Comprehensive Care Management

NOTICE OF PRIVACY PRACTICES

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

We are required by law to protect the privacy of your health information, and to provide you with a copy of this Notice which describes the health information privacy practices of the Comprehensive Care Management Corporation (CCMC), the Beth Abraham Health Services Long Term Home Health Care Program and the Comprehensive Care Management Diagnostic and Treatment Center, Inc. and affiliated providers that provide health care services jointly with these programs. We are also required to abide by the terms of the Notice currently in effect. You will also be able to obtain a copy by accessing our website at www.comprehensivecaremanagement.com, calling our office at (718) 652-1151 or asking for a copy at the time of your next medical visit.

WHO IS COVERED BY THIS NOTICE?

CCMC arranges for health care to patients jointly with physicians and other health care professionals and organizations. This Notice applies to our use and disclosure of your health information for purposes of enrollment, eligibility and payment as well as our use and disclosure of your health information for purposes of providing you with treatment. The privacy practices described in this notice will be followed by:

• Any CCMC contracted health professional who treats you at any of our locations, at your place of residence, or at their office.
• Employees, medical staff, trainees, students or volunteers at any of our locations;
• Any business associates of CCM (which are described further below).

Types of Consent

General Consent. We must obtain a "general written consent" in order to use and disclose your health information to treat you, obtain payment for that treatment and conduct our health care operations. We must obtain this general written consent the first time we provide you with treatment or services. This general written consent is a broad permission that does not have to be repeated each time we provide treatment or services to you.

Written Authorization. Except as described in this Notice, we will obtain your written authorization before using your health information or sharing it with others outside of CCM. We will only use and disclose your health information for the purposes that are described on the written authorization. A written authorization will have an expiration date; however, you may revoke that written authorization at any time, except to the extent that we have already relied upon it. To revoke a written authorization, please write to the Privacy Officer.

HOW WE MAY USE AND DISLCOSE YOUR HEALTH INFORMATION

1. The following lists various ways in which we may use or disclose your health information for purposes of treatment, payment and health care operations.

For Treatment We will use and disclose your health information in providing you with treatment and services and coordinating your care and may disclose information to other providers involved in your care. Your health information may be used by doctors involved in your care and by nurses and home health aides as well as by physical therapists, social workers, or other persons involved in your care. For example, members of the multidisciplinary team will discuss your plan of care and contact any specialists regarding care provided to you.

For Payment We may use and disclose your health information for billing and payment purposes. We may disclose your health information to your personal representative, or to insurance or managed care companies, Medicare, Medicaid or the state agency charged with administering CCMC. For example, we may disclose health information to Medicare or the state administering agency in order to determine your continued eligibility for CCM program services. We will also require you to sign a release permitting the disclosure of personal information to Medicare, Medicaid, and the state-administering agency for these purposes as a condition of your enrollment agreement. Finally, we may share your information with other health care providers and payors for their payment activities.

Health Care Operations We may use your health information or share it with others in order to conduct our health care operations. For example, we may use your health information to evaluate the performance of our staff in caring for you, or to educate our staff on how to improve the care they provide for you. Finally, we may share your health information with other health care providers and payors for certain of their health care operations if the information is related to a relationship the provider or payor currently has or previously had with you, and if the provider or payor is required by federal law to protect the privacy of your health information.

Appointment Reminders, Treatment Alternatives, Benefits And Services. We may use your health information to contact you with a reminder that you have an appointment for treatment or services. We may also use your health information in order to recommend possible treatment alternatives or health-related benefits and services that may be of interest to you.

Fundraising Activities. We may use certain limited information to contact you in an effort to raise funds for CCM and its operations.

Business Associates. Our business associates are individuals and organizations that carry out functions or activities on our behalf that involve protected health information. We may disclose your protected health information to a contractor or business associate who needs the information to perform services for CCM. Our business associates are committed to preserving the confidentiality of this information.

2. Patient Roster

We may use your health information in, and disclose it from, our Patient Roster, or share it with family and friends involved in your care, without your written authorization. We will always give you an opportunity to object unless there is insufficient time because of a medical emergency (in which case we will discuss your preferences with you as soon as the emergency is over). We will follow your wishes unless we are required by law to do otherwise.

