NOTICE OF HIPAA PRIVACY PRACTICES
This notice describes how medical information about you may be used and disclosed, as well as how you may obtain access to this information. Please review it carefully.
When it comes to your health information, you have certain rights. This notice describes our privacy practices.
What is HIPAA?
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal program. It requires that all medical records and other individually identifiable health information used or disclosed by Na’au Nutrition in any form (whether electronically, on paper, or verbally) are kept properly confidential. This Act gives you, the patient, new rights to understand and control how your health information is used.
HIPAA provides penalties for covered entities that misuse personal health information. As required by HIPAA, Mariah Ecker RD LD has prepared this explanation of how Na’au Nutrition is required to maintain the privacy of your health information and how Na’au Nutrition may use and disclose your health information.
How we Use Your Medical Information and Disclosures
Na’au Nutrition may use or share your health information in the following ways:
Treatment: We are permitted to use and disclose your medical information to those involved in your treatment. For example, your care may require the involvement of another health care professional (HCP). An example of this would be disclosing a visit summary to your primary care physician so that your physician can continue to oversee your care. At times, we may request that other HCP share your medical information with us.
Payment: We are permitted to use and share your medical information to bill and collect payment from insurance companies for the services provided to you. For example, we may complete a claim form to obtain payment from your insurer or those responsible for receiving and paying the claim. The form will contain medical information necessary to pay the claim, such as a description of the medical service provided to you.
How else can we use or share your health information?
We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. We can share portions of your health information with local, state, and/or federal registry programs as required. We can share your health information for these activities in a limited data set, which excludes some identifying information. For more information see:
Respond to lawsuits and legal actions. We can share health information about you in response to a court or administrative order, or in response to a subpoena.
Work with a medical examiner or funeral director. We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
Address workers' compensation, law enforcement, and other government requests. We can use or share health information about you: for workers' compensation claims; for law enforcement purposes or with a law enforcement official or correctional institution; with health oversight agencies for activities authorized by law; or for special government functions, such as military, national security, and presidential protective services.
Help with public health and safety issues. We can share health information about you for certain situations such as: preventing disease; helping with product recalls; reporting births and deaths; reporting suspected abuse, neglect, or domestic violence; reporting reactions to medications or product problems; or preventing or reducing a serious threat to anyone’s health or safety.
Do research. We can use or share your information for health research. We can share your health information for these activities in a limited data set, which excludes some identifying information.
Disclosures That Can Be Made Without Your Authorization
There are situations in which we are permitted by law to disclose or use your medical information without your written authorization or an opportunity to object. These situations are outlined in the next six sections.
In other instances, we will ask for your written authorization before using or disclosing any identifiable health information about you. If you choose to sign an authorization to disclose information, you can later revoke that authorization, in writing, to stop future uses and disclosures. However, any revocation will not apply to disclosures or uses already made or taken in reliance on that authorization. Examples of situations where it is necessary for you to provide specific authorization are for employment-related physicals or release of medical records to attorneys.
Public Health, Abuse or Neglect, and Health Oversight:
We may disclose your medical information for public health activities. Public health activities are mandated by federal, state, or local government for the collection of information about disease, vital statistics (like births and death), or injury to a public health authority. We may disclose medical information, if authorized by law, to a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition. We may disclose your medical information to report reactions to medications, problems with products, or to notify people of recalls of products they may be using. We may also disclose medical information to a public agency authorized to receive reports of child abuse or neglect. Hawaii law requires physicians to report child abuse or neglect. Regulations also permit the disclosure of information to report abuse or neglect of elders or the disabled.
We may disclose your medical information to a health oversight agency for those activities authorized by law. Examples of these activities are audits, investigations, licensure applications and inspections which are all government activities undertaken to monitor the health care delivery system and compliance with other laws, such as civil rights laws.
