NOTICE OF PRIVACY PRACTICES

Effective April 14, 2003

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.

If you have any questions, would like more information, or you do not understand this Notice of Privacy Practices (“Notice”) or our privacy practices, please contact your local Infusion Partners office and ask the manager for more information. If you cannot determine the location of the local office, please contact the Director of Quality Management at the Infusion Partners corporate office at 1-800-839-1417 for assistance.

OUR PLEDGE REGARDING MEDICAL INFORMATION

We understand that information about you and your health is personal and private, and we will do our best to protect that information. We create a record of the care and services you receive. This record helps us provide quality care and meet legal requirements. This notice covers all records of your care, whether created by field staff or staff in the office, and whether the information is on paper or stored in electronic format (computer records).

This notice will tell you about the ways in which we may use and disclose medical information about you. It also describes your rights and our responsibilities regarding the use and disclosure of your medical information.

WORDS AND TERMS TO KNOW

Business associates: People or companies who may do work for Infusion Partners, but are who are not employees of Infusion Partners

Disclose: Sharing medical information with your permission, to those who need to know

Medical Information: Health information, which may include your name, address, age, religion, and information about your care

Notice: This information handout

Provider: Companies and agencies that provide care, such as doctors, nurses, and pharmacies

HEALTH INFORMATION

Infusion Partners keeps a medical and billing record of your care. Your medical record may include your symptoms, test results, diagnoses, treatments, and a plan for future care or treatment. Your billing record may include facts about your bill and insurance. Your records also include identifying data such as your address, telephone number, Social Security number, and insurance plan. Together this is called your health information. Infusion Partners uses your health information for treatment, payment, and operations.

Your health information is used as a:

· Basis for planning your care and treatment

· Means of communication among many health professionals who help with your care

· Legal document describing the care you received

· Record by which you or your insurance company can check that the services we billed for were actually provided to you

· Source of information to:

o Improve the care we give, educate health professionals and improve the public health

o Market our services to physicians, hospitals and insurance representatives

Understanding how your health information is used helps you to:

· Ensure accuracy

· Follow the agreed-upon treatment plan

· Know who, what, when, where, and why others may use all or part of your health information

· Make a more informed decision when giving permission to share information with appropriate companies, agencies, and health care workers

YOUR HEALTH INFORMATION RIGHTS

Although your medical and billing records are the property of Infusion Partners, the information belongs to you. Infusion Partners complies with all federal and state laws and regulations about patient health information. We have policies that give you the right to request in writing your desire to:

· Right to Look at and Copy

• You may look at and get a copy or part of your health information. Infusion Partners may charge a fee for the costs of copying, mailing, or other supplies needed to meet your request.
• We may deny your request to look at and copy your health information. If we deny your request, you may request that the denial be reviewed. A licensed health care professional chosen by Infusion Partners will review your request and the denial; the person conducting this review will not be the person who denied your request. We will abide by the outcome of the review.
• Your request must be in writing and must include exactly what information you are requesting copies of, including dates of service.
• Your request must specify how you want to receive the copy, either in written or electronic format. Some records may not be available in electronic format.

· Right to Change

• You may ask us to change any information in your health information that you feel is incorrect. Your request must be in writing. In addition, you must provide a reason that supports your request for a change.
• Infusion Partners may deny your request if it is not in writing, is not accompanied by a reason that supports the change, if the information is not part of the information you would be allowed to look at and copy under the law, is not created by us, or if the information is correct and complete.

· Right to an Accounting of Disclosures.

• Receive a list of companies/agencies/persons who have received your health information. The information we provide must include: the date of disclosure, the name and address of the person or entity receiving the information, a brief description of what was disclosed, and why.
• Exceptions to this right include that you are not entitled to a list of disclosures:
• made to carry out treatment, payment, or operations
• made to persons involved in your care
• made for national security or intelligence purposes
• made to correctional officers or law enforcement officials
• made to you about your own health information.
• made because of an authorization that you made in writing (such as authorizing a release of information to an attorney).
• Your request must be in writing. Your request must state a time period that may not be longer than six (6) years and may not include dates before April 14, 2003. Your request must state how you want to receive the information (in writing, electronically, etc.). The first list of disclosures you ask for within a 12-month period will be free. We may charge you for the costs of providing additional lists. We will notify you of the cost and you may choose to remove or change your request before you pay for the request.

