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Notice of Privacy Practices

By law, USAble Life is required to protect the privacy of your protected health information. We must also give you this Notice to tell you how we may use and give out (“disclose”) your protected health information held by us. “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. We are required to abide by the terms of this Notice of Privacy Practices. We may change the terms of our Notice at any time. The new Notice will be effective for all protected health information that we maintain at that time. It will be available upon request and on our website.

1. Use and Disclosure of Protected Health Information

Following are examples of the types of uses and disclosures of your protected health information that USAble is permitted to make. These examples are not meant to be exhaustive, but to describe the types of uses and disclosures that we may make.

Treatment: We will use and disclose your protected health information to provide, coordinate, or manage your health care and any related services. This includes the coordination of your health care with another provider. For example, we would disclose your protected health information, as necessary, to a physician or hospital that provides care to you.

Payment: Your protected health information will be used and disclosed, as needed, to obtain payment for your health care services provided by us or by another provider. This may include responses to inquiries regarding invoices for the health care services we provide.

Health Care Operations: We may use or disclose your protected health information in order to support our business activities, including for quality assessment, employee review, training and conducting or arranging for other business activities. We also may share your protected health information with third-party “business associates” that perform various activities for us. We will have a written contract with business associates to protect the privacy of your protected health information. We may use or disclose your protected health information, as necessary, to provide you with information about our services or other health-related benefits and services that may be of interest to you; you may contact our Privacy Officer to opt out of receiving these materials.

Other Permitted and Required Uses and Disclosures That May Be Made Without Your Authorization or Opportunity to Agree or Object

These situations include:

Required by Law: We may use or disclose your protected health information to the extent that the use or disclosure is required by law. The use or disclosure will be made in compliance with the law and will be limited to the relevant requirements of the law.

Public Health: We may disclose your protected health information for public health activities and purposes to a public health authority that is permitted by law to collect or receive the information. For example, a disclosure may be made for the purpose of preventing or controlling disease.

Communicable Diseases: We may disclose your protected health information, if authorized by law, to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading the disease or condition.

Health Oversight: We may disclose protected health information to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections. Oversight agencies seeking this information include government agencies that oversee the health care system, government benefit programs, other government regulatory programs and civil rights laws.

Abuse or Neglect: We may disclose your protected health information if we believe that you have been a victim of abuse, neglect or domestic violence to the governmental entity or agency authorized to receive such information. In this case, the disclosure will be made consistent with the requirements of applicable federal and state laws.

Food and Drug Administration: We may disclose your protected health information to a person or company required by the Food and Drug Administration for the purpose of quality, safety, or effectiveness of FDA-regulated products or activities including: to report adverse events, product defects or problems, biologic product deviations, or to track products; to enable product recalls; to make repairs or replacements, or to conduct post marketing surveillance, as required.

Legal Proceedings: We may disclose protected health information in the course of any judicial or administrative proceeding, in response to an order of a court or administrative tribunal (to the extent such disclosure is expressly authorized), or in certain conditions in response to a subpoena, discovery request or other lawful process.

Law Enforcement: We may also disclose protected health information, so long as applicable legal requirements are met, for law enforcement purposes.

Coroners, Funeral Directors, and Organ Donation: We may disclose protected health information to a coroner, medical examiner or funeral director to assist them in performing their legally-authorized duties.

Research: We may disclose your protected health information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your protected health information.

Criminal Activity: Consistent with applicable federal and state laws, we may disclose your protected health information if we believe that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public. We may also disclose protected health information if it is necessary for law enforcement authorities to identify or apprehend an individual.

Military Activity and National Security: When the appropriate conditions apply, we may use or disclose protected health information of individuals who are Armed Forces personnel (1) for activities deemed necessary by appropriate military command authorities; (2) for the purpose of a determination by the Department of Veterans Affairs of your eligibility for benefits; or (3) to a foreign military authority if you are a member of that foreign military services. We may also disclose your protected health information to authorized federal officials for conducting national security and intelligence activities, including for the provision of protective services to the President or others legally authorized.

Workers’ Compensation: We may disclose your protected health information as authorized to comply with workers’ compensation laws and other similar legally established programs.

Minors: We may share a minor’s health information with the minor’s parents or guardians unless such disclosure is prohibited by state or federal law.

Uses and Disclosures of Protected Health Information Based upon Your Written Authorization

Other uses and disclosures of your protected health information will be made only with your written authorization, unless otherwise permitted or required by law as described below. For example, uses or disclosures for certain marketing activities or that constitute a sale of your protected health information will be made only with your written authorization, unless otherwise permitted or required by law. You may revoke any authorization in writing at any time. If you revoke your authorization, we will no longer use or disclose your protected health information for the reasons covered by your written authorization. Please understand that we are unable to take back any disclosures that you previously authorized.

