Privacy Policy

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.

Use and Disclosure of Health Information: Central Wyoming Hospice Program, (“CWHP”, “we”, “our”, “us”, or “the program”) may use protected health information (“PHI”) for purposes of providing treatment, obtaining payment for care, and conducting health care operations. We have established policies to guard against unnecessary disclosure of PHI.

Summary of when PHI may be used and disclosed:

To Provide Treatment: CWHP will use PHI to coordinate your care: (within the Hospice Team, and with others involved in your care including your doctor, pharmacists, suppliers of medical equipment or other health care professionals, and with family members.) For example, your doctor will need information about your symptoms in order to prescribe medicines.

To Obtain Payment: CWHP may include PHI in invoices to collect payment from third parties for the care you receive from us. For example, we may be required by your health insurer to provide PHI regarding your health care status so that the insurer will reimburse you or CWHP. We also may need to obtain prior approval from your insurer and may need to explain to the insurer your need for hospice care and the services that will be provided to you.

To Conduct Health Care Operations: CWHP may use and disclose PHI for its own operations in order to facilitate the function of its program and as necessary to provide quality care to all of our patients. Health care operations include such activities as:

  • Quality assessment and improvement activities.
  • Activities designed to improve health or reduce health care costs.
  • Protocol development, case management and care coordination.
  • Contacting health care providers and patients with information about treatment alternatives and other related functions that do not include treatment.
  • Professional review and performance evaluation.
  • Training programs including those in which students, trainees or practitioners in health care learn under supervision.
  • Training of non-health care professionals.
  • Accreditation, certification, licensing or credentialing activities.
  • Review and auditing, including compliance reviews, medical reviews, legal services and compliance programs.
  • Business planning and development including cost management and planning related analyses and formulary development.
  • Business management and general administrative activities of CWHP. For example, we may use PHI to evaluate staff performance, combine your PHI with other CWHP patients in evaluating how to more effectively serve all our patients, disclose your PHI to our staff and contracted personnel for training purposes, use your PHI to contact you as a reminder regarding a visit to you, or contact you or your family as part of general fundraising and community information mailings (unless you tell us you do not want to be contacted).

We may disclose certain PHI about you including your name, your general health status, your religious affiliation and where you are in the Charles M. and Cara Lou Chapman Hospice Home.

We may disclose this information to people who ask for you by name. Please inform us if you do not want your information to be disclosed.

For Fundraising Activities. CWHP may use PHI excluding your name, address or phone number without permission in order to raise money for the program. If you do not want us to contact you, your family, or anyone associated with you, notify a staff member at Central Wyoming Hospice Program.

For Appointment Reminders. We may use and disclose PHI to contact you as a reminder that you have an appointment for a home visit.

For Treatment Alternatives. We may use and disclose PHI to inform you about possible treatment options or alternatives that may be of interest.

PHI may also be used and disclosed:

When Legally Required. CWHP will disclose your PHI when it is required to do so by any federal, state, or local law.

When There Are Risks to Public Health. CWHP may disclose PHI for public activities and purposes in order to:

  • Prevent or control disease, injury or disability, report disease, injury, vital events such as birth or death and the conduct of public health surveillance, investigations and interventions.
  • Report adverse events, product defects, to track products or enable product recalls, repairs and replacements and to conduct post-marketing surveillance and compliance with requirements of the Food and Drug Administration.
  • Notify a person who has been exposed to a communicable disease or who may be at risk of contracting or spreading a disease.
  • Notify an employer about an individual who is a member of the workforce as legally required.
  • To Report Abuse, Neglect or Domestic Violence. CWHP is allowed to notify government authorities if the program believes a patient is the victim of abuse, neglect or domestic violence. We will make this disclosure only when specifically required or authorized by law or when the patient agrees to the disclosure.

To Conduct Health Oversight Activities: CWHP may disclose PHI to a health oversight agency for activities including audits, civil administrative or criminal investigations related to receipt of health care or public benefits, inspections, licensure or disciplinary action. We may not disclose your PHI if you are the subject of an investigation and your PHI is not directly related to your receipt of health care or public benefits.

In Connection With Judicial And Administrative Proceedings: CWHP may disclose PHI in the course of any judicial or administrative proceeding in response to an order of a court or administrative tribunal as expressly authorized by such order or in response to a subpoena, discovery request or other lawful process, but only when CWHP makes reasonable efforts to either notify you about the request or to obtain an order protecting your health information.

