Information regarding your health care, including payment for health care, is protected by two federal laws: the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), 42 U.S.C. §1320d et seq., 45 C.F.R. Parts 160 & 164, and the Confidentiality Law, 42 U.S.C. § 290dd-2, 42 C.F.R. Part 2. Under these laws, Justin M. Smith may not say to anyone that you are a counseling client, nor may he disclose any information identifying you as having any disorder or problem (alcohol, drug or otherwise), or disclose any other protected information except as permitted by federal law. Justin M. Smith must obtain your written consent before he can disclose information about you for payment purposes. For example, Mr. Smith must obtain your written consent before he can disclose information to your health insurer in order to be paid for services. Generally, you must also sign a written consent before he can share information for treatment purposes or for health care operations. However, federal law permits him to disclose information without your permission:
For example, Mr. Smith can disclose information without your consent to obtain legal or financial services, or to a medical facility to provide health care to you, as long as there is a qualified service organization agreement in place. Before Mr. Smith can use or disclose any information about your health in a manner which is not described above, he must first obtain your specific written consent allowing him to make the disclosure. Any such written consent may be revoked by you in writing.
Under HIPAA you have the right to request restrictions on certain uses and disclosures of your health information. Mr. Smith is not required to agree to any restrictions you request, but if he does agree then it is bound by that agreement and may not use or disclose any information which you have restricted except as necessary in a medical emergency. You have the right to request that he communicates with you by alternative means or at an alternative location. Mr. Smith will accommodate such requests that are reasonable and will not request an explanation from you. Under HIPAA you also have the right to inspect and copy your own health information maintained by Mr. Smith, except to the extent that the information contains psychotherapy notes or information compiled for use in a civil, criminal or administrative proceeding or in other limited circumstances. Under HIPAA you also have the right, with some exceptions, to amend health care information maintained in Mr. Smith records, and to request and receive an accounting of disclosures of your health related information made by Mr. Smith during the six years prior to your request. You also have the right to receive a paper copy of this notice.
Mr. Smith’s Duties
Mr. Smith is required by law to maintain the privacy of your health information and to provide you with notice of his legal duties and privacy practices with respect to your health information. Mr. Smith is required by law to abide by the terms of this notice. He reserves the right to change the terms of this notice and to make new notice provisions effective for all protected information she maintains. He will provide this written notice at the counseling session following the change. Complaints and Reporting Violations You may make a complaint to Mr. Smith and the Secretary of the United States Department of Health and Human Services if you believe your privacy rights have been violated under HIPAA. You will not be retaliated against for filing such a complaint. Violation of the Confidentiality Law is a crime. Suspected violations of the Confidentiality Law may be reported to the United States Attorney in the district where the violation occurs.