3. Family and Friends Involved In Your Care

If you do not object, we may share your health information with a family member, close personal friend or other person you identify who is involved in your care or payment for that care. We may also notify a family member, personal representative or another person responsible for your care about your location and general condition, or about the unfortunate event of your death. In some cases, we may need to share your information with a disaster relief organization that will help us notify these persons.

We will allow your family and friends to act on your behalf to pick-up filled prescriptions, medical supplies, X-rays, and similar forms of protected health information, unless contraindicated, when we determine, in our professional judgment, that it is in your best interest to make such disclosures.

4. Emergencies Or Public Need

   Emergencies. We may use or disclose your health information as necessary in emergency treatment situations.

   As Required By Law. We may use or disclose your health information when required by law to do so. We will notify you of these uses and disclosures if notice is required by law.

   Public Health Activities. We may disclose your health information to authorized public health officials including disclosures to prevent or control disease, injury or disability, or to report victims 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.

   Health Oversight Activities. We may disclose your health information to government agencies for activities authorized by law, such as audits, investigations, inspections and licensure actions or for activities involving oversight of the health care system. As a condition of enrollment, we will require you to sign a release permitting the disclosure of personal information to Medicare, Medicaid, and the state-administering agency for these purposes.

   Product Monitoring, Repair And Recall. We may disclose your health information to a person or company that is regulated by the Food and Drug Administration for the purpose of: (1) reporting or tracking product defects or problems; (2) repairing, replacing, or recalling defective or dangerous products; or (3) monitoring the performance of a product after it has been approved for use by the general public.

   Lawsuits and Disputes. We may disclose your health information in response to a court or administrative order. We also may disclose information in response to a subpoena, discovery request, or other lawful process; efforts must be made to contact you about the request or to obtain an order or agreement protecting the information.

   Law Enforcement. We may disclose your health information for certain law enforcement purposes, including, for example, to comply with reporting requirements; to comply with a court order, subpoena, warrant, or similar legal process; or to answer certain requests for information concerning crimes.

   To Avert A Serious Threat To Health Or Safety. We may use your health information or share it with others when necessary to prevent a serious and imminent threat to your health or safety, or the health or safety of another person or the public. In such cases, we will only share your information with someone able to help prevent the threat.

   Military, Veterans and other Specific Government Functions. If you are a member of the armed forces, we may use and disclose your health information as required by military command authorities. We may disclose health information to authorized federal officials for national security purposes, or to conduct special investigations, or as needed to protect the President of the United States or certain other officials.

   Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release health information about you to the correctional institution or law enforcement official if necessary to provide you with health care, to protect your health and safety or the health and safety of others; or for the safety and security of the correctional institution.

   Coroners, Medical Examiners, Funeral Directors, Organ Procurement Organizations. We may release your health information to a coroner, medical examiner, funeral director or, if you are an organ donor, to an organization involved in the donation of organs, eyes and tissue.

   Disaster Relief. We may disclose your health information to public or private entities authorized by law or by charter to assist in disaster relief efforts.

   Research. We may use or disclose your health information for research purposes if a review board has approved such action based on a determination that the research will cause minimal risk to you and to your privacy. When required, we will obtain a written authorization from you prior to using your health information for research.

5. Completely De-identified Or Partially De-identified Information

   We may use and disclose your health information if we have removed any information that has the potential to identify you so that the health information is "completely de-identified". We may also use and disclose "partially de-identified" health information about you if the person who will receive the information signs an agreement to protect the privacy of the information as required by federal and state law.

6. Incidental Disclosures

   While we will take reasonable steps to safeguard the privacy of your health information, certain disclosures of your health information may occur during, or as an unavoidable result of, our otherwise permissible uses or disclosures of your health information. For example, during the course of a treatment session, other patients in the treatment area may see or overhear discussion of your health information.

7. Special Protections

Special privacy protections apply to HIV-related information, alcohol and substance abuse treatment information, mental health information, and genetic information. Some parts of this general Notice of Privacy Practices may not apply to these types of information.

YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION

Listed below are your rights regarding your health information. Each of these rights is subject to certain requirements, limitation and exceptions. Exercise of these rights may require submitting a written request to CCM. At your request, CCM will provide reasonable assistance to you in exercising these rights. You have the right to:

1. Request Restrictions You have the right to request restrictions on the way we use and disclose your health information to treat your condition, collect payment, or run our health care operations. You also have the right to request restrictions on the health information we disclose about you to a family member, or other person who is involved in your care or the payment for your care. To request restrictions please write to the Privacy Officer. Your request should include: a) what information you want to limit; b) whether you want to limit how we use the information, how we share it with others, or both; and c) to whom you want the limits to apply.

   We are not required to agree to your request for a restriction, and in some cases the restriction you request may not be permitted under law. However, if we do agree, we will be bound by our agreement unless the information is needed to provide you with emergency treatment or comply with the law. Once we have agreed to a restriction, you have the right to revoke the restriction at any time. Under some circumstances, we will also have the right to revoke the restriction as long as we notify you before doing so; in other cases, we will need your permission before we can revoke the restriction.

2. Access Your Personal Health Information You have the right to inspect and obtain a copy of your clinical or billing records or other written information that may be used to make decisions about your care, subject to some exceptions. Your request must be made in writing. In most cases we may charge a reasonable fee for our costs in copying and mailing your requested information. The standard fee is $0.75 per page and must generally be paid before or at the time we give the copies to you.
   
   
3. Request Amendment You have the right to request amendment of your health information maintained by CCM if you believe it is inaccurate or incomplete and for as long as the information is kept in our records. Your request must be made in writing and must state the reason for the requested amendment.

We may deny your request for amendment if the information (a) was not created by CCM, unless the originator of the information is no longer available to act on your request; (b) is not part of the health information maintained by CCM; (c) is not part of the information to which you have a right of access; or (d) is already accurate and complete, as determined by CCM.If we deny your request for amendment, we will give you a written denial including the reasons for the denial and the right to submit a written statement disagreeing with the denial. We will also include information on how to file a complaint with us or with the Secretary of the Department of Health and Human Services.

4. Request an Accounting of Disclosures You have the right to request an "accounting" of certain disclosures of your health information. This is a listing of disclosures made by CCM or by others on our behalf, but does not include disclosures for treatment, payment and health care operations (as described in Section 1 of this Notice), disclosures made pursuant to your Authorization, incidental disclosures, and certain other exceptions.

   To request an accounting of disclosures, you must submit a request in writing, stating a time period beginning after April 13, 2003 that is within six years from the date of your request. The first accounting provided within a 12-month period will be free; for further requests, we may charge you our costs.

5. Request Confidential Communications You have the right to request that we communicate with you concerning your health matters in a certain manner, for example by alternative means or at alternative locations. We will try to accommodate your reasonable requests.
   
   
6. Request a Paper Copy of This Notice You have the right to obtain a paper copy of this Notice upon request from any CCM center. You may also obtain a copy of this Notice at our website, www.comprehensivecaremanagement.com.

   Changes to This Notice

We reserve the right to change this Notice and to make the revised or new Notice provisions effective for all health information already received and maintained by CCM as well as for all health information we receive in the future. We will provide a copy of the revised Notice upon request.

FOR FURTHER INFORMATION OR TO FILE A COMPLAINT

If you have any questions about this Notice or would like further information concerning your privacy rights, please contact the Privacy Officer at (718) 652-1151.

If you believe that your privacy rights have been violated, you may file a complaint with CCM or with the Office of Civil Rights in the U.S. Department of Health and Human Services. To file a complaint with CCM, contact the Privacy Officer, at 1250 Waters Place, Tower 1, Suite 602, Bronx, NY 10461 or call (718) 652-1151. Complaints do not have to be in writing, though it is recommended. We will not retaliate or take any action against you for filing a complaint.

The privacy practices outlined in this Notice are effective in their entirety on April 14, 2003.