HIPAA - Matria Healthcare, Inc. Notice of Privacy Practices

NOTICE EFFECTIVE DATE: January 1, 2006

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.

This Notice of Privacy Practices applies to the healthcare components of the following Matria entities: Matria Women’s & Children’s Health, LLC, Matria of New York, Inc., Matria Healthcare of Illinois, Inc.

CONTACT INFORMATION

If you have any questions about this notice, please contact Privacy Officer, Matria Healthcare, Inc., 1850 Parkway Place, Marietta, Georgia 30067, telephone: 770- 767-8191, E-mail address: PrivacyOfficer@matria.com.

OUR PLEDGE REGARDING YOUR MEDICAL INFORMATION

We understand that information about you and your health is personal and we are committed to protecting this information. A record of the services and products you receive from Matria Healthcare, Inc. ("Matria") is created and maintained in order to provide you with quality services and to comply with certain legal requirements. This notice applies to all the records of your care created or maintained by Matria. Your record may include documents provided to Matria by your insurance company or treating physician.

This notice will tell you how we may use and disclose your health information. It also describes your rights and certain obligations we have regarding the use and disclosure of this information.

HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION

The following categories describe different ways that we may use and disclose health information. For each category we will explain what we mean and in some instances provide an example. Not every use or disclosure will be listed. However, all of the ways we are permitted to use and disclose health information will fall within one of the following categories.

Treatment

We may use your health information in the normal course of providing you with necessary services or supplies. For example, we may review your health information in order to provide you with services or supplies prescribed by your physician. We may also disclose your health information to people outside of Matria who are involved with us in providing services or supplies to you.

Payment

We may use and disclose your health information to others for purposes of receiving payment for the services or supplies you receive. For example, a bill may be sent to you or an insurance company or health plan. The information on the bill may contain information that identifies you, your diagnosis, and the service or supplies provided.

Healthcare Operations

We may use and disclose your health information for operational purposes, that is, for use by Matria staff other than those providing services or supplies. For example, your health information may be used by our quality improvement department to evaluate the performance of our staff, assess the quality of care and outcomes in your case and in similar cases and to determine how we may continually improve the quality and effectiveness of the services we provide. At times, we may remove identifiers from your health information so others may use the anonymous information to study healthcare delivery.

Appointment Reminders/Contacts

We may use and disclose your health information to contact you as a reminder that you have an appointment for treatment or to discuss with you an order of supplies. We may also use and disclose your health information in order to tell you about or recommend possible treatment options or alternatives that may be of interest to you.

Individuals Involved in Your Care or Payment for Your Care

We may release your health information to a friend or family member who is involved in your care or helps pay for your care.

Research

We may use or disclose your health information for research purposes pursuant to your signed authorization, or with institutional review board or privacy board approval.

As Required by Law

We will disclose your health information when required to do so by federal, state or local law.

To Avert a Serious Threat to Health or Safety

We will disclose medical information about you when necessary to prevent a serious threat to your health and safety or the health and safety of another person or the general public.

Government

If you are a member of the armed forces, we may disclose your health information as required by military command authorities. We may release your health information to authorized federal officials for national security activities authorized by law.

Public Health Risks

We may disclose your health information for a number of public health activities. These include disclosures:

To prevent or control disease, injury or disability;
To report births and deaths;
To report child abuse or neglect;
To report adverse events, product defects or problems, to track products, to notify patients of product recalls, and to conduct post-marketing surveillance as required by the Food and Drug Administration;
To notify your employer under limited circumstances related primarily to workplace injury or illness or medical surveillance;
To notify a person who may have been exposed to a disease or who may be at risk for contracting or spreading a disease or condition; and
To notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect or domestic violence.

Health Oversight

We may disclose your health information to a health oversight agency for health oversight activities authorized by law, which may include audits, investigations, inspections and licensure. These activities are necessary for the government to monitor the healthcare system, government programs and compliance with civil rights laws.

Lawsuits and Disputes

If you are involved in a lawsuit or a dispute, we may disclose your health information in response to a court or administrative order. We may also disclose your health information in response to a subpoena, search warrant, discovery request or other lawful process by someone else involved in the dispute.

Law Enforcement

We may disclose your health information if asked to do so by a law enforcement official:

To identify or locate a suspect, fugitive, material witness or missing person;
About the victim of a crime if, under certain limited circumstances, we are unable to obtain the person's agreement;
About a death if there is reason to believe it may be the result of criminal conduct;
About criminal conduct at any of our facilities; and
In emergency circumstances to report a crime, the location of the crime or victims, or the identity, description or location of the person who committed the crime.

Coroners/Medical Examiners/Funeral Directors

We may disclose your health information to a coroner, medical examiner or funeral director to assist them in performing their duties.

OTHER USES OR DISCLOSURES

Uses or disclosures of your health information other than those identified in this notice will be made only with your written authorization. You may revoke that authorization at any time.

YOUR HEALTH INFORMATION RIGHTS

You have the following rights regarding your health information:

To request restrictions/limitations on certain uses and disclosures of your health information. However, Matria is not required to agree to such a request;
To request that we communicate with you about health matters in a certain way. For example, you can ask that we only contact you at work or by mail;
To inspect and obtain a copy of your health record;
To receive a paper copy of this notice in addition to viewing it on our Web site at www.matria.com;
To request an amendment of incorrect or incomplete information in your health record; and
To receive an accounting of certain disclosures made to entities outside of Matria.

All requests must be submitted in writing.

COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint with Matria or with the Secretary of the Department of Health and Human Services. All complaints must be submitted in writing. Matria will investigate all complaints promptly and thoroughly. You will not be retaliated against for filing a complaint.

Forms for making any requests referenced in this notice or for filing a complaint may be obtained from our Web site at www.matria.com or by contacting Matria's Privacy Officer (see Contact Information).

MATRIA'S OBLIGATIONS TO YOU

Matria is required by law to:

Maintain the privacy of your health information;
Provide you with this notice of its legal duties and privacy practices with respect to your health information;
Abide by the terms of this notice;
Notify you if we are unable to agree to a requested restriction on how your health information is used or disclosed;
Accommodate reasonable requests you may make to communicate health information as requested; and
Obtain your written authorization to use or disclose your health information for reasons other than those listed above and permitted by law.

CHANGES TO THIS NOTICE

We reserve the right to change this notice and its practices. We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future. We will post a copy of the current notice on our Web site at www.matria.com. The notice will contain on the first page, in the top right-hand corner, the effective date. In addition, each time you register or are admitted for treatment or health care services or supplies, we will offer you a copy of the current notice in effect.

Matria Authorization for Disclosure of Protected Health Information

Matria Patient Complaint Form

Matria Request for Amendment of Health Information

Matria Request for an Accounting of Disclosures Form

Matria Request for Health Information

Matria Request for Restriction and/or Confidential Communications