· Right to Request Restrictions

• You may request that Infusion Partners limits the medical information we use or disclose about you for treatment, payment, or health care operations.
• You may request that Infusion Partners limits the medical information we provide about you to someone involved in your care, such as a family member or friend.
• Your request must be in writing and must describe
• What information you want us to limit
• Whether you what us to limit our use, disclosure, or both
• Who you want the limits to apply to
• Infusion Partners does not have to agree to your request. If we do agree, we will follow your request unless the information is needed to provide emergency treatment.
• You may change or terminate your request at any time, either orally or in writing.
• We must inform you if we decide to terminate your request for a restriction. Such termination is only effective for information created or received after we have informed you that we are terminating your request.

· Right to change your mind about sharing health information except what was already shared.

· Right to a paper copy of this Notice (this request does not need to be in writing).

· Right to Ask for Private Communications

• Have us communicate with you in a certain way or at a certain location, as long as your request is reasonable.
• Your request must be in writing; you do not have to give a reason for your request.
• Your request must state how or where you wish to be contacted.
• You must include information on how payment for health services will be handled, if your request affects our ability to send billing notices to you.

Written requests for copies of health information, restrictions on disclosure of information, requests for amendments, or any other request, should be addressed to the Manager of your local Infusion Partners office as listed on the back of the Infusion Partners “Patient Orientation for Infusion Services” booklet. This will allow your request to be processed in a timely manner.

OUR RESPONSIBILITIES

Infusion Partners is required to:

· Protect the privacy of your health information

· Provide you with a current copy of the Notice of Privacy Practices

· Do what we say in this Notice

· Display the most current copy of the Notice on our website, infusionpartners.com

· Notify you if cannot agree to your written request to restrict how we disclose your health information. Infusion Partners will honor all patient information requests if possible.

We will use and share your health information only with your permission, except as described in this notice or as required by state or federal regulations.

We have the right to change this Notice and our privacy practices, and apply these changes to the health information we already have about you, and any information we receive about you in the future. A copy of the current Notice is posted on our web site, www.infusionpartners.com.

How Infusion Partners shares information for treatment, payment, and operations:

1. We will use your health information for treatment. For example,

• Information received from your doctor will be recorded in your medical record, including your diagnosis and orders for treatment
• Information obtained by a nurse or pharmacist will be recorded in your medical record and used to determine your progress and response to treatment
• We will provide your physician, nurse and any other provider involved in your care with information that may assist in your treatment.
• If you are transferred to another physician, nursing agency or home infusion provider, Infusion Partners will provide information to the new provider. These copies of your medical record will help the new provider continue your plan of care.
• Staff at different Infusion Partners offices may share your health information with one another if they need to consult about your treatment options.

2. We will use your health information for payment. For example,

• We will send a bill to you and/or your insurance company. The information may include your name, address, telephone number, Social Security number, diagnosis, prescriptions dispensed by our pharmacy, medical supplies delivered, and dates of service.
• We will give other providers the information they need for their own billing purposes. For example, if we arrange for a nurse from another company to provide care in your home, we will share the information they need to bill you or your insurance company for their services.

• Staff at different Infusion Partners offices may share your health information with one another if they need to consult about payment issues.

3. We will use your health information for Infusion Partners operations. For example,

• Infusion Partners employees may use the information in your medical record to see how you are progressing under your treatment plan.

• Your name and other information may be posted on a scheduling board within the Infusion Partners office so that nurses, pharmacists and other employees may plan a nursing visit or schedule a delivery.
• If you use our services in an Ambulatory Infusion Center (AIC), other patients in the AIC may become aware of some of your health information through incidental disclosure, such as overhearing a nurse ask you how you are tolerating your medication or seeing your name on an IV bag.
• Infusion Partners employees may access your medical record to determine the medications and medical supplies you may need in the future. This will allow us to be sure we have the needed items in stock.
• We may use your health information to review the performance of our staff.
• We may provide your health information to doctors, nurses, pharmacists, students of medical professions, and other personnel for review and learning purposes.

• Staff at different Infusion Partners offices may share your health information with one another if they need to consult about emergencies, staffing assistance, and other operational issues.
• We may contact you to request completion of a satisfaction survey and use your survey comments to improve our services

4. We will allow our business associates to use your health information if needed. We require our business associates to protect the information we provide to them. For example,

• The employees of the maker of our medical records computer software may become aware of some of your health information while providing occasional software support.
• A limited amount of your health information may be provided to a collections agency if your account is overdue.
• We will allow employees of the agency that accredits us as a home infusion provider to view your health information, so that they may grade our performance and suggest areas of improvement in our operations

5. We will give your health information to:

• A family member, relative, friend, or another person that you say is involved in your care
• Such a person may receive instructions from a nurse or pharmacist in how to care for you
• Such a person may request and receive updates about your medical condition
• Such a person may be permitted to accept deliveries of medications and/or supplies from our pharmacy department
• Persons or organizations who help pay for your care

6. We may use your health information for research. For example,

• We may use your health information for research done by Infusion Partners employees. Published research will not include your name or any other information that would allow someone to identify specifically who you are.
• If you have enrolled in a research study and have signed a consent form to participate in the study, Infusion Partners will share your health information with the study coordinator(s).

