About the Notice

In the Privacy Notice, the word “Agency” means Preferred Therapy Services. When referring to the Agency, we use “Preferred.” In this notice, “medical information” means the same as “health information.” When you receive benefits from Preferred, we may get health information about you. Health information includes any information that relates to:

• Your past, present, or future physical or mental health
• Providing health care to you
• The past, present, or future payment for your health care

This notice tells you about your privacy rights, Preferred’s duty to protect health information that identifies you, and how Preferred may use or disclose health information that identifies you without your written permission. This notice does not apply to health information that does not identify you or anyone else. Please share this notice with everyone in your household who receives benefits from Preferred.

Your Privacy Rights

The law gives you the right to:

• View or receive a copy of the health information Preferred has about you, in most situations.
• Ask Preferred to correct certain information, including certain health information, about you if you believe the information is wrong or incomplete. Most of the time, Preferred cannot change or delete information, even if it is incorrect. However, if Preferred decides it should make a change, it will add the correct information to the record and note that the new information takes the place of the old information. The old information will remain in the record. If preferred denies your request to change the information, you can have your written disagreement placed within the record.
• Request a list of the times Preferred has disclosed health information about you.
• Ask Preferred to limit the use or disclosure of health information about you more than the law requires. However, the law does not require Preferred to adhere.
• Request a list of the times Preferred has disclosed health information about you.
• Withdraw permission you have given Preferred to use or disclose health information that identifies you, unless Preferred has already taken action based on your permission. You must withdraw your permission in writing. Preferred’s duty is to protect health information that identifies their clients. The law requires Preferred to protect the privacy of health information that identifies you. It also requires Preferred to give you this notice of its legal duties and privacy practices.
• In most situations, Preferred may not use or disclose health information that identifies you without your written permission. This notice explains when Preferred may use or disclose health information that identifies you without your permission.
• For all other uses and disclosures, Preferred must obtain your written permission, which you may withdraw at any time.
• If Preferred changes it’s Privacy Practices, they must notify you of the changes by mailing a new Privacy Notice to the most recent address you have given. Preferred will mail the new Privacy Notice within 60 days of the changes. The new practices will apply to all the health information Preferred has about you, regardless of when preferred received or created the information. Preferred employees must protect the privacy of health information that identifies you as part of their job description with Preferred. Preferred does not give employees access to health information unless they need it for a business reason. Business reasons for needing access to health information could include: making benefit decisions, paying bills and/or planning for the caregiver's needs. Preferred will punish employees who do not protect the privacy of health information that identifies you.

If you have questions about this notice or need more information about your privacy rights, you may contact The Medicaid hotline at 1.800.252.8263.

If you believe Preferred has violated your privacy rights, you may file a complaint by contacting the Medicaid hotline at 1.800.252.8263. You may also file a complaint with the:

• Region VI, Office of Civil Rights, U.S. Department of health and Human Services by mail at 1301 Young Street, Dallas, Texas 75202, by telephone at 214.767.4056, by TDD at 214.7678940 or by fax at 214.767.0432
• Secretary of Health and Human Services, U.S. Department of Health and Human Services, 200 Independence Ave, SW Washington DC 20201

There will be no retaliation for filing a complaint.

How Preferred Therapy Services Uses and Discloses Health Information that Identifies You

Payment

Preferred may use or disclose health information about you to pay or collect payment for your health care. For example when your doctor sends a bill to Medicaid, it includes information about your illness and treatment.

Health Care Operations

Preferred may use or disclose health information about you for health care operations. Health care operations include:

• Conducting quality assessment and improvement activities
• Reviewing the competence, qualifications, and performance of health care professionals or health plans;
• Training healthcare professionals and others
• Conducting accreditation, certification, licensing or credentialing activities
• Carrying out activities related to the creation, renewal, or replacement of a contract for health insurance or health benefits
• Providing medical reviews, legal services, or auditing functions
• Engaging in business management or the general administrative activities of the Agency. Examples of uses and disclosures for health care operations include using or disclosing health information for case management, surveying nursing homes, or making sure providers bill only for the care you actually receive. Preferred may also contact you to tell you about treatment alternatives or additional benefits you may be interested in.

Family Member, Other Relative or Close Personal Friend

Preferred may disclose health information about you to a family member, other relative or close personal friend when:

• The health information is related to that person’s involvement with your care or payment for your care
• You have had an opportunity to stop or limit the disclosure before it happens. Preferred may not disclose mental health records about you or information that identifies you as seeking or receiving substance abuse services to family member, relatives or friends without your written permission or the written permission of your guardian.

