1. BACKGROUND
This Notice of Privacy Practices (the "Notice") describes how we may use and disclose your protected health information. This Notice also describes how you can access and control your protected health information. "Protected health information" is information that may identify you and that relates to your past, present or future physical or mental health or condition, related health care services or your past, present or future payment for health care.
We are required by law to protect the privacy of protected health information, and to provide you with a copy of this Notice, which describes our legal duties and privacy practices with respect to protected health information. Please note, we may change any of the privacy practices set forth in our Notice at any time (a "New Notice"). We are required to abide by the terms of this Notice until a New Notice becomes effective. The New Notice will be effective for all protected health information that we maintain as of the effective date of such New Notice, even if we collected or received the protected health information prior to the New Notice's effective date. A copy of our current Notice is posted at our Websites. You may request a paper copy at any time, even if you have previously agreed to receive the Notice electronically, by calling us at 1-650-690-9100 or toll free at 1-888-947-8957.
2. ACKNOWLEDGEMENT OF RECEIPT OF THIS NOTICE.
Please sign and return the form attached at the end of this Notice to acknowledge your receipt of this Notice.
3. WRITTEN AUTHORIZATION POLICY.
We will generally obtain your written authorization before using your protected health information or disclosing it to outside persons or organizations. You may revoke any written authorization you have provided to us at any time, except to the extent that we have made any use(s) or disclosure(s) of your protected health information in reliance on the authorization. To revoke an authorization, please send your request in writing with a copy of the authorization being revoked (or, if not available, a detailed description of the authorization including the date) to our Privacy Official at the address above.
4. EXCEPTIONS TO WRITTEN AUTHORIZATION POLICY.
There are some situations when we may use or disclose protected health information without prior written authorization. They are:
4.1 For Treatment, Payment and Health Care Operations.
We are allowed to use or disclose your protected health information without your prior written authorization to provide you with treatment (i.e., to provide you with health care-related products and services), collect payment for that treatment, and/or run our normal business operations. Examples of uses and disclosures for treatment, payment and health care operations are provided below.
4.2 For Disclosures To Family and Friends Involved In Your Care.
Under certain circumstances, we may disclose your protected health information to your family and friends involved in your care without your prior written authorization. More information is provided below.
4.3 In An Emergency or For Public Health.
We may use or disclose your protected health information without your prior written authorization in an emergency or for important public health needs. For example, we may share your protected health information with public health officials who are authorized to investigate and control the spread of diseases. Additional examples of emergency, public health or similar uses or disclosures of protected health information are provided below.
4.4 If Information Does Not Identify You.
We may use or disclose your health information if we have removed any information that might reveal your identity.
4.5 Research.
Under some circumstances, we may use or disclose your protected health information without your prior written authorization in connection with research activities, as further described below.
4.6 Appointment Reminders and Other Communications.
We may use or disclose protected health information without your prior written authorization to provide you or others with, among other things, (1) appointment reminders, (2) product/supply re-order notifications and/or (3) information about treatment alternatives or other health-related products, benefits and services that we provide. More information is provided below.
5. HOW TO ACCESS YOUR PROTECTED HEALTH INFORMATION.
You can request to inspect and receive a copy your protected health information. More information is provided below.
6. HOW TO CORRECT YOUR PROTECTED HEALTH INFORMATION.
You can request that we amend your protected health information if you believe it is inaccurate or incomplete. More information is provided below.
7. HOW TO KEEP TRACK OF THE WAYS YOUR PROTECTED HEALTH INFORMATION HAS BEEN SHARED WITH OTHERS.
You may request an accounting from us that provides information about when and how we have disclosed your protected health information to certain outside persons or organizations. The accounting will not include certain types of disclosures, such as disclosures pursuant to your authorization. More information is provided below.
8. HOW TO REQUEST RESTRICTIONS ON CERTAIN USES AND DISCLOSURE.
You can request that we adopt stricter privacy protections on the way we use or disclose your protected health information for certain purposes as described in more detail below. However, we are not required to agree to any requests for stricter privacy protections. Please submit your request in writing to our Privacy Official at the address above specifying the PHI and the restriction(s) being requested.
9. HOW TO REQUEST MORE CONFIDENTIAL COMMUNICATIONS.
You can request that we contact or send protected health information to you in a way that is more confidential, such as to your home instead of to your work address. We will not ask you the reason for your request, and we will try to accommodate all reasonable requests.
