HIPAA Privacy Policy

CONFIDENTIALITY NOTICE/HIPAA NOTICE OF PRIVACY

THIS INFORMATION DESCRIBES HOW MEDICAL AND DRUG AND ALCOHOL RELATED INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

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General Information

Information about your treatment and care, including payment for care, is protected by two federal laws: The Health Insurance Portability and Accountability Act of 1996 (“HIPAA”)* and the Confidentiality Law**. Under these laws Manchester Alcoholism Rehabilitation Center dba Farnum Center (“the program”) may the program disclose any information identifying you as an alcohol or drug abuser, or disclose any other protected information except as permitted by the federal laws referenced below.

The program must obtain your written consent before it can disclose information about you for payment purposes. For example, the program must obtain your written consent before it can disclose information to your health insurer in order to be paid for services. Generally, you must also sign a written consent before the program can share information for treatment purposes or for health care operations. However, federal law permits the program to disclose information in the following circumstances without your written permission:

  1. To program staff for the purposes of providing treatment and maintaining the clinical record;
  2. Pursuant to an agreement with a business associate (e.g. Clinical laboratories, pharmacy, record storage services, billing services);
  3. For research, audit or evaluations (e.g. State licensing review, accreditation, program data reporting as required by the State and/ or Federal government);
  4. To report a crime committed on the program’s premises or against program personnel;
  5. To medical personnel in a medical/ psychiatric emergency;
  6. To appropriate authorities to report suspected child abuse or neglect;
  7. To report certain infectious illnesses as required by state law;
  8. As allowed by a court order.

Before the program can use or disclose any information about your health in a manner which is not described above, it must first obtain your specific written consent allowing it to make the disclosure. Any such written consent may be revoked by you in writing. (NOTE: Revoking a consent to disclose information to a court, probation department, parole office, etc. may violate an agreement that you have with that organization. Such a violation may result in legal consequences for you.)

*42 U.S.C. 130D et. Seq., 45 C.F.R. Parts 160 & 164 ** 42 U.S.C. 290dd-2, 42 C.F.R. Part 2

Your Rights

The Use of Your Information by the Program

In order to provide you with the best care, the program will use your health and treatment information in the following ways:

The Program’s Duties

The program is required by law to maintain the privacy of your health information and to provide you with notice of its legal duties and privacy practices with respect to your health information. The program is required by law to abide by the terms of this notice. The program reserves the right to change the terms of this notice and to make new notice provisions effective for all protected health information it maintains. The program will provide current patients with an updated notice, and will provide affected former patients with new notices when substantive changes are made in the notice.

Complaints and Reporting Violations

Patients have the right to make a complaint about the confidentiality and Privacy of their Health Information. If you need help filing a complaint or have a question about the complaint form, please call OCR toll free number: 1-800-368-1019.

You can submit your complaint in any written format. We recommend that you use the OCR Health Information Privacy Complaint Form which can be found on our web site or at an OCR Regional office. If you prefer, you may submit a written complaint in your own format. Be sure to include the following information in your written complaint:

Office for Civil Rights
U.S Department of Health and Human Services,
JFK Federal Building – Room 1875
Boston, MA 02203
(617) 565-1340 Phone
(617) 565-3809 FAX
(617) 565-1343 (TDD)

You will not be retaliated against for filing such a complaint.
Violation of the Confidentiality law by a program is a crime. Suspected violations of the Confidentiality Law may be reported to the United States Attorney in the district where the violation occurs.

Changes to this Notice
We may change this Notice at any time by updating this posting. Changes to the new Notice will be effective when posted and the new effective date will be identified.

Contact Us
To exercise your rights, or for more information or to ask questions about our privacy practices or this Notice, you may contact us in one or more of the following ways:
Mail:
Manchester Alcoholism Rehabilitation Center dba Farnum Center
Attn: Compliance Officer
555 Auburn Street, Manchester, NH 03103
Email address: ComplianceFC@Farnumcenter.org
Toll free telephone number: 1 (888) 840-4243

Effective Date of Notice

This Notice is effective as of January 14, 2021 and supersedes and replaces any prior online version of this Notice. Print Farnum’s HIPAA Privacy Policy

View Farnum’s Privacy Policy