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Your Health Information Rights

SomniHealth

Notice of Privacy Practices

 

 

PLEASE REVIEW THIS NOTICE CAREFULLY

 

SomniHealth is committed to maintaining your privacy and understands the importance of safeguarding your personal health information. We are required by federal law to maintain the privacy of health information that identifies you or that could be used to identify you (known as “Protected Health Information” or “PHI”). PHI is information about you, including basic demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services. This “Notice of Privacy Practices (“Notice”) describes your rights under federal and state law, where applicable, and also describes how we may use and disclose PHI about you to carry out treatment, payment, or health care operations, and for other specified purposes that are permitted or required by law.

SomniHealth is committed to following the terms of the Notice. Except as described in this Notice, we will not use or disclose your PHI without your written authorization. We reserve the right to change our practices and the Notice and to make the revised Notice effective for all PHI we maintain. Upon request, we will provide the revised Notice to you.

 

You have the following rights with respect to your PHI:

 

• Obtain a paper copy of the Notice upon request. You may request a copy of the Notice at any time. Even if you hav agreed to receive the Notice electronically, you are still entitles to a paper copy. To obtain a paper copy, contact Customer Service at 510.864.4800.
• Request a restriction on certain uses and disclosures of PHI. You have the right to request additional restrictions on SomniHealth’s use or disclosure of PHI about you by sending a written request to: Chief Privacy Officer, SomniHealth, 1926 Broadway, Alameda, CA 94501-1513. We are not required to agree to those restrictions.
• Inspect and obtain a copy of PHI. You have the right to inspect and obtain a copy of the PHI about you contained in a “designated record set” usually will include prescription and billing records. To inspect or receive a copy of your PHI for your inspection, you must send a written request to: Chief Privacy Officer, SomniHealth, 1926 Broadway, Alameda, CA 94501-1513. SomniHealth may charge you a fee for the costs of copying, mailing, or other supplies that are necessary to grant each request. SomniHealth may deny your request to inspect and copy in certain limited circumstances. If denied access to your PHI, you may request a review of the denial.
• Request an amendment of PHI. If you feel that your PHI maintained by SomniHealth is incomplete or incorrect, you may request that SomniHealth amend it. You may request an amendment as long as SomniHealth maintains the PHI. To request an amendment, you must send a written request to: Chief Privacy Officer, SomniHealth, 1926 Broadway, Alameda, CA 94501-1513. In addition, you must include a reason that supports your request. In certain cases, SomniHealth may deny your request for amendment. If SomniHealth denies your request for amendment, you have the right to file a statement of disagreement with the decision and SomniHealth will reply.
• Receive an accounting of disclosures of PHI. You have the right to receive an accounting of the disclosures we have made of your PHI for purposes other than treatment, payment, or health care operations. The accounting will exclude disclosures SomniHealth has made directly to you, disclosures to friends or family members involved in your care, incidental disclosures permitted by law, and disclosures for notification purposes. The right to receive an accounting is subject to certain other exceptions, restrictions, and limitations. To request an accounting, you must submit your request in writing to: Chief Privacy Officer, SomniHealth, 1926 Broadway, Alameda, CA 94501-1513. Your request must specify the accounting time period, but may not be longer than six years. You may be charged the cost of providing the accountings which may not include dates prior to April 14, 2003. SomniHealth will notify you of the cost involved and you may choose to withdraw or modify your request at that time.
• Request communications of PHI by alternative means or at alternative locations. You may request that SomniHealth contact you about medical matters only in writing and that the communication be sent to a different residence or post office box. To request confidential communication of PHI about you, submit your request in writing to: Chief Privacy Officer, SomniHealth, 1926 Broadway, Alameda, CA 94501-1513. Your request must state how, or when, you would like to be contacted. We will accommodate all reasonable requests.

 

 

Examples of How SomniHealth May Use and Disclose PHI

 

The following categories describe and provide examples of different ways that we may use and disclose PHI about you:

 

• SomniHealth will use PHI for treatment. Example: Information obtained by SomniHealth will be used to dispense prescription medical devices to you. We will document in your record information related to the equipment dispensed to you and services provided to you. We will use your PHI to communicate with health care providers such as your doctor and sleep lab.
• SomniHealth will use PHI for payment. Example: We will contact your insurer Durable Medical Equipment benefit manager, or other third-party payer to determine whether it will pay for your prescription equipment and the amount of your co-payment responsibility. We will bill you or a third-party payer for the cost of prescription devices dispensed to you. The information on or accompanying the bill may include information that identifies you, as well as the prescription devices you are using.
• SomniHealth will use PHI for health care operations. Example: SomniHealth may use information in your health record to monitor the performance of the employees providing treatment to you. This information may be used in an effort to continually improve the quality of effectiveness of the health care and services SomniHealth provides.

