HOME CARE MEDICAL, INC. (HCM) IS REQUIRED BY LAW TO ADHERE TO A FEDERALLY MANDATED SET OF SECURITY REQUIREMENT AND PRIVACY PROVISIONS COVERING THE SHARINF AND TRANSMITTING OF PATIENT INFORMATION WHETHER WRITTE, SPOKEN OR COMPUTERIZED.
HCM reserves the right to change our privacy practices and the terms of this Notice at any time, provided such changes are permitted by applicable law. We reserve the right to make changes in our privacy practices and the new terms of our Notice effective for all health information that we maintain, including health information we created or received before the changes were made. Before a significant change is made in policy, we will change this Notice and make the new Notice available on our website at www.homecaremedical.com and upon verbal or written request.
You may request a copy of our Notice at any time. For more information about HCM’s privacy policies and practices, please refer to the contact information at the end of this Notice.
USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION (PHI)
Information that can be used to identify an individual that is directly related to that individual’s health and is used by a covered entity in electronic transactions and maintained or transferred in any medium (including paper documents) is considered PHI. HCM uses and discloses PHI about its patients for purposes of treatment, payment and healthcare operations.
Treatment: HCM may disclose information about you to a physician, nursing service or other healthcare professional involved in your care.
Payment: It may be necessary to use and disclose your healthcare information in order to obtain payment for services rendered to you or for pre-authorization purposes. This includes workmen’s compensation benefits. HCM will restrict the disclosure of PHI to health plans when patient pays for product/service 100% out-of-pocket.
Healthcare Operations: HCM may use or disclose your healthcare information as it pertains to our healthcare operations. Examples of this would be for the purposes of Performance Improvement, outcomes, analysis, evaluating professional staff performance, accreditation, certification, licensing or credentialing activities.
Business Associates: HCM may disclose your PHI to persons or organization that perform a service for or on behalf of HCM that requires the use or disclosure of PHI. Such persons or organizations are business associates of HCM.
Legal Requirements: When required by federal, state or local law, we may use or disclose your healthcare information. This may include response to a court-ordered subpoena, lawsuit proceedings and compliance with civil rights and the health care system in general. If you are an inmate of a correctional institution or under custody of law enforcement, we may disclose information for certain purposes. For example, we may disclose information necessary to provide you with healthcare.
Marketing Related Services: HCM does not sell patient data to third party sources for marketing or fundraising purposes. HCM may provide you with marketing materials in a face-to-face encounter or provide a promotional gift of nominal value. We may also contact you to give you information about certain health related products and services that may be of interest to you. However, a patient may opt out of all communications of this nature by contacting HCM.
Public Health Risks: HCM may disclose PHI to public health authorities that are authorized by law to collect information for the purpose of: reporting suspected abuse, neglect or maintaining vital records such as birth or death. Also, PHI may be disclosed in order to notify patients of potential exposure to communicable disease or risk of spreading or contracting a disease.
National Security: HCM may disclose your PHI to federal officials for intelligence or national security purposes. If you are a member of the military your PHI may be disclosed if required by appropriate command authorities.
Family and Friends: HCM may disclose your PHI to family or friends involved in your care, however, a signed authorization or legal document must be on record prior to disclosure. In instances where a patient’s authorization is unable to be obtained and good faith effort was made to determine if release of information is in patient’s best interests, HCM staff will use their professional judgment to disclose and will only disclose PHI required for immediate care or a service.
Patient Authorization: In addition to HCM’s use of your PHI for purposes of treatment, payment and healthcare operations, the patient may also give signed authorization to disclose PHI to any individual or entity. However, disclosure is not a guarantee and it will be HCM’s discretion whether or not to proceed with the disclosure.
PATIENT RIGHTS REGARDING THEIR PHI
Confidential Communication: You have the right to request that HCM communicate with you about your health and related issues in a particular manner or location. A written request must be made and HCM will attempt to accommodate all reasonable requests.
Requesting Restrictions: You have the right to request a restriction in our use and disclosure of your PHI. Additionally, you have the right to request that HCM limit the disclosures of your PHI to family and friends. HCM is not required to abide by your request but every effort will be made to accommodate. Your request must be made in writing and specify clearly the information that you want restricted, if there are limits to the use and disclosure and to whom the limits apply.
Inspection and Copies: Within 30 calendar days from written request, you have the right to inspect and obtain a copy of the PHI that is used to make decisions about you. Records will be available by appointment only and during HCM operating business hours. HCM has the right to charge for hard copies and/or electronic copies of medical records in compliance with STATUTE 146.83 (3f).
