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Notice of Privacy
Shreveport Fire Department – Emergency Medical Service NOTICE OF PRIVACY PRACTICES Effective September 23, 2013
IMPORTANT: 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.
The Shreveport Fire Department – Emergency Medical Service (EMS) is required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and Subtitle D of the Health Information and Technology for Economic and Clinical Health Act (HITECH) to protect the privacy of certain confidential health care information, known as Protected Health Information (PHI), to provide you with a notice of our legal duties and privacy practices with respect to your PHI, and to notify you following a breach of your unsecured PHI. EMS is also required to abide by the terms of the version of this Notice currently in effect. This Notice also provides contact information for questions and for obtaining further assistance if you need more help. EMS must also protect your medical treatment information.
Uses and Disclosure of PHI under HIPAA and HITECH: EMS may use PHI for purposes of treatment, payment and health care operations, in most cases without your written permission.
For treatment: Making PHI available for continuation of treatment.
For payment: Reimbursement for the services and/or submittals to Insurance companies / Medicaid / Medicare For health care operations: Quality assurance activities/licensing/training programs.
Uses and Disclosures of PHI Without Your Authorization under HIPAA and HITECH:
EMS is permitted to use and disclose PHI without your written HIPAA-compliant authorization for the following:
• For EMS's use in treating you /obtaining payment for services provided/EMS's health care operations activities.
• For the treatment activities of another health care provider as it pertains to your case.
• To another health care provider (hospital/insurance company/other entity) for payment activities.
• When the law requires EMS to disclose your PHI.
• For health care fraud and abuse detection or for legal compliance activities.
• To a family member/relative/close personal friend/other individual involved in your care with your verbal agreement and in certain circumstances where we are unable to obtain your agreement and believe the disclosure is in your best interests;
• To a public health authority in certain situations as required by law
• For health oversight activities.
• For judicial and administrative proceedings as required by a court or administrative order/subpoena/etc.
• For law enforcement activities in limited situations, such as warrants or locating a suspect.
• For military, national defense and security, or other special government functions.
• To avert a serious threat to the health and safety of a person or the public at large.
• For workers' compensation purposes in compliance with workers' compensation laws.
• To coroners/medical examiners/funeral directors for carrying on their duties as authorized by law.
• Organ procurement organizations (eye/tissue transplantation/etc.).
• To a correctional institution (if necessary for the health and safety of the inmate or correctional staff).
• For research projects/fundraising, but this will be subject to strict oversight and approvals.
• EMS use (EMS will not release any personal identifiers)
Any use or disclosure of PHI other than those listed above will only be made with your written HIPAA-compliant authorization. You may revoke your authorization at any time, in writing, except to the extent that EMS has already used or disclosed medical information in reliance on that authorization.
Business Associates: EMS may hire/recruit third party Business Associates (BA) to provide services needed by EMS. The BA’s, through a written contract with EMS to safeguard all PHI, may receive, create, maintain, use or disclose PHI to perform various functions on behalf of EMS or to provide certain types of services to EMS.
Patient Rights: As a patient, you have a number of rights under HIPAA and HITECH with respect to your PHI, including:
The right to access, copy or inspect your PHI. You may inspect and request copies of most medical and billing information about you that we maintain. We will normally provide you with access to this information within 30 days of your request. We may also charge you a reasonable fee to copy any medical information that you have a right to access. In limited circumstances, we may deny you access to your medical information, and you may appeal certain types of denials. If you wish to inspect or request copies of your medical information, you should contact an EMS Co-Privacy Officer as indicated at the end of this Notice.
The right to amend your PHI. You have the right to ask us to amend written medical and billing information that we may have about you. We will generally amend your information within 60 days of your request and will notify you when we have amended the information. We are permitted by law to deny your request to amend your information if we believe that the documented information in the report is correct. Requests for amendments must be made in writing to the EMS HIPAA Compliance Officer at the address indicated at the end of this Notice.