Government Programs Providing Public Benefits

Preferred may disclose health information about you to another government agency offering public benefits if:

• The information relates to whether you qualify for or are signed up for Medicaid or the Children’s Health Insurance Program and the law requires or specifically allows the disclosure
• The other government agency has the same privacy protections as Preferred, has programs that serve similar types of people and the disclosure is needed to coordinate or improve how the programs are run

Health Oversight Activities

Preferred may sometimes use or disclose health information about you for Health Oversight Activities which include looking into:

• Medicaid Fraud
• Whether a Nursing Home is providing adequate care
• Whether a Nurse Aide injured a Nursing Home Resident

Preferred may disclose health information for Oversight Activities only to another Health Oversight Agency. A Health Oversight Agency must be a government agency or someone acting on behalf of a government agency.

Public Health

Preferred may disclose health information about you to:

• A public health authority for purposes of preventing or controlling disease, injury or disability
• An official of a foreign government agency who is acting with the public health authority
• A government agency allowed to receive reports of child abuse or neglect

Victims of Abuse, Neglect or Domestic Violence

If Preferred believes you are the victim of abuse, neglect or domestic violence, the agency may disclose health information about you to a government agency that receives reports of abuse, neglect, or domestic violence if:

• A law requires the disclosure
• You agree to the disclosure
• A law allows the disclosure and the disclosure is needed to prevent serious harm to you or someone else
• A law allows the disclosure, you are unable to agree or disagree, the information is needed for immediate action, and the information will not be used against you. If Preferred makes a report under this section, Preferred will tell you or your representative about the report unless, it believes that telling you would place you at risk of harm. Preferred will not disclose information that identifies you as seeking or receiving substance abuse services

Serious Threat to Health or Safety

Preferred may use or disclose health information about you if it believes the use or disclosure is needed:

• To prevent or lessen a serious and immediate threat to the health and safety of a person or the public
• For law enforcement authorities to identify or catch an individual who has admitted participating in a violent crime that resulted in serious physical harm to the victim, unless the information was learned while initiating or in the course of counseling or therapy
• For law enforcement authorities to catch an individual who has escaped from lawful custody. DSHS will not disclose information that identifies you as seeking or receiving substance abuse services

For Other Law Enforcement Purposes

Preferred may disclose health information about you to a law enforcement official for the following law enforcement purposes:

• To comply with a grand jury subpoena
• To comply with an administrative request, such as a civil investigative demand, if the information is relevant to an investigation that relates to the administration of one of the Agency’s programs
• To identify and locate a suspect, fugitive, witness or missing person
• In response to a request for information about an actual suspected crime victim
• To alert a law enforcement official of a death that an Agency suspects is the result of criminal conduct
• To report evidence of a crime on an Agency’s property

Preferred will not disclose information that identifies you as seeking or receiving substance abuse services

For Judicial or Administrative Proceedings

An agency may disclose health information about you in response to:

• An order from a regular or administrative court
• A subpoena or other discovery request by a party to a lawsuit when that Agency or another Agency is a party to the lawsuit. Preferred will not disclose information that identifies you as seeking or receiving substance abuse services

As Required by Law

Preferred must use or disclose health information about you when a law requires the use or disclosure.

Contractors

Preferred may disclose health information about you to their contractors if the contractor: needs the information to perform services for Preferred and agrees to protect the privacy of the information.

Research

Preferred may use or disclose health information about you for research board approves the use. The board will ensure that your privacy is protected when your health information is used in research. Your health information may also be used to allow a researcher to prepare for research, as long as the researcher agrees to keep the information confidential or after you die, for research that involves information about people who have died.

Other Uses and Disclosures

Preferred may use or disclose health information about you:

• To create health information that does not identify any specific individual
• To the U.S. Military or a foreign military for military purposes, if you are a member of the group asking for information
• For purposes of lawful national security activities
• To federal officials to protect the President and others
• To a prison or jail, if you are an inmate of that prison or jail, or to law enforcement personnel if you are in custody
• To comply with workers’ compensation laws or similar laws
• To tell or help in telling a family member or another person involved in your care about your location, general condition, or death. Preferred may not disclose mental health records about you or information that identifies you as seeking or receiving substance abuse services to a family member or anyone without your written permission or the written permission of your guardian