Legal Proceedings and Law Enforcement
We may disclose your medical information in the course of judicial or administrative proceedings in response to an order of the court (or the administrative decision-maker) or other appropriate legal process. Certain requirements must be met before the information is disclosed.
If asked by a law enforcement official, we may disclose your medical information under limited circumstances provided that the information:
o Is released pursuant to legal process, such as a warrant or subpoena; o Pertains to a victim of crime and you are
o Pertains to a person who has died under circumstances that may be
related to criminal conduct;
o Is about a victim of crime and we are unable to obtain the person’s
o Is released because of a crime that has occurred on these premises; or o Is released to locate a fugitive, missing
person, or suspect.
We may also release information if we believe the disclosure is necessary to prevent or lessen an imminent threat to the health or safety of a person.
Workers’ Compensation: We may disclose your medical information as required by the Hawaii workers’ compensation law.
Military, National Security and Intelligence Activities, Protection of the President: We may disclose your medical information for specialized governmental functions such as separation or discharge from military service, requests as necessary by appropriate military command officers (if you are in the military), authorized national security and intelligence activities, as well as authorized activities for the provision of protective services for the President of the United States, other authorized government officials, or foreign heads of state.
Research, Organ Donation, Coroners, Medical Examiners, and Funeral Directors: When a research project and its privacy protections have been approved by an Institutional Review Board or privacy board, we may release medical information to researchers for research purposes. Also, we may release your medical information to a coroner or medical examiner to identify a deceased or a cause of death. Further, we may release your medical information to a funeral director where such a disclosure is necessary for the director to carry out his duties.
Required by Law: We may release your medical information where the disclosure is required by law.
Your Health Information Rights
Request a copy of this Notice. You can ask for a paper copy of this notice at any time. Please ask your registered dietitian for a copy or email firstname.lastname@example.org
Request copies of your medical record or claims record. You can ask for an electronic or paper copy of your medical record or health and claims records and other health information. We may charge you a reasonable, cost-based fee for copying your information. Requests must be made in writing.
Ask us to correct your medical record or your claims records. You may request an amendment of your medical information in the designated record set. We may refuse your request, but we’ll tell you why in writing within 60 days. You must make your request in writing and you must provide a reason for the request.
Requested Restrictions. You may request that we restrict or limit how your protected health information is used or disclosed for treatment, payment, or healthcare operations. We do not have to agree to this restriction, but if we do agree, we will comply with your request except under emergency circumstances. To request a restriction, submit the following in writing: (a) The information to be restricted, (b) what kind of restriction you are requesting (i.e. on the use of information, disclosure of information or both), and (c) to whom the limits apply. You should not consider that your request has been granted until such time as you receive written confirmation from us agreeing to your restriction. You may also request that we limit disclosure to family members, other relatives, or close personal friends that may or may not be involved in your care.
Request confidential communications. You may request that we send communications of protected health information by alternative means or to an alternative location. You must make this request in writing and you must tell us how or where you wish to be contacted.
Choose someone to act for you. If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action.
File a complaint if you feel your rights are violated. If you are concerned that your privacy rights have been violated, you have the right to file written complaint with our office, or with the Department of Health and Human Services, Office of Civil Rights, about violations of the provisions of this notice or the policies and procedures of our office. We will not retaliate against you for filing a complaint. Please feel free to contact us for more information. A complaint to the Secretary should be filed within 180 days of the occurrence or action that is the subject of the complaint. We will not require you to waive your right to file a complaint as a condition of the provision of treatment, payment, enrollment in a health plan, or eligibility for benefits.
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information, tell us what you want us to do and we will follow your instructions.
If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
Our Responsibility to You
We are required by law and regulation to protect the privacy of your medical information, to provide you with this notice of our privacy practices with respect to protected health information, and to abide by the terms of the notice of privacy practices in effect. We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
Changes to This Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request.
Questions and Contact Information
If you have any questions about this Notice or your privacy rights, please contact Mariah Ecker at email@example.com or