For Law Enforcement Purposes: As permitted or required by State law, CWHP may disclose your PHI to a law enforcement official for certain law enforcement purposes as follows:

  • As required by law for pursuant to the court order, warrant, subpoena or summons or similar process.
  • To a law enforcement official if CWHP has a suspicion that your death was the result of criminal conduct including criminal conduct at CWHP.
  • In an emergency in order to report a crime.

To Funeral Directors: CWHP may disclose PHI to funeral directors consistent with applicable law and if necessary, to carry out their duties with respect to your funeral arrangements. If necessary to carry out their duties, we may disclose PHI prior to and in reasonable anticipation of your death. For Organ, Eye Or Tissue Donation: CWHP may use or disclose PHI to organ procurement organizations or other entities engaged in the procurement, banking or transplantation of organs, eyes or tissue for the purpose of facilitating the donation and transplantation.

For Research Purposes: CWHP may, under very select circumstances, use your PHI for research. Before the program discloses any PHI for such research purposes, the project will be subject to an extensive approval process.

Authorization to use or disclose health information

Other than is stated above, CWHP will not disclose your PHI other than with your written authorization. If you or your representative authorizes CWHP to use or disclose your PHI, you may revoke that authorization in writing at any time.

Your rights with respect to your health information:

You have the following rights regarding your PHI maintained by CWHP:

  • Right to request restrictions on certain uses and disclosures of your PHI. You have the right to request a limit on CWHP’s disclosure of your PHI to someone who is involved in your care or the payment of your care. However, we are not required to agree to your request. To make a request for restrictions contact the Executive Director at 577-4832.
  • Right to receive confidential communications: to request that CWHP communicate with you in a certain way. (E.g. only by e-mail, only in private, etc). If you wish to arrange confidential communications please notify the Executive Director at 577-4832. We will not require that you provide any reasons for your request and will attempt to honor any reasonable requests for confidential communications.
  • Right to inspect and copy your PHI, including billing records. Please direct requests to the Executive Director at 577-4832. We may charge a reasonable fee for costs.
  • You or your representative have the Right to request an amendment to your health care information if you believe your PHI is incorrect or incomplete. Requests may be made as long as the PHI is maintained by CWHP, must be made in writing to the Executive Director, 319 S Wilson Casper WY 82601, and must include a reason for the amendment. The request may be denied if your records were not created by CWHP, if the records you are requesting are not part of CWHP’s records, if the PHI you wish to amend is not part of the PHI you are permitted to inspect and copy, or if, in the opinion of CWHP, the records containing your health information are accurate and complete.
  • You or your representative have the Right to request an accounting of disclosures of your PHI made by CWHP for certain reasons, including reasons related to public purposes authorized by law and certain research. The request must be made in writing to the Executive Director 319 S. Wilson Casper WY 82601. The request should specify the time period for the accounting starting on or after April 14, 2003. Accounting requests may not be made for periods of time in excess of six (6) years. CWHP would provide the first accounting you request during any 12-month period without charge. Subsequent accounting requests may be subject to a reasonable cost-based fee.
  • You or your representative have a Right to a separate paper copy of this Notice at any time even if you have received this Notice previously. To obtain a separate paper copy, pleases contact the Executive Director at 577-4832.
Duties of Central Wyoming Hospice Program

CWHP is required by law to maintain the privacy of your PHI as provided by law and to provide you and your representative this Notice of its duties and privacy practices. CWHP is required to abide by the terms of this Notice as may be amended from time to time. We reserve the right to change the terms of its Notice and to make the new Notice provisions effective for all PHI that we maintain. If CWHP changes its Notice, we will provide a copy of the revision to you or your appointed representative. You or your representative have the right to express complaints to CWHP and to the Secretary of the Department OF Health and Human Services (DHHS) if you or your representative believe that your privacy rights have been violated. Any complaints to CWHP should be made in writing to the Executive Director, 319 S Wilson Casper WY 82601. CWHP encourages you to express any concerns you may have regarding the privacy of your information. You will not be retaliated against in any way for filing a complaint.

CONTACT PERSON: CWHP has designated the Executive Director as its contact person for all issues regarding patient privacy and your rights under the Federal privacy standards. You may contact this person at: 319 S. Wilson Casper WY 82601 (307) 577-4832.

EFFECTIVE DATE: This notice is effective April 14, 2003.

If you have any questions regarding this notice, please contact:

Executive Director
319 S. Wilson
Casper, WY 82601
(307) 577-4832

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Central Wyoming Hospice & Transitions (CWHTP) depends upon donations from individuals and businesses, as well as grants and fundraisers to offset the ever increasing gap between third party reimbursements and the actual costs of providing services.

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