7. We may call you about appointments, treatment, or billing functions. For example,

• We may call you to schedule a nursing visit or delivery.
• We may call you to see how you are progressing with your treatment plan.
• We may call you about your insurance benefits, the status of claims with your insurance company, or to request payment on a bill from Infusion Partners.

8. We may send you written information about the opportunity to contribute funds to a Foundation, which benefits patients who cannot afford home infusion services. For example,

• After your care is completed, you may get a card or informational brochure in the mail describing the Foundation and the services it provides.

9. We may share health information about you to assist public health activities, disaster relief, or as required by law. For example,

• To prevent or control disease, injury, or disability
• Report child or elder abuse or neglect
• Report reactions to medications or problems with faulty products or equipment
• Notify people about recalls of medications or products they may be using
• Notify a person who may have been exposed to a disease or who may be at risk of getting or spreading a disease or condition
• Notify an appropriate government authority if we believe a patient has been the victim of abuse, neglect, or domestic violence. In circumstances where required by law, we must get your permission before disclosing information about you to law enforcement officials.

10. We may use your health information for Worker’s Compensation. For example,

• If you are injured on the job, we may share medical information about you for worker’s compensation or similar programs that provide benefits for, or surveillance of, work-related injuries or illness.

11. We may share your health information with a health oversight agency for activities authorized by law. For example,

• Your health information may be disclosed to an oversight agency during an audit, investigation, or inspection. Such oversight activities allow the government to monitor the health care system, government programs, and compliance with civil rights laws.

12. We may share your health information with a correctional institution. For example,

• If you are an inmate or in the custody of law enforcement, your information will be shared to provide you with health care, protect your health and safety, protect the safety of others, and assist in the security of the correctional institution.

13. We will give your health information to law enforcement if required by law, or if a reasonable person would determine that such a disclosure is necessary. Only the minimum necessary information would be disclosed. For example,

• In response to a court order, subpoena, warrant, summons, or similar process. Only the requested information would be released.
• To identify or locate a suspect, fugitive, material witness, or missing person
• If we suspect you are a victim of an accident or crime
• If death occurs, which we believe may be the result of a crime
• In an emergency to report a crime committed on the premises; the location of the crime or victims; identity of the victims; description or location of the person who committed the crime
• For intelligence, counterintelligence, and other national security activities

OTHER USES OF MEDICAL INFORMATION

Other uses of your health information that are not described in this Notice or the laws that apply to us will only be made if you agree in writing. If you give us the right to use your medical information by such a written request, you may change your mind at any time. If you do change your mind, we will no longer use your health information for the reasons covered in your written request, with the understanding that we cannot take back any information that we have already released with your written agreement, and that we are required to keep records of the care we provide.

WHERE TO SEND WRITTEN REQUESTS

Written requests (not complaints) about your health information should be directed to the manager of the Infusion Partners office that is directly involved in your care. The addresses of all Infusion Partners offices are listed on the back of the “Patient Orientation for Infusion Services” booklet that you received when you started care with Infusion Partners. If you cannot locate this booklet, or if you cannot determine which Infusion Partners office is directly involved with your care, you may call the Infusion Partners corporate office at 1-800-839-1417 and ask for assistance.

FILING A COMPLAINT

If you believe your privacy rights have been violated and you wish to file a complaint with Infusion Partners, your complaint must be made in writing to:

Directory of Quality Management

Infusion Partners Corporate Office

4623 Wesley Ave., Suite H

Cincinnati, OH 45212

If you have questions about this process, call (513) 396-6060 or 1-800-839-1417.

If you believe your privacy rights have been violated, you have the right to file a complaint in writing with the Secretary of the Department of Health and Human Services. Additional information about how to file a complaint may be found on the Office of Civil Rights web site, www.hhs.gov/ocr/hipaa/.

You will not be retaliated against for filing a complaint, nor will care or other services be withheld or diminished because you filed a complaint.

Reference: 45 CFR Part 164.520 as published in the Federal Register on August 14^th, 2002.