Notice of Privacy Practices
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, and contact Community Care Health with any questions or concerns by phone at (855) 343-2247, or by mail at: Community Care Health Attn: Privacy Officer, P.O. Box 45026, Fresno, CA 93718.
Required by law. We may use and disclose your PHI to comply with the law.
Public health activities. We will disclose PHI when we report to a public health authority for purposes such as public health surveillance, public health investigations or suspected child abuse.
Reports about victims of abuse, neglect or domestic violence. We will disclose your PHI in these reports only if we are required or authorized by law to do so, or if you otherwise agree.
To health oversight agencies. We will provide PHI as requested to government agencies that have the authority to audit or investigate our operations.
Lawsuits and disputes. If you are involved in a lawsuit or dispute, we may disclose your PHI in response to a subpoena or other lawful request, but only if efforts have been made to tell you about the request or obtain a court order that protects the PHI requested.
Law enforcement. We may release PHI if asked to do so by a law enforcement official in the following circumstances: (a) to respond to a court order, subpoena, warrant, summons or similar process; (b) to identify or locate a suspect, fugitive, material witness or missing person; (c) to assist the victim of a crime if, under certain limited circumstances, we are unable to obtain the person’s agreement; (d) to investigate a death we believe may be due to criminal conduct; (e) to investigate criminal conduct; and (f) to report a crime, its location or victims or the identity, description or location of the person who committed the crime (in emergency circumstances).
Coroners, medical examiners and funeral directors. We may disclose PHI to facilitate the duties of these individuals.
Organ procurement. We may disclose PHI to facilitate organ donation and transplantation
Medical research. We may disclose PHI for medical research projects, subject to strict legal restrictions.
Serious threat to health or safety. We may disclose your PHI to someone who can help prevent a serious threat to your health and safety or the health and safety of another person or the general public.
Special government functions. We may disclose PHI to various departments of the government such as the U.S. military or U.S. Department of State.
Workers’ compensation or similar programs. We may disclose your PHI when necessary to comply with worker’s compensation laws.
Use the Authorization to Disclose PHI form to authorize Community Care Health to disclose selected information to selected person and/or entities.
- Was not created by us, unless the person who created the information is no longer available to make the amendment;
- Is not part of the PHI we keep about you;
- Is not part of the PHI that you would be allowed to see or copy; or
- Is determined by us to be accurate and complete.
- The list will not include disclosures we have made as authorized by law. For example, the accounting will not include disclosures made for treatment, payment and health care operations purposes (except as noted herein). Also, no accounting will be made for disclosures made directly to you, under an authorization that you provided, or those made to your family or friends. The list will not include other disclosures, including incidental disclosures, disclosures we have made for national security purposes, disclosures to law enforcement personnel or disclosures made before January 1, 2014.
- The list we provide will include disclosures made within the last six years (subject to the January 1, 2014, beginning date) unless you specify a shorter period.
- You may also request and receive an accounting of disclosures of electronic health records made for payment, treatment, or health care operations during the prior three years for disclosures made on or after January 1, 2014.
- The first list you request within a 12-month period will be free. You may be charged for providing any additional lists within a 12-month period.
If you have any questions about this Notice, would like to exercise a right described herein, please contact CCH at the phone number or address listed below. If you believe that CCH has not protected your privacy and you wish to complain, you may file a written grievance at the following address: Community Care Health – Appeals and Grievances, P.O. Box 45026, Fresno, CA 93718. Grievance forms are also available from the CCH Customer Service Team. If you need help completing the form, or you need a translation service, please contact our Customer Service Team at (855) 343-2247.