JOINT NOTICE OF PRIVACY PRACTICES 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. A federal regulation known as the "HIPAA Privacy Rule" requires us to maintain the privacy of your "protected health information" and to provide you with this detailed written notice of our legal duties and privacy practices concerning your protected health information. Your protected health information includes any information which (a) relates to your past, present or future physical or mental health or condition, the provision of health care to you, or payment for health care provided to you; and (b) individually identifies you or can be reasonably used to identify you. This notice applies to The Regional Cancer Center, including our staff, employees and volunteers, and to the physicians, nurses, diagnostic imaging technologists and other health care professionals who provide services to patients at our facilities. The Regional Cancer Center and all of the health care professionals who provide services at our facilities are participating as an organized health care arrangement in a clinically integrated care setting under the provisions of the HIPAA Privacy Rule. As an organized health care arrangement, The Regional Cancer Center and each of the other providers of health care services will share your protected health information with each other, as necessary, to carry out treatment, payment and health care operations at the following facilities of The Regional Cancer Center: 2500 West 12th Street, Erie, Pennsylvania, 16505 1116 Park Avenue, Meadville, Pennsylvania, 16335 1245 Park Avenue, Meadville, Pennsylvania 16335 2412 Lake Avenue, Ashtabula, Ohio, 44004 Whenever the words "we" or "us" are used in this notice, they are intended to include the employees of The Regional Cancer Center and each of the other providers of health care services at the facilities of The Regional Cancer Center. If you have any questions, or would like additional information about this notice, you may contact our privacy officer at 814-838-0474, or 1-800-477-6647. I. HOW WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION A. Treatment, Payment, And Health Care Operations - We may use and disclose (release) your protected health information for treatment, payment, and health care operations without obtaining your authorization. The following section contains some examples of ways we may use and disclose your protected health information for treatment, payment and health care operations. These examples do not list every possible use or disclosure for treatment, payment, and health care operations. 1. Treatment - We may use and disclose (release) your protected health information for our treatment purposes as well as the treatment purposes of other health care providers who treat you. Treatment includes the provision, coordination, and management of health care services provided to you by one or more health care providers. Treatment also includes consultations with other health care providers. Some examples of treatment uses and disclosures include: Disclosure of your protected health information to a home health agency that provides treatment to you. Disclosure of your protected health information to another physician to whom we have referred you for care or who has referred you to us for care. Disclosure of your protected health information to a hospital or other health care facility where you are being treated. 2. Payment - We may use and disclose (release) your protected health information for the purpose of allowing us to secure payment for the health care provided to you. We may also disclose your protected health information to another health care provider for the payment activities of that health care provider. Some examples of payment uses and disclosures include: Disclosing information to your health insurer to determine whether you are eligible for coverage or whether proposed treatment is a covered service or medically necessary. Submitting a claim form to your health insurer for payment. Sending a bill to a family member or other person responsible for payment for services rendered to you. Disclosing limited protected health information to consumer reporting agencies for collection of payments owed to us. 3. Health Care Operations - We may use and disclose (release) your protected health information for conducting our health care operations. If another health care provider, company or health plan that is required to comply with the HIPAA Privacy Rule has, or has had, a relationship with you, we may disclose protected health information about you for certain health care operations of that health care provider, company, or health plan. Some examples of our health care operations include: Quality assessment activities designed to assist us in determining how to improve the medical treatment we have provided to others. Legal, accounting and auditing functions. Peer review activities, including reviewing the competence, qualifications, and performance of health care professionals. Training programs for students, trainees, health care providers or business personnel. Accreditation, certification, licensing, and credentialing activities. Taking patient photographs for identification purposes Solicitation by us or by a foundation related to us for the purpose of raising funds for our organization. B. Other Uses and Disclosures We Can Make Without Your Written Authorization Or Opportunity to Agree or Object. - We may use and disclose (release) protected health information about you in the following circumstances without your authorization or opportunity to agree or object, subject to certain conditions that may apply: 1. When Required by Law - We may use and disclose protected health information when required by federal, state, or local law. 2. For Public Health Activities - We may use and disclose protected health information to public health authorities or other persons authorized to carry out certain activities related to public health. These disclosures may include, for example, tumor registry reports and FDA-related reports and disclosures related to problems with products or services. 