 

 

SomniHealth is likely to use or disclose PHI for the following purposes:

 

• Business associates. SomniHealth may contract with business associates for some of its services. For example, a mailing service may be used to send you refill reminders. When these services are contracted, SomniHealth may disclose PHI about you to our business associate to the extent necessary to perform the job that SomniHealth requested. To protect PHI about you, SomniHealth requires the business associate to appropriately safeguard the PHI.
• Communication with individuals involved in your care or payment for your care. Health care professionals such as sleep care specialists using their professional judgment, may disclose PHU to other health care professionals, a family member, other relative, close personal friend, or any other person that you expressly or implicitly authorize to have access to your PHI relevant to that person’s involvement in your care or payment related to your care.
• Minors. In most situations, a parent or guardian has the right to act as the personal representative of their minor children. However, in some circumstances, state laws treat minors as adults with respect to health care services. In those cases, SomniHealth will follow state laws regarding disclosure of a minor’s PHI.
• Personal communications. We may contact you to provide refill reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.
• Incidental disclosures. We may disclose PHI incidental to our provision of treatment, payment, or health care operations. For example, in our telephone discussions with your health care professional or conversations with you, someone passing by might overhear PHI.
• Food and Drug Administration (FDA). SomniHealth may disclose to the FDA or its agents PHI relative to adverse events with respect to drugs, foods, supplements, products and product defects, or postmarketing surveillance information to enable product recalls, repairs, or replacements.
• Workers’ compensation. SomniHealth may disclose PHI about you to the extent authorized by and to the extent necessary to comply with laws relating to workers’ compensation or other similar programs established by law.
• Public health. As required by law, SomniHealth may disclose PHI aboubt your to public health or legal authorities charged with preventing or controlling disease, injury, or disability.
• Law enforcement. SomniHealth may disclose PHI about you for law enforcement purposes or in response to a valid subpoena.
• As required by law. SomniHealth must disclose PHI about you when required to do so by law.
• Health oversight activities. SomniHealth may disclose PHI about you to an oversight agency for activities authorized by law. These oversight activities include audits, investigations, and inspections, as necessary for our licensure and for the government to monitor the health care system, government programs, and compliance with civil rigihts laws.
• Judicial and administrative proceedings. If you are involved in a lawsuit or a dispute, SomniHealth may disclose PHI about you in response to a court or administrative order. SomniHealth may also disclose PHI about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the requested PHI.

 

 

SomniHealth is permitted to use or disclose PHI about you for the following purposes:

 

• Coroners, medical examiners, and funeral directors. SomniHealth may release PHI about you to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. SomniHealth may also disclose PHI to funeral directors consistent with applicable law to carry out their duties.
• Notification. SomniHealth may use or disclose PHI about you to notify or assist in notifying a family member, personal representative, or another person responsible for your care, your location, and general condition.
• Correctional institution. If you are, or become, an inmate of a correctional institution, SomniHealth may disclose to the institution or its agents PHI necessary for your health and the health and safety of others.
• To avoid a serious threat to health or safety. SomniHealth may use and disclose PHI about you when necessary to prevent serious threat to your health and safety or the health and safety of the public or another person.
• Military and veterans. If you are a member of the armed forces, SomniHealth may release PHI about you as required by military command authorities. SomniHealth may also release PHI about foreign military personnel to the appropriate military authority.
• National security and intelligence activities. SomniHealth may release PHI about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.
• Protective services for the president and others. SomniHealth may disclose PHI about you to authorized federal officials so that they may provide protection to the president, other authorized persons, or foreign heads of state or to conduct special investigations.
• Victims of abuse, neglect, or domestic violence. SomniHealth may disclose PHI about you to a government authority, such as a social service or protective services agency, if SomniHealth reasonably believes you are a victim of abuse, neglect, or domestic violence. SomniHealth will only disclose this type of information to the extent required by law, if you agree to the disclosure, or if the disclosure is allowed by law and SomniHealth believes it is necessary to prevent serious harm to you or someone else or the law enforcement or public official that is to receive the report represents that it is necessary and will not be used against you.

 

 

Other Uses and Disclosures of PHI

 

SomniHealth will obtain you written authorization before using or disclosing PHI about you for purposes other than those provided for above (or as otherwise permitted or required by law). You may revoke this authorization in writing at any time. Upon receipt of the written revocation, SomniHealth will stop using or disclosing PHI about you, except to the extent that SomniHealth has already taken action in reliance on the authorization.

 

How to Obtain More Information or Report a Problem

 

If you have questions or would like additional information about SomniHealth’s privacy practices, you may contact: Chief Privacy Officer, SomniHealth, 1926 Broadway, Alameda, CA 94501-1513. If you believe your privacy rights have been violated, you can file a complaint with SomniHealth’s Chief Privacy Officer or with the Office for Civil Rights. There will be no retaliation for filing a complaint.

 

State Law

 

Some of the restrictions described in this Notice may be limited in some cases by applicable state laws that are more stringent than the federal standards. SomniHealth has always complied with state privacy laws and will continue to do so.

 

Effective Date

 

This notice is effective as of September 15, 2005.