The right to request an accounting of our disclosures of your PHI. You may request an accounting from us of certain disclosures of your medical and billing information that we have made in the last six years prior to the date of your request. We are not required to give you an accounting of information we have disclosed for purposes of treatment, payment, or health care operations, or when we share your health information with our business associates, like our billing company or a medical facility from/to which we have transported you.
The right to request that EMS restrict the uses and disclosures of your PHI. Unless the law requires otherwise, you have the right to request that we restrict how we use and disclose your medical and billing information that we have about you.
The right to receive confidential communications of your PHI. A reasonable WRITTEN request may be made to have your PHI sent to an alternative location such as a post office box rather than to your home address.
The right to receive notification of breaches of your unsecured PHI. You have a right to receive notification from EMS of breaches of your unsecured PHI. If your unsecured PHI is used, disclosed, accessed or acquired in violation of the Privacy Rule so that the privacy or security of the unsecured PHI is compromised, EMS must notify you within 60 days of the breach, including a brief description of what happened, the dates of the breach and its discovery, steps that you should take to protect yourself from potential harm resulting from the breach, and a brief description of what EMS is doing to investigate the breach, mitigate losses, and protect against further breaches.
Internet, electronic and paper copies of this Notice. A copy of this notice can be found on our web site at: www.Shreveportfire.org
Your Legal Rights and Complaints. You also have the right to complain to us, or to the Secretary of the United States Department of Health and Human Services if you believe your privacy rights have been violated. You will not be retaliated against in any way for filing a complaint with us or with the government. You may direct all questions, comments or complaints to an EMS Co-Privacy Officer as indicated at the end of this Notice. Complaints must be received no later than 60 days from the date of the incident.
The EMS HIPAA Compliance Officer can be contacted for further information as follows:
EMS Office
Shreveport Fire Department
263 North Common, Shreveport La. 71101
318-673-6727 (fax) 318-673-6720 (Office)
The Shreveport Fire Department reserves the right to change the terms of this Notice at any time. Changes will be effective immediately and will apply to all PHI (Protected Health Information) that we maintain.
The Shreveport Fire Department – Emergency Medical Service (EMS) is required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and Subtitle D of the Health Information and Technology for Economic and Clinical Health Act (HITECH) to protect the privacy of certain confidential health care information, known as Protected Health Information (PHI), to provide you with a notice of our legal duties and privacy practices with respect to your PHI, and to notify you following a breach of your unsecured PHI. EMS is also required to abide by the terms of the version of this Notice currently in effect. This Notice also provides contact information for questions and for obtaining further assistance if you need more help. EMS must also protect your medical treatment information.
Uses and Disclosure of PHI under HIPAA and HITECH: EMS may use PHI for purposes of treatment, payment and health care operations, in most cases without your written permission.
For treatment: Making PHI available for continuation of treatment.
For payment: Reimbursement for the services and/or submittals to Insurance companies / Medicaid / Medicare For health care operations: Quality assurance activities/licensing/training programs.
Uses and Disclosures of PHI Without Your Authorization under HIPAA and HITECH:
EMS is permitted to use and disclose PHI without your written HIPAA-compliant authorization for the following:
• For EMS's use in treating you /obtaining payment for services provided/EMS's health care operations activities.
• For the treatment activities of another health care provider as it pertains to your case.
• To another health care provider (hospital/insurance company/other entity) for payment activities.
• When the law requires EMS to disclose your PHI.
• For health care fraud and abuse detection or for legal compliance activities.
• To a family member/relative/close personal friend/other individual involved in your care with your verbal agreement and in certain circumstances where we are unable to obtain your agreement and believe the disclosure is in your best interests;
• To a public health authority in certain situations as required by law
• For health oversight activities.
• For judicial and administrative proceedings as required by a court or administrative order/subpoena/etc.
• For law enforcement activities in limited situations, such as warrants or locating a suspect.
• For military, national defense and security, or other special government functions.
• To avert a serious threat to the health and safety of a person or the public at large.
• For workers' compensation purposes in compliance with workers' compensation laws.
• To coroners/medical examiners/funeral directors for carrying on their duties as authorized by law.
