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.
At Acacia Health, protecting your privacy is an important part of providing compassionate, patient-centered care.
We understand that your medical information is personal and sensitive. We are committed to respecting your confidentiality and protecting your health information in accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the California Confidentiality of Medical Information Act (CMIA), and other applicable laws.
This Notice of Privacy Practices explains your rights regarding protected health information (PHI), how we may use or disclose your information, and our responsibilities as a healthcare provider.
This notice is intended to apply to the following Acacia healthcare operations, subject to confirmation of their legal entities and applicable privacy arrangements:
- Acacia Hospice & Palliative Services
- Acacia Hospice of The Desert
- [Insert Additional Covered Acacia Healthcare Entities, Including Home Health, If Applicable]
We are committed to providing comfort, assurance, and care while respecting the privacy and dignity of every patient and family we serve.
1. Your Rights Regarding Your Health Information
You have important rights concerning the protected health information we maintain about you.
Request Access To Your Medical Records
You have the right to inspect or obtain a copy of certain medical records and other health information maintained about you.
You may request your records in paper or electronic form when applicable.
We generally respond to requests for access within 30 days, subject to legally permitted extensions or applicable shorter state-law deadlines.
In certain circumstances, we may charge a reasonable, cost-based fee permitted by law.
If access is denied, we will provide an explanation and information about any available review rights.
Request Corrections To Your Health Information
If you believe information in your medical record is incorrect or incomplete, you may request an amendment.
We may deny certain amendment requests as permitted by law. If we deny your request, we will explain the reason in writing and describe your available rights.
We generally respond to amendment requests within 60 days, subject to permitted extensions.
Request Confidential Communications
You may request that we communicate with you through a particular method or at a particular location.
For example, you may ask us to:
- Contact you using a specific telephone number
- Send correspondence to an alternative mailing address
- Use an appropriate alternative communication method
We will accommodate reasonable requests in accordance with applicable law.
Request Restrictions On Information Sharing
You may ask us to restrict certain uses or disclosures of your health information for treatment, payment, or healthcare operations.
We are generally not required to agree to every requested restriction.
However, when you pay out of pocket in full for a healthcare item or service, you may request that we not disclose information about that item or service to your health plan for payment or healthcare operations. We must honor that request unless disclosure is required by law.
Request An Accounting Of Disclosures
You may request an accounting of certain disclosures of your PHI made during the six years preceding your request.
Certain disclosures, including many disclosures for treatment, payment, and healthcare operations, are excluded from the accounting requirement.
You may receive one accounting within a 12-month period without charge. Additional requests during that period may be subject to a reasonable, cost-based fee.
Request A Copy Of This Notice
You may request a paper copy of this Notice of Privacy Practices at any time, even if you previously agreed to receive it electronically.
We will provide a copy promptly upon request.
Choose Someone To Act On Your Behalf
If you have a legally authorized personal representative, such as a healthcare agent acting under a valid power of attorney or a legal guardian, that person may exercise certain privacy rights on your behalf.
We may request documentation confirming the representative’s authority before releasing information or acting on a request.
File A Privacy Complaint
If you believe your privacy rights have been violated, you may file a complaint with Acacia Health or the U.S. Department of Health and Human Services Office for Civil Rights.
We will not retaliate against you for filing a complaint or exercising your privacy rights.
2. How We May Use And Disclose Your Health Information
HIPAA permits healthcare providers to use and disclose PHI for certain purposes without obtaining a separate written authorization.
We may use or disclose your health information for treatment, payment, healthcare operations, and other activities permitted or required by law.
Treatment And Care Coordination
We may use and disclose your health information to provide, coordinate, or manage your healthcare services.
For example, information may be shared with:
- Physicians and other treating healthcare professionals
- Hospice and palliative care team members
- Home health professionals
- Pharmacies
- Hospitals or other healthcare providers
- Other professionals involved in your treatment or care coordination
Example: Your hospice care team may share relevant medical information with your physician to coordinate symptom management, medications, and your individualized care plan.
Payment And Insurance Processing
We may use or disclose information as necessary to obtain payment for healthcare services.
This may include disclosures to Medicare, Medicaid, private insurance plans, or other responsible payers.
Example: We may provide necessary information to a health plan to verify coverage or process payment for hospice services.
Healthcare Operations
We may use or disclose information for legitimate healthcare operations.
