HOMECARE Management Corporation is committed to keeping information about you confidential and maintaining your privacy. Under the Healthcare Insurance Portability and Accountability Act of 1996, you also have certain legal rights to privacy. 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 and ask questions about any part that you do not understand.

Protected Health Information and its use for Treatment, Payment, and Healthcare Operations

Protected Health Information (PHI) includes all confidential information which identifies you or could be used to identify you. The information may relate to your treatment and care, diagnosis, or progress. This information may be written, in a computer file, or spoken, and it may be related to your past, present or future health, health care, or payment for that health care.

When you sign our Consent for the Use and Disclosure of Protected Health Information, you consent to HOMECARE Management Corporation using and disclosing your Protected Health Information (PHI) for Treatment, Payment, and Healthcare Operations (TPO). Treatment means the provision, coordination, or management of healthcare and related services, including coordination and consultation with other providers. Payment includes activities to obtain reimbursement for services. Healthcare operations includes activities that relate to the way we carry out our business, including activities to monitor the quality of services provided and conduct internal oversight as well as Customer Service functions, such as resolving complaints.

We may also disclose your PHI to third parties who are our Business Associates. This may include such things as providing information about your health care treatment for an electronic claims processing system maintained by a business associate. In the case of treatment for mental health or substance abuse disorders or services related a developmental disability, it may include providing information to an Area Program or Local Managing Entity for MH/DD/SA Services. We will require our business associates to appropriately safeguard your PHI.

Disclosure we can make without your consent or authorization

Unless you object, we may disclose your PHI without your Consent or Authorization to those directly involved in your care, such as family members, or to others identified by you if the information is relevant to that person’s involvement with you. In addition, in an emergency or if you are incapacitated, we may rely on our professional judgment as to information to disclose. For example, if you should be in an accident and unable to speak for yourself, we may tell hospital personnel about medications you are taking.

You have the right to request a limit on the health information we use or disclose about you for treatment, payment, or health care operations. You also have the right to request a limit on the health information we disclose about you to someone who is involved in your care. To request restrictions, make your request in writing, telling us (1) what information you want to limit, (2) whether you want to limit our use, disclosure, or both, and (3) to whom you want the limit to apply. You may make this request when you sign the Consent for the Use and Disclosure of PHI or at any time in the future. Note: We are not required to agree to your request.

Disclosures we can make without your consent, authorization, or notice

There are certain other uses and disclosures of your PHI that we can make without your consent, authorization, or notice. These include disclosures required by law, disclosures relevant to public health, including child abuse agencies, disclosures about victims of abuse, neglect or domestic violent, health oversight, for judicial and administrative proceedings when there is a court order, and under warrant or judicial subpoena if the information sought is relevant and material, the specific request is reasonably limited, and information which does not reveal your identity cannot reasonably be used.

Disclosure of Minimally Necessary Information

We will make reasonable efforts to limit individually identifiable health information to that which is minimally necessary to accomplish the intended purpose. All disclosures made under a specific authorization by you will be limited to the information you describe.

Right to inspect and request amendments to PHI

With few exceptions, you have the right to inspect your PHI which is contained in a “designated record set.” This information includes your treatment and billing records or other information used in whole or in part to make decisions about your treatment and care. Information used for quality control or peer review analysis and not used to make decision about individuals is not in the designated record set.

Under certain conditions, access to the record may be denied. If this occurs, HOMECARE Management Corporation will give the reason in writing and will give you access to other PHI to the extent possible. Reasons for denial include findings by a Licensed Health Care Professional determining the access requested is likely to endanger you or another person, is reasonably likely to cause harm to another person mentioned in the PHI, or that access by your personal representative is reasonably likely to cause harm to you or another person. We may also deny you access if the information was obtained from a non-health care provider under promise of confidentiality.

You may contest any denial of access to your records. If you do so, your request and the information requested will be reviewed by the CEO of HOMECARE Management Corporation or his clinically trained designee.

You also have the right to request that we amend your record. This request must be in writing and must include your justification for the amendment.

If we agree to your request, we will make the amendment and inform you that we have done so. We will also inform others who may have relied on the PHI. If another healthcare provider notifies us that they have amended the information they provided us, we will also make the amendment in our records.

We are not required to amend the record if the information is accurate and complete or if it was not created by HOMECARE Management Corporation and the originator of the records is available. We are also not required to make the amendment if it is not part of the information kept by us or not information that you would be permitted to inspect.

We will usually respond to your request within 60 days, but we can extend this period for an additional 30 days. If we deny your request, we will provide you, in writing, the basis for this denial. You can file a statement disagreeing with our decision, and you may request that we provide your statement with all future disclosures of your PHI. We may prepare a rebuttal to your statement, and we will provide you with a copy of any such rebuttal.

Right to an accounting of disclosures

You have the right to request a list of disclosure that we have made to others, except those necessary to carry out health care treatment, payment or operations or disclosures we made to you. This request must be in writing and must state a time period for the accounting, which may not begin prior to April 14, 2003, and may not be longer than six years prior to the date you request the accounting.

Authorization to use or disclose PHI other than as discussed above

We will use or disclose your PHI in a manner not covered by this notice or by law only with your written authorization. This authorization must contain the specific information to be used or disclosed, the purpose of the use or disclosure, to whom the information is to be disclosed, and for what time period the authorization is valid. We will provide you with a copy of the authorization upon request. If we disclose your PHI under your authorization, there is the potential that the information will be subject to re-disclosure by the recipient and no longer protected by state or federal law. You may revoke the authorization in writing at any time except to the extent we have already acted upon it.

Complaints

If you have any concerns or complaints regarding HOMECARE Management Corporation’s use or disclosure of protected health information, you may voice this concern to any individual within the company. All employees are required to immediately document your complaint and refer it to management for investigation and follow-up. You may also voice your concerns directly to our Privacy Officer, Margaret Mason, at 888-301-6934 or to the Chief Executive Office, Rankin Whittington at 1-800-223-2841. If you do not wish to talk with any of these people, or if you are not satisfied with our response to your concerns, you may contact the North Carolina CARE-LINE at 1-800-662-7030 and they will document and investigate the complaint.

You will not be penalized or retaliated against for filing a complaint.

Right to change this notice

HOMECARE Management Corporation reserves the right to change this notice at any time and to make the revised or changed notice effective for health information we already have about you as well as any information we receive in the future. You may request a copy of the current notice at any time.