Notice of Privacy Practices

1. Our Commitment to Your Privacy

Keystone Health Group is committed to protecting the privacy of your health information. This Notice of Privacy Practices describes how we may use and disclose your protected health information (PHI) to carry out treatment, payment, and health care operations, and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information.

"Protected health information" is information about you, including demographic information, that may identify you and that relates to your past, present, or future physical or mental health or condition and related health care services.

2. Special Protections for Substance Use Disorder Records

Because Keystone Health Group provides substance use disorder treatment, your records are protected by additional federal confidentiality requirements under 42 CFR Part 2 (Confidentiality of Substance Use Disorder Patient Records), in addition to HIPAA. These regulations provide stronger protections than HIPAA for substance use disorder treatment records.

Under 42 CFR Part 2, we generally may not disclose that you are receiving substance use disorder treatment, or any information about your treatment, without your written consent — except in limited circumstances described below. This protection applies even to other healthcare providers, unless you provide written consent.

3. How We May Use and Disclose Your Health Information

Treatment

We may use your health information to provide, coordinate, or manage your health care and any related services. For example, we may share your health information with other healthcare providers involved in your care.

Payment

We may use and disclose your health information to obtain payment for services we provide to you. For example, we may disclose information to your health insurance company to obtain prior authorization or to bill for services rendered.

Health Care Operations

We may use and disclose your health information in connection with our health care operations, including quality assessment and improvement activities, training programs, accreditation activities, and business management.

Required by Law

We will disclose your health information when required to do so by federal, state, or local law, including reporting requirements for communicable diseases, abuse, neglect, or domestic violence.

To Avert a Serious Threat to Health or Safety

We may use and disclose your health information when necessary to prevent a serious and imminent threat to your health or safety or the health or safety of the public or another person.

4. Your Rights Regarding Your Health Information

• Right to Inspect and Copy: You have the right to inspect and copy your health information that is maintained in a designated record set. We may charge a reasonable fee for copies.
• Right to Amend: If you believe that health information we have about you is incorrect or incomplete, you may ask us to amend the information.
• Right to an Accounting of Disclosures: You have the right to request a list of certain disclosures we have made of your health information.
• Right to Request Restrictions: You have the right to request a restriction or limitation on the health information we use or disclose about you for treatment, payment, or health care operations.
• Right to Request Confidential Communications: You have the right to request that we communicate with you about medical matters in a certain way or at a certain location.
• Right to a Paper Copy of This Notice: You have the right to a paper copy of this notice at any time, even if you have agreed to receive this notice electronically.

5. Changes to This Notice

We reserve the right to change this notice and to make the revised or changed notice effective for health 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 in our facility. The notice will contain on the first page, in the top right-hand corner, the effective date.

6. Complaints

If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer or with the Secretary of the Department of Health and Human Services. You will not be penalized for filing a complaint.

To file a complaint with Keystone Health Group, contact our Privacy Officer at:
Keystone Health Group
Attn: Privacy Officer
Los Angeles, California
Phone: (800) 555-0100

7. Contact Information

If you have questions about this notice or our privacy practices, please contact our Privacy Officer at (800) 555-0100 or by mail at the address above.