Other Permitted and Required Uses and Disclosures That Require Providing You the Opportunity to Agree or Object

Unless you object, we may disclose to a member of your family, a relative, a close friend or any other person you identify, your protected health information that directly relates to that person’s involvement in your health care, if any. Finally, we may use or disclose your protected health information to an authorized public or private entity to assist in disaster relief efforts and to coordinate uses and disclosures to family or other individuals involved in your health care. If you are not present or able to agree or object to the use or disclosure of the protected health information, then your caregiver may, using professional judgement, determine whether the disclosure is in your best interest.

Other Legal Requirements

State and federal laws may provide additional protection of some of your protected health information. For example, we may need to obtain your authorization for a court order to disclose certain sensitive information, such as information regarding mental health or substance use disorder treatment. We also may need to obtain your permission to disclose protected health information to certain state-sponsored registries.

2. Your Rights Regarding Medical Information About You

By law, you have the right to:

  • See and get a copy of your protected health information that is contained in a designated record set that was used to make decisions about you. This means you may inspect and obtain a copy of protected health information about you. You may access or obtain your records, including medical and billing records and any other records that [Insert Practice] uses for making decisions about you. As permitted by federal and state law, we may charge you a reasonable copy fee for a copy of your records. If legally permitted, [Insert Practice] may deny access to certain information, including information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding. In some circumstances, you may have a right to have this decision reviewed. Please contact us using the information below if you have questions about access to your medical record.
  • Have your protected health information amended if you believe that it is wrong, or if information is missing, and USAble Life agrees. If USAble Life disagrees, you may request to have a statement of your disagreement added to your protected health information record. We may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal. Please contact us using the information below about amending your medical record.
  • Receive an accounting of certain disclosures of your protected health information from USAble Life. This right applies to disclosures for purposes other than treatment, payment or health care operations as described in this Notice of Privacy Practices. It excludes disclosures we may have made to you if you authorized us to make the disclosure, to family members or friends involved in your care, or for notification purposes, for national security or intelligence, to law enforcement or correctional facilities, or as part of a limited data set disclosure. The right to receive this information is subject to certain exceptions, restrictions and limitations.
  • Ask USAble Life to communicate with you in a different manner or at a different place. We will accommodate reasonable requests. We may also condition this accommodation by asking you for information as to how payment will be handled or specification of an alternative address or other method of contact. Please make this request using the contact information below.
  • Request that USAble Life limits how your protected health information is used and disclosed. This means you may ask us not to use or disclose any part of your protected health information for the purposes of treatment, payment or health care operations. You may also request that any part of your protected health information not be disclosed to family members or friends who may be involved in your care or for notification purposes. We are not required to agree to a restriction except if you request to restrict disclosure of your protected health information to a health plan, if (i) the disclosure is for payment or other health care operations purposes and is not otherwise required by law and (ii) the information pertains solely to a health care item or service for which you paid USAble Life in full. If USAble Life does agree to the requested restriction, we may not use or disclose your protected health information in violation of that restriction unless it is needed to provide emergency treatment. You may request a restriction by contacting us using the information below.
  • You have the right to obtain a paper copy of this notice from us, upon request, even if you have agreed to accept this notice electronically.
  • You have the right to be notified of a breach of unsecured protected health information that affects you.

To Exercise Your Rights

If you would like to contact USAble Life for further information regarding this notice or the exercise of any of the rights described in this notice, you may do so by contacting our Privacy Office at the following telephone numbers: (501) 212-8871 (Little Rock) or (800) 648-0271 (toll-free).

Complaints

If you believe your privacy rights have been violated, you may file a complaint with USAble Life or with the Secretary of the Department of Health and Human Services. You may file a complaint with USAble Life by writing to the following address:

USAble Life
ATTN: Privacy Officer
P.O. Box 1650
Little Rock, AR 72203-1650

Or electronically to:privacyofficer@usablelife.com

We will not penalize or in any way retaliate against you for filing a complaint with the Secretary or with us.

You may also file a complaint with the Secretary of the U.S. Department of Health and Human Services. Complaints filed directly with the Secretary must: 1) be in writing; 2) contain the name of the entity against which the complaint is lodged; 3) describe the relevant problems; and 4) be filed within 180 days of the time you became or should have become aware of the problem.

Effective Date

The provisions of this notice were effective April 14, 2003. This Notice was last updated on December 20, 2023.