Amendment: You may ask HCM to amend your PHI if you believe it is incorrect or incomplete. To request an amendment you must submit, in writing, the reasons why the PHI should be amended. Requests for amendment may be denied by HCM if the request is for information that is undeniably correct, not part of the original records, information not created by HCM or if the amended information was not part of the PHI which you were permitted to inspect.
Accounting Disclosures: All HCM patients have the right to request an ‘accounting of discloses’ which is a list of certain disclosures HCM has made of your PHI. To obtain this accounting of disclosures, a written request must be submitted. Requests must state a time period and cannot exceed 6 years prior. Charges for requests may be issued for information greater than 12 months old. Individuals have a right to be notified when a breach of their unsecured PHI has occurred. HCM will notify clients in writing when, through a formal risk analysis, a breach has been determined to be medium-to-hisk risk.
Decendents: A decendent’s PHI is protected for 50 years after the indivdual’s death. After that point, the information is no longer considered PHI.
Right to Paper Copy: You are entitled to a paper copy of HCM’s privacy policies. If you receive this notice via a summary, our website or e-mail, you may contact HCM’s corporate offices at 1-262-786-9870 for a paper copy.
Right to File Complaint: If you believe your privacy rights have been violated, you may file a complaint with HCM or with the U.S. Department of Health and Human Services. All complaints must be made in writing and there will be not penalty for doing so.
Right to Provide Authorization: HCM will obtain your written authorization for uses and disclosures that are not identifiable by this notice or permitted by applicable law. Any authorization you provide to HCM regarding the use and disclosure of your PHI may be revoked at any time in writing. After you revoke your authorization, HCM will no longer use or disclose your PHI. However, HCM is required to retain your records of care.
HCM patients have the right to expect that their PHI will be held in the strictest confidence and will not be disclosed to entities outside the realm of care and/or payment. As your health care provider, HCM respects your expectation of privacy and has instituted safeguards with in the organization to meet this expectation. Patient records are secured and protected through various internal processes and procedures.
Consent and authorization to disclose PHI must be granted by the patient prior to performing services or submitting for third party payment of services. Consent to disclose PHI is obtained through patient authorization on the Consent for Assignment form, a signed work order receipt, order receipt confirmation (in the case of mail order shipment) and/or a signed Authorization for Disclosure of Health Information form.
Medicare Guidelines & Requirements
The products and/or services provided to you by Home Care Medical, Inc. are subject to the supplier standards contained in the Federal regulations shown at 42 Code of Federal Regulations Section 424.57(c). These standards concern business professional and operational matters (e.g. honoring warranties, and hours of operation). The full text of these standards can be obtained at http://ppecfr.gpoaccess.gov . You may also obtain a summary of the supplier standards by contacting Home Care Medical’s corporate office at 262-786-9870, ext. 205.
CAPPED RENTAL ITEMS
- Medicare classifies certain pieces of medical equipment as a capped rental.
- With a capped rental, Medicare will pay a monthly rental fee not to exceed 13 months, after which ownership of the equipment is transferred to the Medicare beneficiary.
- Once ownership of the equipment is transferred to the Medicare beneficiary, it is the beneficiary’s responsibility to arrange for any required equipment service or repair.
- Examples of equipment considered capped rental are: hospital beds, wheelchairs, alternating pressure pads, nebulizers, suction pumps, continuous airway pressure (CPAP) devices, patient lifts, and trapeze bars. Items in this category typically have a value of greater than $150.00.
INEXPENSIVE OR ROUTINELY PURCHASED ITEMS (IRE)
- According to Medicare Supplier Standards, equipment in this category can be purchased or rented. Examples of equipment considered to be inexpensive or routinely purchased include: canes, walkers, commode chairs, home blood glucose monitors, seat lift mechanisms, traction equipment, etc.
- Home Care Medical has chosen, in compliance with Medicare guidelines, to only provide IRE items as a purchase. If a beneficiary wants to obtain an IRE as a rental, the beneficiary will need to contact another durable medical equipment provider.
Capped rentals and purchases will be listed on delivery tickets as either a ‘delivery rental’ or ‘delivery purchase’ to designate the category of the product(s) provided.
For products dispensed out of a consignment closet (i.e., received directly from clinic, hospital emergency room, etc.), the beneficiary is notified of the rental or sale classification through the written information the beneficiary receives at the time the equipment is dispensed.
Updated: October 2013