Curative Notice of Privacy Practices
CURATIVE HEALTH PLAN PRIVACY NOTICE 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.
Curative respects the confidentiality of your health information. As part of our commitment to you and as required by state and federal law, we protect the privacy of your Protected Health Information (PHI). PHI is individually identifiable information about a person’s health, health care or payments, including demographic information collected from you.
As required by law, we are providing this notice to inform you how we use PHI about you and when we can share that information with others. It also informs you of your rights with respect to your health information and how you can exercise those rights.
About This Notice
This Notice applies to Curative and its affiliated entities that operate under the same privacy practice. For purposes of this Notice, Curative operates as an “Organized Healthcare Arrangement” or “OHCA” under HIPAA. This means that “Curative” includes—and this Notice applies to—(1) Curative Insurance Company; (2) Curative Medical Austin PLLC; (3) Curative Pharmacy LLC; (4) Curative Labs Inc.; (5) Curative Inc.; (6) Curative Health Holdings Inc.; (7) Curative MSO LLC; and (8) Curative Administrators LLC.
What is Protected Health Information (PHI)?
PHI is information that identifies you, and relates to your past, present or future physical and mental health or conditions, the delivery of healthcare to you, or the past present, or future payment for your healthcare. PHI includes both medical information and individually identifiable information, including your name, address, telephone number, or Social Security number. We protect this information in electronic, written, or oral formats.
We understand the importance of protecting your PHI and restrict access to authorized workforce members who need that information for your treatment, for payment purposes and for health care operations. We will not disclose your PHI without your authorization unless it is necessary to provide your health benefits, administer your benefit Plan, support Plan programs and services, or as required or permitted by law. If we need to disclose your PHI, we will follow the policies described in the Notice to protect your privacy.
How We Use Your Protected Health Information (PHI)
Curative may disclose your PHI without your written authorization, if necessary, in order to provide your health benefits for the following purposes:
Appointment Reminders - We may remind you of appointments that you have with your providers or Curative.
As Required by Law - There are state and federal laws that may require your PHI released to others without your authorization. Some of the reasons may include, but are not limited to:
We may disclose PHI to a governmental, licensing,auditing, and accrediting agency for oversight activities.
We may share information for Public Health activities.
We may disclose PHI to a government authority regarding child abuse, neglect, or domestic violence.
We may share information relative to specialized government functions, such as military and veteran activities, national security and intelligence activities, and protective services for the President of the United States and others.
We may report information to a law enforcement agency if you are a victim of a crime or if we believe you are a victim of a crime.
We may disclose PHI to Disaster Relief Organizations or Agencies that seek your PHI to coordinate your care or notify family and friends of your location or condition in a disaster. (We will provide you with the opportunity to agree or object to such a disclosure whenever we can practically do so.)
We may release information to a coroner or medical examiner for the purpose of identifying a deceased person, determining the cause of death or other duties as required by law.
Business Associates - We may disclose PHI to our business associates who perform functions for you on our behalf or provide us with services that support you if the PHI is necessary for those services.
Events and Fundraising - We may contact you to provide you with information about events and activities, including fundraising programs. If we do contact you for these activities, the communication you receive will have instructions on how you may ask for us not to contact you again for such purposes.
Health Care Operations - We may use and disclose your PHI for our health care operations supporting you. We use health information about you to develop better services for you.
Health or Safety - We may disclose your PHI to prevent or lessen a serious and imminent threat to your health or safety or the health and safety of the general public or another person.
Health Benefits and Services - We may contact you about benefits and services that we provide.
Individuals involved in your care or payment for your care - Unless you object, we may disclose PHI to a family member, friend, or other person you identify that directly relates to that person’s involvement in your care. We may disclose such information to such persons if we can infer from the circumstances that you would not object. In situations where you are not capable of giving consent (because you are not present or due to your incapacity or medical emergency, we may, using our professional judgment, determine that a disclosure to your family member or friend is in your best interest. Additionally, we may disclose information to your representative. If a person has the authority under law to make healthcare decisions for you, we will treat that representative the same way we would treat you with respect to your Protected Health Information. Parents and legal guardians are generally plan member representatives of minors unless the minors are permitted by law to act on their own behalf and make their own medical decisions.
Organ and Tissue Donation Requests – We can share health information about you with organ procurement organizations.
Payments - We may use and disclose your PHI to make coverage determinations; to make or obtain payment; and to determine and fulfill our responsibility to provide benefits. We may also disclose your PHI to another health plan or a health care provider to coordinate payment activities.
Research - We may disclose your PHI for research purposes under specific rules determined by the confidentiality provisions of applicable law. In some situations, federal law allows us to use your PHI for research without your authorization, provided we get approval from a special review board. Such research will not affect your eligibility for benefits, treatment or welfare, and your PHI will continue to be protected.
Response to lawsuits and legal actions – We can share health information about you in response to a court or administrative order, or in response to a subpoena.
Treatment - We may disclose your PHI to your healthcare provider for plan coordination; to help obtain services and treatment you may need; or to coordinate your health care and related services.
Treatment Alternatives - We may contact you to tell you about or recommend possible treatment options or alternatives that may be of interest to you.
Underwriting - We will not use or disclose your genetic information or your refusal to submit to a genetic test to reject, deny, limit, cancel, refuse to renew, increase the premiums for, or otherwise adversely affect eligibility for or coverage under the plan.
Workers’ compensation – We can use or share health information about you for workers’ compensation claims.