10. HOW SOMEONE MAY ACT ON YOUR BEHALF.
You may name a personal representative who may act on your behalf to control the privacy of your protected health information. Parents and guardians will generally have the right to control the privacy of protected health information about minors unless the minors are permitted by law to act on their own behalf.
11. HOW TO FILE A COMPLAINT.
If you believe the privacy of your protected health information has been violated, you may file a complaint with us or with the Secretary of the Department of Health and Human Services. To file a complaint with us, please contact our Privacy Official as set forth above for a copy of our standard complaint form or submit your complaint in writing to our Privacy Official. We will not retaliate or take action against you for filing a complaint.
12. WHAT HEALTH INFORMATION IS PROTECTED
We are committed to protecting the privacy of protected health information we collect about you while providing you with health-related products and services. Some examples of protected health information are:
- information about your health condition (such as your blood glucose levels);
- information about health care products or services you have received or may receive in the future (such as insulin pumps or training on the use of an insulin pump);
- geographic information (such as where you live or work);
- demographic information (such as your race, gender, ethnicity, or age);
- unique numbers that may identify you (such as your Social Security Number, your phone number, or your driver's license or state certificate number); and
- other types of information that may identify who you are.
13. HOW WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION WITHOUT YOUR WRITTEN AUTHORIZATION
13.1 Treatment, payment, and health care operations.
We may use your protected health information, disclose it to or request it from others in order to treat you (i.e., provide you with an insulin pump), obtain payment for that treatment, and run our normal business operations. Below are further examples of how your protected health information may be used or disclosed for our treatment, payment, and health care operations.
Examples of Treatment. We may use your protected health information to provide appointment reminders or to generate product re-order notifications. We may request your protected health information from or disclose your protected health information to your doctor(s) or nurse(s) who are treating you.
Examples of Payment. We may use protected health information to generate a health insurance claim, and to undertake collections of invoices. We regularly and routinely disclose protected health information to health plans or health insurance companies to obtain payment for products and services.
Example of Health Care Operations. We may use your protected health information or share it with others in order to conduct our normal business operations. For example, we may use your protected health information to process and fulfill your product or services orders.
Other Uses and Disclosures of Protected Health Information That May Be Made Without Your Prior Authorization
13.2 Friends and Family Involved in Your Care and Emergencies.
If you need emergency treatment and we are unable to obtain your consent, we may share your protected health information with a family member, relative, or close personal friend who is involved in your care or payment for that care. We may also notify, or assist others in notifying, a family member, friend, or another person responsible for your care about your location, general condition or about your death. In some cases, we may need to share your protected health information with a disaster relief organization that will help us notify these persons.
13.3 As Required By Law.
We may use or disclose your protected health information if we are required by law to do so. We also will notify you of such uses and disclosures if we are required by law to do so.
13.4 Public Health Activities.
We may disclose your protected health information to authorized public health officials (or a foreign government agency collaborating with such officials) so they may carry out their public health activities. For example, we may share your protected health information with government officials who are responsible for controlling disease, injury, or disability.
13.5 Health Oversight Activities.
We may release your protected health information to government agencies authorized to conduct audits, investigations, and inspections of our facilities. These government agencies monitor the operation of the health care system, compliance with government regulatory programs and civil rights laws.
13.6 Product Monitoring, Repair and Recall.
We may disclose your protected health information to the U.S. Food and Drug Administration to: (1) collect, report or track adverse events, product defects or problems; (2) repair, replace, or recall defective or dangerous products; or (3) monitor the performance of a product after it has been approved for use by the general public.
13.7 Lawsuits and Other Proceedings.
We may disclose your protected health information if we are ordered to do so by a court or by another properly authorized body. We may also disclose your protected health information in response to a subpoena, discovery request, or other legal request made by someone involved in the dispute, if we receive satisfactory assurances either that (1) you were notified of the request; or (2) the parties to the dispute have agreed to a qualified protective order regarding your PHI.
13.8 Law Enforcement.
We may disclose your protected health information to law enforcement officials for the following reasons:
- To comply with court orders, subpoenas, or laws that we are required to follow;
- To assist law enforcement officers with identifying or locating a suspect, fugitive, witness, or missing person;
- If you have been the victim of a crime and we determine that: (1) we have been unable to obtain your consent because of an emergency or your incapacity; (2) law enforcement officials need this information immediately to carry out their law enforcement duties; and (3) in our professional judgment disclosure to these officers is in your best interests;
- If we suspect that your death resulted from criminal conduct.