These activities may include:
- Quality assurance and performance improvement
- Staff training and professional oversight
- Accreditation and licensing activities
- Compliance and auditing
- Healthcare administration
- Care coordination and service evaluation
- Other activities permitted under HIPAA
Example: We may review patient care records to evaluate service quality and identify opportunities to improve care delivery.
Appointment Reminders And Healthcare Communications
We may use your contact information to communicate about healthcare services, care coordination, scheduling, and other treatment-related matters.
These communications will be handled according to applicable privacy requirements and your communication preferences.
3. Your Choices About Sharing Health Information
For certain types of disclosures, you may tell us your preferences regarding how your information is shared.
Family Members, Caregivers, And Others Involved In Your Care
We may share relevant information with family members, caregivers, or other individuals involved in your care or payment for your care when permitted by HIPAA.
You may tell us whether you want information shared with these individuals.
If you are unable to communicate your preferences, we may make disclosures permitted by law when we determine that doing so is in your best interest.
We will consider your known preferences and applicable legal requirements.
Disaster Relief And Emergency Circumstances
We may share appropriate information with disaster relief organizations or others involved in emergency assistance, as permitted by law.
Personal Representatives
A legally authorized personal representative may have access to information and privacy rights on your behalf, subject to applicable legal requirements and exceptions.
4. Other Uses And Disclosures Permitted Or Required By Law
In addition to treatment, payment, and healthcare operations, we may use or disclose PHI under certain circumstances permitted or required by federal or California law.
These circumstances may include:
Public Health Activities
We may disclose information to authorized public health agencies for activities such as:
- Reporting certain diseases or conditions
- Reporting adverse reactions to medications
- Supporting legally authorized public health investigations
- Reporting suspected abuse or neglect when permitted or required by law
Health Oversight Activities
We may disclose information to authorized oversight agencies for activities such as audits, inspections, licensing, investigations, and compliance reviews.
Legal And Regulatory Requirements
We may disclose information when required by applicable federal or state law.
This may include disclosures to the U.S. Department of Health and Human Services for HIPAA compliance investigations.
Serious Threats To Health Or Safety
When permitted by law, we may disclose information to help prevent or lessen a serious and imminent threat to an individual’s health or safety or to the safety of others.
Coroners, Medical Examiners, And Funeral Directors
We may disclose appropriate information to coroners, medical examiners, and funeral directors for purposes authorized by law.
Organ And Tissue Donation
We may disclose information to organ procurement organizations or other authorized entities as permitted by law.
Workers’ Compensation
We may disclose information when authorized or required by applicable workers’ compensation laws.
Law Enforcement And Judicial Proceedings
We may disclose information in response to certain lawful requests, court orders, subpoenas, or other legal processes when permitted or required by applicable law.
Additional restrictions may apply to certain sensitive medical records, including records protected by 42 CFR Part 2.
Research
We may use or disclose health information for research when the applicable legal requirements are satisfied, including required authorizations, approvals, or permitted exceptions.
5. Uses And Disclosures Requiring Written Authorization
Certain uses and disclosures of your health information require your written authorization.
These generally include:
- Most uses or disclosures of psychotherapy notes, subject to limited exceptions
- Uses or disclosures of PHI for marketing when HIPAA authorization is required
- Disclosures that constitute a sale of PHI under HIPAA
- Other uses or disclosures not otherwise permitted or required by law
Acacia Health does not sell your protected health information.
When written authorization is required, we will obtain it before making the use or disclosure.
You may revoke an authorization in writing at any time, except to the extent we have already acted in reliance on it or where applicable law provides otherwise.
6. Additional Protection For Substance Use Disorder Records
Certain substance use disorder (SUD) patient records receive additional confidentiality protections under federal law, including 42 U.S.C. § 290dd-2 and 42 CFR Part 2.
When Acacia Health receives, creates, or maintains records subject to these requirements, we handle them in accordance with the applicable federal confidentiality protections.
Special Restrictions On Legal Proceedings
Records protected by 42 CFR Part 2, or testimony describing their contents, generally cannot be used or disclosed in civil, criminal, administrative, or legislative investigations or proceedings against you unless the applicable requirements for your written consent or a qualifying court order are satisfied.
A qualifying court order must be accompanied by a subpoena or other legal requirement compelling disclosure before the records may be used or disclosed.
Treatment, Payment, And Healthcare Operations
When permitted under applicable law and an appropriate consent or other legal basis, Part 2 records may be used or disclosed for treatment, payment, and healthcare operations.