Uses and Disclosures of Protected Health Information (PHI) with Your Written Authorization
News gathering activities - We may contact you to discuss whether or not you want to participate in a news story for plan-related publications or eternal news media. Your written authorization is required for this disclosure of PHI. We will not use or disclose your PHI for any purpose other than those described in this Notice without your written authorization, unless authorized by state or federal law. Additionally, we are not allowed to sell or receive anything of value in exchange for your PHI without your written authorization. If you provide us authorization to use or disclose your PHI, you may revoke your authorization, in writing, at any time. However, uses and disclosures made before your withdrawal are not affected by your action and we cannot take back any disclosures we may have already made with your authorization. If your withdrawal relates to research, researchers are allowed to continue to use the PHI they have gathered before your withdrawal if they need it in connection with the research study or follow-up to the study.
Know Your Rights regarding your Protected Health Information (PHI)
You have the following rights regarding PHI maintained by Curative about you:
Right to Amend Your Records - If you feel that PHI we may have about you is incorrect or incomplete, you may request us to amend the information. You have the right to request an amendment for as long as the information is kept by or for us in enrollment, payment, claims settlement and case or medical management record systems, or that is part of a set of records that is otherwise used by us to make a decision about you. Your request must be submitted in writing, with an explanation as to why the amendment is needed. If we accept your request, we will amend your records. If we cannot change what is in the record, then we will add your supplemental information to the records. We may deny or partially deny your request if you ask us to amend PHI that:
We did not create (unless the person or entity that created the PHI is no longer available to make the amendment)
Is not part of the enrollment, payment, claims settlement, and case or medical management record systems maintained by or for us, or part of a set of records that we otherwise use to make decisions
Is not part of the information which you would be permitted to inspect and copy
Is determined by us to be accurate and complete. If we deny or partially deny your request for amendment, you have the right to submit a written rebuttal and request the rebuttal be made a part of your medical record. We have the right to file a rebuttal responding to yours in your medical record. You also have the right to request that all documents associated with the amendment request (including rebuttals) be transmitted to any other party any time the involved portion of the medical record is disclosed.
Right to Inspect and Copy Your PHI - You have the right to inspect and copy PHI about you that is maintained by us or for us in enrollment, payment, claims settlement, and case or medical management record systems, or that is part of a set of records that is otherwise used by us to make a decision. Your request to inspect or copy your PHI must be submitted to us in writing. We may charge you a reasonable fee for the costs of copying, mailing, or other supplies associated with your request. We may deny your request to inspect or copy your records in certain limited circumstances. If we deny your request, you have the right to have your request reviewed by a licensed health care professional who was not directly involved in the denial of your request.
Right to Notice of Breach - You have the right to receive written notice as soon as possible, but not later than 60 days, after any unauthorized use or disclosure that compromises the privacy and security of your PHI.
Right to Receive an Accounting of Disclosures - You have the right to receive a list of disclosures we have made of your PHI in the 6 years prior to your request. This list will not include disclosures made for treatment, payment and health care operations purposes and certain other disclosures (such as any you asked us to make). Your request must be submitted in writing and state the time period for which you want to receive the accounting, which may not be longer than 6 years. You may receive the list in paper or electronic form. The first accounting you request in a 12-month period will be of no charge. We may charge you for responding to any additional requests in that same time period. We will inform you of any costs before you will be charged anything.
Right to Receive Confidential Communications - You may ask to receive communications of your PHI from us in a certain way or at a certain location. You must make any such request in writing, and you must specify how or where we are to contact you. While we will consider reasonable requests carefully, we are not required to agree to all requests. We will not ask you the reason for your request. We must accommodate reasonable requests by you to receive communications of PHI by alternative means or at alternative locations, if you clearly state that the disclosure of all or part of that information could endanger you.
Right to Receive Paper Copy of this Notice - You have the right to a paper copy of this Notice, even if you have agreed to receive this Notice electronically. You may request a paper copy of this Notice at any time.
Right to Request Additional Restrictions - You may request restrictions on our use and disclosure of your PHI for the treatment, payment, and health care operations. You also have the right to request a limit on the PHI we disclose to someone who is involved in your care or the payment for your care, such as a family member or friend. Your request for restriction must be submitted in writing and state the specific restriction requested. We are not required to agree to your request, except as required by law. If we do agree with your request for restriction, our agreement must be in writing, and we will comply with your request unless the information is needed to provide you emergency treatment or we are required or permitted by law to disclose it. We are allowed to end a non-mandated restriction if we tell you. If we end the restriction, it will affect PHI that was created or received only after we notify you.
Checking Your Identity for Your Protection - For your protection, we may check your identity whenever you have questions about your treatment or payment activities. We will check your identity whenever you get requests to look at, copy or amend your records or to obtain a list of disclosures of your PHI.
How to Exercise Your Rights
To exercise your rights described in this Notice, send your request, in writing to our Privacy Officer address as follows:
Curative
ATTN: Privacy Officer
900 Congress Avenue
Suite 500
Austin, TX 78701
We may ask you to fill out and return to us a form that we will provide to you. If Something is Wrong, Let Us Know Right Away
If you believe that Curative has violated your privacy rights, you may file a complaint with us by calling 855-428-7284 at any time or by sending your complaint to the address shown immediately above.
You may also file a written complaint with the Secretary of the US Department of Health and Human Services (HHS). Your complaint can be sent by mail to the HHS Office of Civil Rights (OCR). To file a complaint with the Secretary, write to:
US Department of Health and Human Services
200 Independence Avenue, SW
Room 509F HHH Bldg.
Washington DC 20201
Website: www.hhs.gov/ocr/privacy/hipaa/complaints/
Phone: 1-877-696-6775
We will not take any action against you if you exercise your right to file a complaint with us or the Secretary.