Notice of Privacy Practices

Effective date: [Month Day, Year]

Draft for attorney review. Replace bracketed items and have a healthcare attorney licensed in your state review before publishing.

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.

This notice applies to Direction Recovery Medical Group, PLLC and Direction Recovery, Inc. (together, "Direction Recovery," "we"). Because we provide substance use disorder treatment, your records are protected by two federal laws: the Health Insurance Portability and Accountability Act (HIPAA) and the federal confidentiality regulations for substance use disorder records at 42 CFR Part 2. Part 2 gives your treatment records extra protection: in most cases we cannot tell anyone that you are a patient here, or share your records, without your written consent.

Our responsibilities

We are required by law to keep your health information private and secure.
We must tell you promptly if a breach occurs that may have compromised your information.
We must follow the practices described in this notice and give you a copy of it.
We will not use or share your information other than as described here unless you tell us in writing that we may. You may change your mind at any time by telling us in writing.

How we may use and share your information

With your written consent

Under 42 CFR Part 2, most disclosures of your substance use treatment records require your written consent. This includes sharing with other health care providers, family members, employers, courts, and insurers in many situations. You may consent to a single disclosure or to ongoing disclosures for treatment, payment, and health care operations, and you may revoke consent at any time in writing, except to the extent we have already acted on it.

Without your consent, as permitted by law

Medical emergencies. To medical personnel when needed to treat a condition that poses an immediate threat to your health.
Within our program. Among our clinicians and staff who need the information to provide your care.
Business associates. To companies that help us operate, such as pharmacies, labs, e-prescribing, billing, and technology vendors, under written agreements requiring them to protect your information.
Court orders. When a court issues an order that meets the special requirements of 42 CFR Part 2, together with a subpoena or similar legal process.
Crimes on our premises or against our staff. To law enforcement, limited to the circumstances of the incident.
Child abuse or neglect. To state authorities as required by state law.
Research, audit, and program evaluation. To qualified researchers and auditors under strict conditions that prohibit re-disclosure.
Public health and safety. As permitted to prevent serious threats to health or safety, and for reporting required by law, such as to the state prescription drug monitoring program.

Things we will never do without your written authorization

Use your information for marketing purposes.
Sell your information.
Share psychotherapy notes, except as required by law.

Your rights

Get a copy of your record. Ask us in writing. We will provide a copy, usually within 30 days, and may charge a reasonable cost-based fee.
Ask us to correct your record. If you think something is wrong or incomplete, ask us in writing. We may say no, but we will tell you why within 60 days.
Request confidential communications. Ask us to contact you in a specific way, for example only by mobile phone or only at a certain address. We will honor reasonable requests.
Ask us to limit what we share. You may ask us not to share certain information. We are not required to agree, except that if you pay for a service in full out of pocket, you may ask us not to share it with your health insurer for payment purposes, and we must agree.
Get a list of disclosures. You may ask for a list of times we have shared your information, for six years before the date you ask. We will include all disclosures except those for treatment, payment, operations, and certain others.
Get a copy of this notice. Ask 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 if someone is your legal guardian, that person can exercise your rights.
File a complaint. If you think your rights have been violated, contact our Privacy Officer using the information below. You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights at 200 Independence Avenue SW, Washington, DC 20201, by calling 1-877-696-6775, or online at www.hhs.gov/ocr/privacy/hipaa/complaints. Violations of 42 CFR Part 2 may be reported to the U.S. Attorney for the district where the violation occurs. We will not retaliate against you for filing a complaint.

Changes to this notice

We may change this notice, and the changes will apply to all information we have about you. The current notice is always available on our website and on request.

Privacy Officer

[Name], Privacy Officer
Direction Recovery, Inc.
[Street address], Huntington, WV 25701
sid@directionrecovery.com
(386) 916-2117

Nondiscrimination and language assistance

Direction Recovery complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, or gender identity. We provide free aids and services to people with disabilities, such as qualified sign language interpreters and information in accessible formats, and free language services to people whose primary language is not English, such as qualified interpreters and translated materials. To request these services, call (386) 916-2117.

If you believe we have failed to provide these services or discriminated in another way, you can file a grievance with our Civil Rights Coordinator at the address above, or with the U.S. Department of Health and Human Services Office for Civil Rights (see complaint information above).

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al (386) 916-2117.