a subpoena, discovery request or other lawful process, but only when the requesting party makes reasonable efforts to either notify you about the request or to obtain an order protecting your health information.
Under certain conditions, CATAPULT HEALTH may disclose your health information to a law enforcement official for certain purposes, including, but not limited to, in an emergency to report a crime or in response to law enforcement’s request for information if you are the victim of a crime.
CATAPULT HEALTH may, consistent with applicable law and ethical standards of conduct, use and disclose your health information if CATAPULT HEALTH, in good faith, believes that such use or disclosure is necessary to prevent or lessen a serious and imminent threat to your health or safety or to the health and safety of the public.
CATAPULT HEALTH may use or disclose your health information to public health authorities or other authorized persons to carry out certain activities related to public health, including the following activities:
CATAPULT HEALTH may disclose your health information in certain cases to proper government authorities if we reasonably believe that a patient has been a victim of domestic violence, abuse, or neglect.
CATAPULT HEALTH may disclose your health information to a coroner or medical examiner to identify a deceased person and determine the cause of death. In addition, we may disclose your health information to funeral directors, as authorized by law, so that they may carry out their jobs.
CATAPULT HEALTH may use or disclose your health information to organizations that help procure, locate, and transplant organs in order to facilitate an organ, eye, or tissue donation and transplantation.
CATAPULT HEALTH may use and disclose health information about you for research purposes under certain limited circumstances. CATAPULT HEALTH must obtain a written authorization to use and disclose health information about you for research purposes except in situations where a research project meets specific, detailed criteria established by HIPAA to ensure the privacy of your health information.
In certain circumstances, CATAPULT HEALTH may use or disclose your health information to facilitate specified government functions related to the military and veterans, national security and intelligence activities, protective services for the President of the United States and others, and correctional institutions and inmates.
CATAPULT HEALTH may release your health information to the extent necessary to comply with laws related to worker’s compensation or similar programs.
CATAPULT HEALTH may disclose your health information to third parties known as “Business Associates” that perform various activities (e.g. legal services, delivery of goods) for us and that agree to protect the privacy of your health information.
Other than as stated above, CATAPULT HEALTH will not use or disclose your health information other than with your written authorization. If you or your representative authorize CATAPULT HEALTH to use or disclose your health information, you may revoke that authorization at any time in writing to CATAPULT HEALTH’s Privacy Officer at the contact information listed below, except to the extent that CATAPULT HEALTH has taken action based on the authorization.
In addition, federal and state law require special privacy protections for certain highly confidential information about you (“Highly Confidential Information”). Subject to compliance with limited exceptions, we will not use or disclose psychotherapy notes, use or disclose your health information for marketing purposes or sell your health information unless you have signed an authorization.
CATAPULT HEALTH is providing you with notice that your health information may be stored electronically and subject to electronic disclosure.
You have the following rights regarding your health information that CATAPULT HEALTH maintains:
You may request restrictions on certain uses and disclosures of your health information (a) for treatment, payment, and health care operations, (b) to individuals (such as a family member, other relative, close personal friend or any other person identified by you) involved with your care or with payment related to your care, or (c) to notify or assist in the notification of such individuals regarding your location and general condition. You may also request additional restrictions on CATAPULT HEALTH’s disclosure of your health information to certain individuals involved in your care that otherwise are permitted by HIPAA. CATAPULT HEALTH is not required to agree to your request(s), except for requests to restrict disclosures of your health information to a health plan if (i) the disclosure is for the purpose of carrying out payment or health care operations and is not otherwise required by law; and (ii) the health information pertains solely to a health care item or service for which you have paid CATAPULT HEALTH out of pocket and in full. If you wish to make a request for restrictions, you must make your request in writing to the CATAPULT HEALTH Privacy Officer. In your request, please include (a) the information that you want to restrict; (b) how you want to restrict the information (for example, restricting disclosures of your health information to certain persons outside of CATAPULT HEALTH); and (c) to whom you want those restrictions to apply. If we do agree to a restriction, we will comply with your request unless the information is needed to provide you emergency treatment.
You have the right to request that CATAPULT HEALTH communicate with you in a certain manner or at a certain location. For example, you may ask that CATAPULT HEALTH only communicate with you at a certain telephone number, address or by email. If you wish to receive confidential communications, please make your request in writing to the CATAPULT HEALTH Privacy Officer. You must specify how you would like to be contacted (for example, by regular mail to your post office box and not your home). CATAPULT HEALTH will honor your reasonable requests for confidential communications.
You have the right to inspect and receive a copy of your health information in certain records that CATAPULT HEALTH maintains. We may deny your request to inspect and copy your health information only in limited circumstances. A request to inspect and copy records containing your health information must be made in writing to the CATAPULT HEALTH Privacy Officer. If you request a copy of your health information, we may charge you a reasonable, cost-based fee for the copying, postage, labor, and supplies used in meeting your request. If your health information is maintained electronically by CATAPULT HEALTH, then at your request CATAPULT HEALTH will provide you with access to your health information in electronic form or format.
If you believe that your health information records are inaccurate or incomplete, you may request that CATAPULT HEALTH amend the records. That request may be made as long as the information is maintained by CATAPULT HEALTH. A request for an amendment of records must be made in writing to the CATAPULT HEALTH Privacy Officer and must include a reason for your request. CATAPULT HEALTH may deny the request in certain cases, including if the request is not in writing or does not include a reason to support the amendment. The request also may be denied if your health information records were not created by CATAPULT HEALTH, if the health information you are requesting to amend is not part of CATAPULT HEALTH’s records, if the health information you wish to amend falls within an exception to the health information you are permitted to inspect and copy, or if CATAPULT HEALTH determines the records containing your health information are accurate and complete.
You have the right to receive an accounting (a list) of certain disclosures of your health information made by CATAPULT HEALTH. The request must be made in writing to the CATAPULT HEALTH Privacy Officer. The request should specify the time period for which you are requesting the information. Accounting requests may not be made for periods of time going back more than six (6) years. The first list that you request in a 12-month period will be free, but we may charge you for our reasonable costs of providing additional lists in the same 12-month period. We will tell you about these costs, and you may choose to cancel your request at any time before costs are incurred.
You have a right to request and receive a paper copy of this Notice at any time, even if you have received this Notice previously or agreed to receive the Notice electronically. To obtain a paper copy, please contact the CATAPULT HEALTH Privacy Officer.
You have a right to be notified following a breach of your unsecured health information, and CATAPULT HEALTH will notify you in accordance with applicable law.
You have the right to make complaints to CATAPULT HEALTH and to the Secretary of the Department of Health and Human Services if you believe that your privacy rights have been violated. Any complaints to CATAPULT HEALTH should be made in writing to the CATAPULT HEALTH Privacy Officer. CATAPULT HEALTH encourages you to express any concerns you may have regarding the privacy of your information. You will not be retaliated against in any way for filing a complaint.
If you have any questions about this Notice, please contact our Privacy Officer at the address and telephone number listed below.
You may contact our Privacy Officer as follows:
8144 Walnut Hill Lane, Suite 1100
Dallas, Texas 75231
Attn: HIPAA Privacy Officer
Phone: (214) 785-2200
Fax: (877) 885-9904
This Notice was published and first became effective on January 1, 2017.