3. Appointment Reminders/Treatment Alternatives - We may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you. 4. Victims of Abuse, Neglect or Domestic Violence - We may use and disclose protected health information for purposes of reporting abuse, neglect or domestic violence, as for example, reports of elder abuse or abuse of a nursing home patient. 5. Health Oversight Activities - We may use and disclose protected health information for purposes of health oversight activities authorized by law. These activities could include audits, inspections, investigations, licensure actions, legal proceedings conducted by health oversight agencies. 6. Judicial and Administrative Proceedings - We may use and disclose protected health information in judicial and administrative proceedings in response to a court order, subpoena, discovery request or other lawful process. 7. Law Enforcement Purposes - We may use and disclose protected health information for certain law enforcement purposes. These purposes may include, for example, complying with a search warrant or other authorized legal process, responding to a request for information about a crime victim, or providing information regarding a crime on our premises. 8. Coroners and Medical Examiners - We may use and disclose protected health information for purposes of providing information to a coroner or medical examiner for the purpose of identifying a deceased patient, determining a cause of death, or facilitating their performance of other duties required by law. 9. Funeral Directors - We may use and disclose protected health information for purposes of providing information to funeral directors as necessary to carry out their duties. 10. Organ and Tissue Donation - If you are an organ donor, we may use and disclose protected health information to entities engaged in the procurement, banking, or transplantation of cadaveric organs, eyes, or tissue in order to facilitate transplantation. 11. Research - We may use and disclose protected health information for research purposes under certain limited circumstances. We must obtain a written authorization to use and disclose protected health information for research purposes, except in situations where a research project meets specific criteria established by the HIPAA Privacy Rule to insure the privacy of protected health information. 12. Threat to Public Safety - We may use and disclose protected health information in limited circumstances when necessary to prevent a threat to the health or safety of a person or to the public. 13. Specialized Government Functions - We may use and disclose protected health information for purposes involving specialized governmental functions such as military and veterans activities, national security and intelligence, protective services for the President and others, medical suitability determinations for the Department of State, and correctional institutions and other law enforcement custodial situations. 14. Workers' Compensation and Similar Programs - We may use and disclose 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 without regard to fault. 15. Business Associates - Some of our functions and operations involving protected health information are performed by business associates, such as accounting and law firms. We may disclose protected health information to our business associates and allow them to create and receive protected health information on our behalf. 16. Creation of De-Identified Information/ Limited Data Set - We may use protected health information in the process of de-identifying that information so that the de-identified information can be disclosed to a third without your authorization. We may also exclude certain direct identifiers in your protected health information to create information known as a "limited data set" to be used or disclosed for the purpose of research, health care operations or public health activities. 17. Disclosures Required by the HIPAA Privacy Rule - We are required to disclose protected health information to the Secretary of the United States Department of Health and Human Services when requested by the Secretary to review our compliance with the HIPAA Privacy Rule. C. Uses and Disclosures for Which You Have the Opportunity to Agree or Object - We may use and disclose protected health information about you in connection with notifications to individuals involved in your care or payment for your care. In some of those situations you may have the opportunity to agree or object to certain uses and disclosures of protected health information about you. If you agree or do not object, then we may make these types of uses and disclosures of protected health information. We may disclose protected health information about you to your family members, close friends or any other persons identified by you if that information is directly relevant to the person's involvement in your care or payment for your care. If you are present and able to consent or object (or if you are available in advance), then we may only use or disclose your protected health information if you agree to the use or disclosure or do not object after you have been informed of your opportunity to object. If you are not present or if you are unable to consent or object, we may exercise professional judgment in determining whether the use or