Notice of Privacy Practices

Our Responsibilities

ABC Occupational Medical Center ("we," "us") is required by the Health Insurance Portability and Accountability Act (HIPAA) and the California Confidentiality of Medical Information Act (CMIA) to protect the privacy of your health information. We must:

• Maintain the privacy and security of your protected health information.
• Give you this notice of our legal duties and privacy practices, and follow the terms of the notice currently in effect.
• Notify you promptly if a breach occurs that may have compromised the privacy or security of your information.
• Not use or share your information other than as described here unless you tell us we can in writing. You may change your mind at any time by letting us know in writing.

When California law is more protective of your privacy than federal law, we follow California law.

How We Use and Disclose Your Health Information

Treatment

We use and share your information with the physicians, nurses, technicians and other professionals who are treating you. Example: a physician treating your injury may share X-ray results with a specialist.

Payment

We use and share your information to bill and get paid by workers' compensation carriers, claims administrators, employers, health plans or other payers. Example: we send information about your visit to the workers' compensation claims administrator to receive payment.

Health Care Operations

We use and share your information to run our practice, improve your care and contact you when necessary. Example: we review records to evaluate the quality of care our staff provides.

Workers' Compensation and Employment-Related Services

Because we provide occupational health services, the following uses and disclosures are especially important for you to understand:

• Workers' compensation. We may disclose your health information as authorized by and to the extent necessary to comply with California workers' compensation laws, including to your employer, its insurer and claims administrator.
• Employer-paid examinations. When your employer has paid for an employment-related service, such as a pre-placement physical or fitness-for-duty exam, California law allows us to tell your employer about functional limitations that may affect your fitness to perform your job or entitle you to leave, without including the medical cause, unless you authorize more.
• Workplace medical surveillance. We may share findings with your employer when needed for the employer to comply with Cal/OSHA or other workplace safety requirements.
• Drug and alcohol testing. Test results are reviewed by a Medical Review Officer and reported to your employer or other authorized party as permitted by law and the consent you sign at the time of testing.

Other Ways We May Share Your Information

We are allowed or required to share your information in other ways, usually for the public good, when we meet the conditions of the law:

• When required by federal, state or local law.
• For public health and safety activities, such as reporting disease, injury or adverse reactions, and preventing a serious threat to health or safety.
• To report suspected abuse, neglect or domestic violence as required by law.
• For health oversight activities, such as audits, investigations, inspections and licensure.
• In response to a court or administrative order, subpoena or other lawful process.
• For law enforcement purposes as permitted by law.
• To coroners, medical examiners and funeral directors.
• For organ and tissue donation requests.
• For research that meets privacy law requirements.
• For specialized government functions, such as military, national security and presidential protective services.
• To business associates who perform services for us under a written agreement that requires them to protect your information.

Uses That Require Your Written Authorization

We will never sell your information, use it for marketing, or share most psychotherapy notes without your written authorization. Other uses and disclosures not described in this notice will be made only with your written authorization, which you may revoke in writing at any time, except to the extent we have already relied on it. California law may require your specific authorization before we share certain sensitive information, such as HIV test results, mental health records or substance use disorder treatment records.

Your Rights

• Get a copy of your medical record. You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. We will provide a copy or summary, usually within 30 days of your request, and may charge a reasonable, cost-based fee.
• Ask us to correct your record. You can ask us to correct health information you think is incorrect or incomplete. We may say no, but we will tell you why in writing within 60 days. California law also allows you to submit a written addendum of up to 250 words.
• Request confidential communications. You can ask us to contact you in a specific way or at a different address. We will say yes to all reasonable requests.
• Ask us to limit what we use or share. You can ask us not to use or share certain information. We are not required to agree, and we may say no if it would affect your care. If you pay for a service in full out of pocket, you can ask us not to share that information with your health plan for payment or operations, and we will say yes unless a law requires us to share it.
• Get a list of those with whom we have shared information. You can ask for a list (accounting) of the times we have shared your information for six years prior to the date you ask, who we shared it with and why. We will provide one list a year for free.
• Get a copy of this notice. You can ask for a paper copy of this notice at any time, even if you agreed to receive it electronically.
• Choose someone to act for you. If you have given someone medical power of attorney or someone is your legal guardian, that person can exercise your rights.

To exercise any of these rights, contact our Privacy Officer using the information below.

Complaints

If you believe your privacy rights have been violated, you can file a complaint with us using the contact information below. You can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/complaints. We will not retaliate against you for filing a complaint.

Changes to This Notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available on request, in our offices and on this website.

Contact Our Privacy Officer

Privacy Officer, ABC Occupational Medical Center
5300 California Avenue, Suite 105, Bakersfield, CA 93309
Phone: (661) 861-1880 · Fax: (661) 912-0444
Email: info@abcoccupational.com