• Organ procurement organizations (eye/tissue transplantation/etc.).
• To a correctional institution (if necessary for the health and safety of the inmate or correctional staff).
• For research projects/fundraising, but this will be subject to strict oversight and approvals.
• EMS use (EMS will not release any personal identifiers)
Any use or disclosure of PHI other than those listed above will only be made with your written HIPAA-compliant authorization. You may revoke your authorization at any time, in writing, except to the extent that EMS has already used or disclosed medical information in reliance on that authorization.
Business Associates: EMS may hire/recruit third party Business Associates (BA) to provide services needed by EMS. The BA’s, through a written contract with EMS to safeguard all PHI, may receive, create, maintain, use or disclose PHI to perform various functions on behalf of EMS or to provide certain types of services to EMS.
Patient Rights: As a patient, you have a number of rights under HIPAA and HITECH with respect to your PHI, including:
The right to access, copy or inspect your PHI. You may inspect and request copies of most medical and billing information about you that we maintain. We will normally provide you with access to this information within 30 days of your request. We may also charge you a reasonable fee to copy any medical information that you have a right to access. In limited circumstances, we may deny you access to your medical information, and you may appeal certain types of denials. If you wish to inspect or request copies of your medical information, you should contact an EMS Co-Privacy Officer as indicated at the end of this Notice.
The right to amend your PHI. You have the right to ask us to amend written medical and billing information that we may have about you. We will generally amend your information within 60 days of your request and will notify you when we have amended the information. We are permitted by law to deny your request to amend your information if we believe that the documented information in the report is correct. Requests for amendments must be made in writing to the EMS HIPAA Compliance Officer at the address indicated at the end of this Notice.
The right to request an accounting of our disclosures of your PHI. You may request an accounting from us of certain disclosures of your medical and billing information that we have made in the last six years prior to the date of your request. We are not required to give you an accounting of information we have disclosed for purposes of treatment, payment, or health care operations, or when we share your health information with our business associates, like our billing company or a medical facility from/to which we have transported you.
The right to request that EMS restrict the uses and disclosures of your PHI. Unless the law requires otherwise, you have the right to request that we restrict how we use and disclose your medical and billing information that we have about you.
The right to receive confidential communications of your PHI. A reasonable WRITTEN request may be made to have your PHI sent to an alternative location such as a post office box rather than to your home address.
The right to receive notification of breaches of your unsecured PHI. You have a right to receive notification from EMS of breaches of your unsecured PHI. If your unsecured PHI is used, disclosed, accessed or acquired in violation of the Privacy Rule so that the privacy or security of the unsecured PHI is compromised, EMS must notify you within 60 days of the breach, including a brief description of what happened, the dates of the breach and its discovery, steps that you should take to protect yourself from potential harm resulting from the breach, and a brief description of what EMS is doing to investigate the breach, mitigate losses, and protect against further breaches.
Internet, electronic and paper copies of this Notice. A copy of this notice can be found on our web site at: www.Shreveportfire.org
Your Legal Rights and Complaints. You also have the right to complain to us, or to the Secretary of the United States Department of Health and Human Services if you believe your privacy rights have been violated. You will not be retaliated against in any way for filing a complaint with us or with the government. You may direct all questions, comments or complaints to an EMS Co-Privacy Officer as indicated at the end of this Notice. Complaints must be received no later than 60 days from the date of the incident.
Your Legal Rights and Complaints
You also have the right to complain to us, or to the Secretary of the United States Department of Health and Human Services if you believe your privacy rights have been violated. You will not be retaliated against in any way for filing a complaint with us or with the government. You may direct all questions, comments or complaints to an EMS Co-Privacy Officer as indicated at the end of this Notice. Complaints must be received no later than 60 days from the date of the incident.Contact Information:
The EMS HIPAA Compliance Officer can be contacted for further information as follows:
EMS Office
Shreveport Fire Department
263 North Common, Shreveport La. 71101
318-673-6727 (fax) 318-673-6720 (Office)