Additional restrictions may apply to further uses or disclosures, including disclosures for certain legal proceedings.
Fundraising And Part 2 Records
If Acacia Health uses Part 2 records for fundraising in circumstances permitted by law, we will provide the required clear and conspicuous opportunity to decline fundraising communications.
These special protections apply when the information is subject to Part 2. Not every medical record concerning substance use is automatically a Part 2 record.
7. California Medical Privacy Protections
In addition to HIPAA, certain health information is protected by California law, including the California Confidentiality of Medical Information Act (CMIA).
California law may impose additional restrictions on the use or disclosure of certain medical information, including information relating to mental health, substance use treatment, and other specially protected records.
Where applicable California law provides stronger privacy protections than HIPAA, we follow the legal requirements that apply to the particular information and disclosure.
Requests for medical records and other patient privacy rights will be handled according to applicable federal and California requirements.
8. Our Responsibilities To Protect Your Information
Acacia Health is required by law to maintain the privacy of PHI and to provide individuals with notice of our legal duties and privacy practices.
We are responsible for:
- Maintaining appropriate safeguards for protected health information
- Using and disclosing PHI only as permitted or required by law
- Providing this Notice of Privacy Practices
- Following the terms of the notice currently in effect
- Respecting applicable patient privacy rights
- Providing required notifications following a breach of unsecured PHI
- Maintaining appropriate policies, procedures, and business associate arrangements
We use authorized technology service providers, including Microsoft 365 and HighLevel, to support healthcare-related communications and administrative operations.
These systems are configured to support the secure handling of information under applicable HIPAA requirements.
When third-party service providers handle PHI on our behalf, we require appropriate contractual and privacy protections, including Business Associate Agreements where required.
No electronic system can be guaranteed to be completely secure. We maintain safeguards appropriate to the information and applicable legal requirements.
9. Changes To This Notice
Acacia Health reserves the right to revise this Notice of Privacy Practices.
Changes may apply to all PHI we maintain, including information created or received before the revised notice becomes effective.
When material changes occur, we will update the notice and make the revised version available as required by law.
The current version will be available upon request, at applicable service locations, and on our website.
10. How To Exercise Your Privacy Rights
To request medical records, amend information, request confidential communications, ask for restrictions, or exercise other privacy rights, please contact our designated Privacy Officer or the appropriate Acacia Health office.
Certain requests may need to be submitted in writing.
We may need to verify your identity or legal authority before responding to requests involving PHI.
We will respond within the timeframes required by applicable law.
11. Contact Our Privacy Officer
For questions about this notice, requests involving protected health information, or privacy-related concerns, please contact:
Acacia Health Privacy Officer
Daniel Repchian cco@acaciahealth.net
Acacia Hospice & Palliative Services
17780 Fitch, Suite 201
Irvine, CA 92614
Phone: (714) 576-2222
Acacia Hospice of The Desert
75108 Gerald Ford Drive, Suite 3
Palm Desert, CA 92211
Phone: (760) 898-4308
Acacia Home Health & Palliative
17780 Fitch #200
Irvine, CA 92614
Phone: (949) 335-5515
General Inquiries: (800) 993-9391
Website: https://www.acaciahealth.net
12. Filing A HIPAA Privacy Complaint
If you believe your privacy rights have been violated, you may file a complaint with Acacia Health using the contact information above.
You may also submit a complaint to:
U.S. Department Of Health And Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
Phone: 1-877-696-6775
Website: https://www.hhs.gov/hipaa/filing-a-complaint/index.html
Acacia Health will not retaliate against you for filing a complaint or exercising your rights under HIPAA.
13. Availability Of This Notice
You have the right to receive a copy of this Notice of Privacy Practices.
The notice is available:
- On our website
- Upon request from our office
- In printed form upon request
- As part of applicable patient intake or admission procedures
We will make a good faith effort to obtain acknowledgment of receipt when required by HIPAA. An acknowledgment confirms that the notice was provided; it does not constitute consent to uses or disclosures that otherwise require authorization.
Additional Website Policies
Our Commitment To Your Privacy
At Acacia Health, our mission is to provide comfort, assurance, and care to our patients and their families.
Respecting your privacy, protecting your health information, and helping you understand your rights are essential parts of that commitment.
For questions about your protected health information or HIPAA privacy rights, contact our Irvine office at (714) 576-2222 or our Palm Desert office at (760) 898-4308.