disclosure of protected health information is in your best interest as, for example, allowing a person to act on your behalf to pick up filled prescriptions, medical supplies, x-rays or other things that contain protected health information about you. We may also use and disclose protected health information to notify your family members or close friends of your location, general condition or death. D. Confidentiality of Certain Medical Records - The confidentiality of drug and alcohol treatment records, HIV related information, and mental health records maintained by us is specially protected by Pennsylvania law. We will only disclose such information if you consent in writing, or if the disclosure is allowed by a court order, or if other limited circumstances apply. E. Other Uses and Disclosures of Protected Health Information Require Your Authorization - All other uses and disclosures of protected health information which do not fit into one of the above categories will only be made with your written authorization. If you have authorized us to use or disclose protected health information about you, you may revoke your authorization at any time, except to the extent that we have already taken action based on your authorization. II. YOUR PRIVACY RIGHTS A. Further Restriction on Use or Disclosure - You have a right to request additional restrictions on the use and disclosure of your protected health information to carry out treatment, payment or health care operations. You may also request additional restrictions on our disclosure of protected health information to persons involved in your care or the payment for your care. We are not required to agree to a request for a further restriction. If we do agree to your request, we are required to comply with our agreement, except in certain cases, including treatment of you in an emergency. To request a further restriction, you must submit a written request to our privacy officer specifying what information you want restricted; how you want the information restricted; and to whom you want the restriction to apply. Confidential Communication - You have the right to request that we communicate your protected health information to you by a certain means or at a certain location. For example, the you might request that we only contact you at home, rather than at work. We are required to accommodate requests for confidential communications that are reasonable. To make a request for confidential communications, you must submit a written request to our privacy officer specifying how or where you want to be contacted. C. Accounting of Disclosures - You have the right to request an accounting of certain disclosures that we have made of your protected health information. This accounting would be a list of disclosures made by us during a specified period of up to six years Prior to the date of the accounting was requested D. Right to Inspect and Copy - You have a right to request an opportunity to inspect and receive a copy of your protected health information in certain records that we maintain. This includes your medical and billing records, but does not include psychotherapy notes or information gathered or prepared for a civil, criminal or administrative proceeding. We may deny your request to inspect and copy protected health information only in certain limited circumstances. If you request a copy of your protected health information, we may charge you a reasonable fee as provided by Pennsylvania law. To exercise your right of access, you must submit a written request to our privacy officer. E. Right to Request an Amendment - You may request that your protected health information be amended. Your request may be denied if the information in question is accurate and complete. Your request may also be denied if the information in question was not created by us (unless the original source of the information is no longer available), is not part of our records, or is not the type of information that would be available to you for inspection or copying. If your request to amend your health information is denied, you may submit a written statement disagreeing with our denial, which we will keep on file and distribute with all future disclosures of the information to which it relates. To request an amendment, you must submit a written request to our privacy officer specifying the change that you want and the reasons for the requested change. F. Paper Copy of Privacy Notice - You have a right to receive, upon request, a paper copy of this notice at any time. To obtain a paper copy, please contact our privacy officer. III. CHANGES TO THIS NOTICE We may revise this notice at any time. We may make any revision effective for all protected health information that we maintain at the time of this revision, including information that we created or received prior to the effective date of the change. We will post a copy of our current notice in our reception area. You may also get a copy of our current notice from our privacy officer, or you may access our current notice at our web site at www.trcc.org. IV. COMPLAINTS If you believe that we have violated your privacy rights, you may submit a complaint to our Privacy Officer or to the Secretary of Health and Human Services. To file a complaint with us, submit the complaint in writing to our privacy officer. We will not retaliate against you for filing a complaint. V. LEGAL EFFECT OF THIS NOTICE This notice is not intended to create contractual or other rights independent of those created in the HIPAA Privacy Rule. VI. EFFECTIVE DATE This notice was first effective on April 14, 2003. This notice was revised July 31, 2006 and effective August 1, 2006. Return To Patient Area Page Return To Physician Area Page