13.9 To Avert a Serious Threat to Health or Safety.
We may use or disclose your protected health information with others when necessary to prevent a serious threat to your health or safety, or to the health or safety of another person or to the public. In such cases, we will only disclose your protected health information with someone able to help prevent the threat, including the target of the threat. We may also disclose your protected health information to law enforcement officers if you tell us that you participated in a violent crime that may have caused serious physical harm to another person, or if we determine that you escaped from lawful custody.
13.10 Military and Veterans.
If you are in the Armed Forces, we may disclose protected health information about you to appropriate military command authorities for activities that they deem necessary to carry out their military mission. We may also release protected health information about foreign military personnel to the appropriate foreign military authority.
13.11 Inmates and Correctional Institutions.
If you are an inmate or you are detained by a law enforcement officer, we may disclose your protected health information to the prison officers or law enforcement officers if necessary to provide you with health care, or to maintain safety, security, and good order at the place where you are confined. This includes disclosing protected health information that is necessary to protect the health and safety of other inmates or persons involved in supervising or transporting inmates or detainees.
13.12 Workers' Compensation.
We may disclose your protected health information as authorized by and to the extent necessary to comply with laws relating to workers' compensation or similar programs that provide benefits for work-related injuries or illness.
13.13 Coroners, Medical Examiners, and Funeral Directors.
Should you die, we may disclose your protected health information to a coroner or medical examiner. This information may be necessary, for example, to determine the cause of death or for identification purposes. We may also release your protected health information to funeral directors as necessary to carry out their duties.
13.14 Organ Donation.
We may use or disclose protected health information to organ procurement organizations or other entities engaged in the procurement, banking, or transportation of cadaveric organs or other body parts for the purpose of facilitating donation and transplantation.
13.15 Research.
In most cases, we will ask for your written authorization before using or disclosing your protected health information with others in order to conduct research. However, under some circumstances, we may use and disclose your protected health information without your prior authorization if we obtain approval through a special review process to ensure that research without your authorization poses minimal risk to your privacy. Under no circumstances, however, would we allow researchers to use your name or identity publicly. We may also use or disclose protected health information for research purposes if we remove certain information that may directly identify you such as your name, telephone number, Social Security number, medical record number and account number. We may also release your protected health information without your prior written authorization to people who are preparing a future research project, so long as any information identifying you does not leave our premises. If you die, we may share your protected health information with people who are conducting research using the information of deceased persons, so long as they agree not to remove from our offices any information that identifies you.
13.16 As Requested by the Secretary.
We are required to disclose protected health information to the Secretary of the U.S. Department of Health and Human Services, or any officer or employee thereof, in connection with any investigation by the Secretary into our privacy practices.
13.17 Victims of Abuse, Neglect, or Domestic Violence.
We may release your protected health information to a public health authority who is authorized to receive reports of abuse, neglect, or domestic violence. We will make every effort to obtain your permission before releasing this information, but in some cases we may be required or authorized to act without your permission.
13.18 Marketing.
We may use or disclose your protected health information (including disclosures to other companies) to make marketing communications to you, or to others, about the health-related products and services that we provide, and about alternative treatments, therapies, health care providers, or settings of care that may be of interest to you.
14. HOW YOU CAN ACCESS AND CONTROL YOUR PROTECTED HEALTH INFORMATION
The following describes the actions you may take with respect to the protected health information that we maintain.
14.1 Inspect and Copy Records.
You may request to inspect and obtain a copy of any of your protected health information that may be used to make decisions about you and your treatment for as long as we maintain this information in our records. This includes medical and billing records. Under federal law, however, you may not inspect or copy the following: (1) information compiled in reasonable anticipation or, or use in, legal proceedings; or (2) protected health information that is subject to a law that prohibits access to protected health information.
To inspect or obtain a copy of your protected health information, please complete and submit our Request for Access to Protected Health Information form to the Patient Services Department. For a copy of the Request for Access to Protected Health Information form, please call us at 1-650-690-9100 or toll free at 1-888-947-8957. If you request a copy of your protected health information, we may charge a fee for the costs of copying, mailing, or other supplies we use to fulfill your request.
