Notice of Privacy Practices

Standard: Notice of Privacy Practices

An individual has a right to adequate notice of the uses and disclosures of protected health information that may be made by Georgia Pain Physicians, and of the individual's rights and Georgia Pain Physicians' legal duties with respect to protected health information.

Content of Notice

I. Required elements.

Georgia Pain Physicians will provide a notice that is written in plain language and that contains the following elements:

A. Header: The notice contains the following statement as a header or otherwise prominently displayed: "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."

B. Uses and disclosures: The notice contains the following information.

1. A description, including at least one example, of the types of uses and disclosures that Georgia Pain Physicians is permitted to make for each of the following purposes: treatment, payment and health care operations.

2. A description of each of the other purposes for which Georgia Pain Physicians is permitted or required to use or disclose protected health information without the individual's written authorization.

3. If a use or disclosure for any purpose described in paragraphs (1) or (2) of this section is prohibited or materially limited by other applicable law, the description of such use or disclosure will reflect the more stringent law as defined.

4. For each purpose described in paragraph (1) or (2) of this section, the description will include sufficient detail to place the individual on notice of the uses and disclosures that are permitted or required by law.

5. A statement that other uses and disclosures will be made only with the individual's written authorization and that the individual may revoke such authorization.

C. Separate statements for certain uses or disclosures: Georgia Pain Physicians intends to engage in the following activities, and will provide a separate statement in the notice that:

1. Georgia Pain Physicians may contact the individual to provide appointment reminders or information about treatment alternatives or other heath-related benefits and services that may be of interest to the individual.

D. Individual rights: The notice contains a statement of the individual's rights with respect to protected health information and a brief description of how the individual may exercise these rights, as follows.

1. The right to request restrictions on certain uses and disclosures of protected health including a statement that Georgia Pain Physicians is not required to agree to a requested restriction.

2. The right to receive confidential communications of protected health information.

3. The right to inspect and copy protected health information as per the law.

4. The right to request to amend protected health information as provided by the law.

5. The right to receive an accounting of disclosures of protected health information.

6. The right of an individual, including an individual who has agreed to receive the notice electronically, to obtain a paper copy of the notice from Georgia Pain Physicians upon request.

E. Georgia Pain Physicians' duties. The notice contains:

1. A statement that Georgia Pain Physicians is required by law to maintain the privacy of protected health information and to provide individuals with notice of its legal duties and privacy practices with respect to protected health information.

2. A statement that Georgia Pain Physicians is required to abide by the terms of the notice currently in effect.

3. For Georgia Pain Physicians to apply a change in a privacy practice that is described in the notice to protected health information that Georgia Pain Physicians created or received prior to issuing a revised notice, a statement that it reserves the right to change the terms of its notice and to make the new notice provisions effective for all protected health information that it maintains. The statement also describes how it will provide individuals with a revised notice.

F. Complaints: The notice contains a statement that individuals may complain to Georgia Pain Physicians and to the Secretary of the Department of Health and Human Services if they believe their privacy rights have been violated, and a brief description of how the individual may file a complaint with the Privacy Officer of Georgia Pain Physicians, and a statement that the individual will not be retaliated against for filing a complaint.

G. Contact: The notice will contain the name, or title, and telephone number of the Privacy Officer to contact for further information.

H. Effective date: The notice contains the date on which the notice is first in effect, which may not be earlier than the date on which the notice is printed or otherwise published.

II. Revisions to the notice.

Georgia Pain Physicians will promptly revise and distribute its notice whenever there is a material change to the uses or disclosures, the individual's rights, Georgia Pain Physicians's legal duties, or other privacy practices stated in the notice. Except when required by law, a material change to any term of the notice may not be implemented prior to the effective date of the notice in which such material change is reflected.

III. Provision of notice.

Georgia Pain Physicians will make the notice available on request to any person and to individuals as specified.

IV. Specific requirements for certain covered health care providers. If Georgia Pain Physicians has a direct treatment relationship with an individual it will:

A. Provide the notice no later than the date of the first service delivery, including service delivered electronically, to such individual after the compliance date.

B. In an emergency treatment situation, as soon as reasonably practicable, Georgia Pain Physicians must make a good faith effort to obtain written acknowledgement of receipt of the notice and document the good faith and effort, and reason if unable to obtain.

C. Georgia Pain Physicians will: 1. Have the notice available at the service delivery site for individuals to request to take with them. 2. Post the notice in a clear and prominent location where it is reasonable to expect individuals seeking service from Georgia Pain Physicians to be able to read the notice.

D. Whenever the notice is revised, make the notice available upon request on or after the effective date of the revision and promptly comply with the requirements.

V. Specific requirements for electronic notice.

A. Georgia Pain Physicians' web site provides information about customer services and/or benefits and will prominently post its notice on the web site and make the notice available electronically through the web site.

B. If capable, Georgia Pain Physicians may provide the notice required by this section to an individual by e-mail, if the individual agrees to electronic notice and such agreement has not been withdrawn. If Georgia Pain Physicians knows that the e-mail transmission has failed, a paper copy of the notice will be provided to the individual. Provision of electronic notice by Georgia Pain Physicians will satisfy the provision requirements when made timely.

C. If the first service delivery to an individual is delivered electronically, Georgia Pain Physicians will provide electronic notice automatically and contemporaneously in response to the individual's first request for service.

D. The individual who is the recipient of electronic notice retains the right to obtain a paper copy of the notice from Georgia Pain Physicians upon request.

VI. Joint notice by separate covered entities.

If Georgia Pain Physicians and another organization participate in organized health care arrangements, it may comply with this section by a joint notice, provided that:

A. The covered entities participating in the organized health care arrangement agree to abide by the terms of the notice with respect to protected health information created or received by Georgia Pain Physicians as part of its participation in the organized health care arrangement.

B. The joint notice meets the implementation specifications, except that the statements required by this section may be altered to reflect the fact that the notice covers more than Georgia Pain Physicians; and

1. Describes with reasonable specificity the covered entities, or class of entities, to which the joint notice applies.

2. Describes with reasonable specificity the service delivery sites, or classes of service delivery sites, to which the joint notice applies.

3. If applicable, states that the covered entities participating in the organized health care arrangement will share protected health information with each other, as necessary to carry out treatment, payment or health care operations relating to the organized health care arrangement.

C. The covered entities included in the joint notice will provide the notice to individuals in accordance with the applicable implementation specifications. Provision of the joint notice to an individual by any one of the covered entities included in the joint notice will satisfy the provision requirements of this section with respect to all others covered by the joint notice.

VII. Documentation.

Georgia Pain Physicians will document compliance with the notice requirements by retaining copies of the notices issued by Georgia Pain Physicians and, if applicable, any written acknowledgements of receipt of the notice of documentation of good faith efforts to obtain such written acknowledgement.