Notice of Privacy Practices

Your Rights

When it comes to your health information, you have rights. Drive Mental Health is responsible for helping you exercise them.

Get an electronic or paper copy of your record

You may ask to inspect or receive an electronic or paper copy of the medical record and other health information we maintain about you. We will generally provide a copy or summary within 30 days. We may charge a reasonable, cost-based fee when permitted by law.

Ask us to correct your record

You may ask us to correct health information that you believe is inaccurate or incomplete. We may deny the request in some circumstances, but we will explain a denial in writing, generally within 60 days.

Request confidential communications

You may ask us to contact you in a particular way or at a different address. We will accommodate reasonable requests.

Ask us to limit what we use or share

You may ask us not to use or disclose certain information for treatment, payment, or health care operations. We are not always required to agree. If we do agree, we will honor the restriction except when information is needed for emergency treatment or another legal exception applies.

If you pay in full out of pocket for a service, you may ask us not to disclose information about that service to your health plan for payment or health care operations. We will agree unless disclosure is required by law.

Receive an accounting of disclosures

You may ask for an accounting of certain disclosures made during the six years before your request. The accounting will not include disclosures for treatment, payment, health care operations, disclosures you authorized, and certain other exclusions permitted by law. One accounting in a 12-month period is free; a reasonable, cost-based fee may apply to additional requests.

Receive this notice

You may request a paper copy at any time, even if you agreed to receive the notice electronically.

Choose a personal representative

A person with legal authority to act for you, such as a health care agent or legal guardian, may exercise your rights. We will verify that authority before taking action.

File a complaint

You may complain to Drive Mental Health or to the U.S. Department of Health and Human Services if you believe your privacy rights were violated. We will not retaliate against you for filing a complaint.

Your Choices

In certain situations, you may tell us whether and how to share information. Tell us your preference, and we will follow it when the law gives you that choice.

• You may direct us to share information with family members, close friends, or others involved in your care or payment for care.
• You may make choices about disclosure in a disaster-relief situation.
• If you cannot tell us your preference, we may share information when we believe it is in your best interest or when needed to reduce a serious and imminent threat to health or safety.

We will obtain written authorization for most uses or disclosures involving marketing, sale of health information, or psychotherapy notes. This document assumes Drive Mental Health does not sell health information and does not use patient information for fundraising.

How We Use and Share Information

Treatment

We may use your health information and share it with professionals involved in your treatment or care coordination.

Payment

We may use and share information to bill for services and obtain payment from health plans or other responsible parties.

Health care operations

We may use and share information to operate the practice, manage services, improve quality, conduct compliance activities, and contact you when necessary.

Other uses and disclosures permitted or required by law

Subject to applicable legal conditions and any more protective federal or New York law, we may use or disclose information for:

• Public health and safety activities, including disease prevention, product recalls, adverse-event reporting, abuse or neglect reporting, and reducing a serious threat to health or safety.
• Health research when legal requirements are met.
• Compliance with federal or state law and review by health oversight agencies.
• Organ and tissue donation requests.
• Coroners, medical examiners, and funeral directors when a person dies.
• Workers' compensation, certain law-enforcement requests, and special government functions.
• Responses to court or administrative orders, subpoenas, lawsuits, and other legal proceedings when applicable requirements are satisfied.

New York and federal laws may provide additional protection for mental health information and other sensitive records. When a more protective law applies, Drive Mental Health will follow that law and obtain written authorization when required.

Substance Use Disorder Records

To the extent Drive Mental Health creates, receives, or maintains substance use disorder patient records protected by 42 CFR Part 2, those records receive additional federal protection.

If Part 2 information would be used for fundraising, Drive Mental Health would provide clear advance notice and a choice about whether to receive those communications.

Our Responsibilities

• We are required by law to protect the privacy and security of your protected health information.
• We will notify you promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in the notice that is currently in effect.
• We will provide a copy of the current notice upon request. It is also posted on the practice website.
• We will not use or share your information except as described in this notice or as otherwise permitted by law unless you authorize us in writing. You may revoke an authorization in writing, subject to actions already taken in reliance on it.

Changes to This Notice

Drive Mental Health may change the terms of this notice. A revised notice may apply to all health information maintained by the practice, including information created or received before the change. The current notice will be available upon request, through the practice, and on DriveMentalHealth.com.

Questions and Complaints

You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by writing to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting hhs.gov/hipaa/filing-a-complaint.

Drive Mental Health will not retaliate against you for filing a complaint.