EFFECTIVE DATE: April 14, 2003

In 1996 the US Congress passed a law that has come to be known as “HIPAA”. Its full name is The Health Insurance Portability and Accountability Act of 1996. One of the things that congress was trying to do when it passed this law was to provide protection and privacy for personal health information. The HIPAA law includes a section known as the Privacy Rule. The Privacy Rule prohibits health care providers, such as Key Rehabilitation, from using or releasing the personal health information of its patients except as it is needed to provide treatment, receive payment for treatment, or perform the health care operations as described below.

Uses and releases of personal health information other than those mentioned require that the patient sign an authorization allowing the specific use requested by the health care provider.

Key Rehabilitation’s obligations under HIPAA:

Key Rehabilitation is required by law to maintain the privacy of personal health information. In addition, Key Rehabilitation is required to provide this notice of its duty and a description of its privacy practices with respect to personal health information.

First of all, Key Rehabilitation is bound to abide by the terms of this notice for as long as this notice is effect, but Key Rehabilitation has the right to change this notice. If Key Rehab changes this notice, the new notice may include provisions that are effective for all protected personal health information that Key maintains, including information that was received or created prior to Key issuing the revised notices.

Key Rehabilitation must post this Notice at its service delivery sites in locations where it can be seen, and copies of the Notice are available for individuals to take with them. Whenever the Notice is revised, the revised notice will be available upon request on and after the effective date of the revision, and the revised notice will be posted in place of the outdated version.

Uses and Disclosures of personal health information that are allowed by the HIPAA Privacy Rule:

HIPAA allows health care providers to use personal health information to carry out its business activities as long as those activities don’t violate an individual’s privacy. Below are the allowed uses of personal health information.

1. Disclosures of personal health information are permitted to the patient or their personal representative upon request, and unless you object, we may disclose your personal health information to a member of your family, a relative, and or a close personal friend to the extent that that person is involved in your health care.

2. Disclosures are permitted for purposes of providing treatment to you including, but not limited to:

§ The provision, coordination, or management of health care and related services.

§ Consultation between Key Rehab and other health care providers regarding your treatment, and

§ Key Rehab may disclose your personal health information if it is necessary to refer you to another health care provider.

3. Disclosures are permitted for purposes of payment including:

§ The various activities necessary to obtain payment for the provision of health care such as, but limited to:

Billing and collection activities

Determining eligibility and coverage under an insurance plan, and

Utilization review activities

4. Disclosures are permitted for purposes of “Health Care Operations” including, but not limited to:

§ The administrative, financial, legal, and quality improvement activities necessary to run a health care business and to support the core functions of treatment and payment. Examples of health care operations include, but are not limited to:

Business planning and development

Conducting or arranging for medical review, legal, and auditing services

Business management and general administrative activities

Providing appointment reminders by mail or phone

5. Disclosures of personal health information are permitted to public health authorities that are legally authorized to receive such reports for specified public health purposes, such as, but not limited to the following:

§ As required by law

§ For public health reasons, such as the prevention or control of disease, injury, or disability.

§ For judicial and administrative proceedings

§ For law enforcement purposes

§ For worker’s compensation cases

6. Other uses and disclosures of your personal health information will only be made after Key Rehab has discussed it with you and obtained your written authorization. You may revoke that authorization at any time except to the extent that Key Rehab has already taken action on the authorization. If you wish to revoke your authorization it must be done in writing.

Your Rights Regarding your Personal Health Information:

1. You have the right to request additional restrictions on the use and release of your personal health information as it relates to treatment, payment, and health care operations. Key Rehabilitation will consider all requests, however, Key Rehabilitation is not required by law to agree to such requests.

2. You have the right to request that your personal health information be communicated to you in a confidential manner, by some alternative means, or at some alternative location if you feel that it is necessary. Key Rehabilitation will accommodate any reasonable requests.

3. You have the right to inspect and copy your personal health information for as long as Key Rehabilitation maintains it. If you request a copy of your personal health information, we may charge a reasonable fee for our costs in copying and mailing the record.

4. You have the right to have Key Rehabilitation amend your personal health information if you believe that something is wrong or missing from the record. You can make such a request as long as Key Rehabilitation maintains the information.

5. You have the right to receive an accounting of disclosures of your personal health information that occurred during the six years prior to the date on which you requested the accounting. A disclosure is the release of your personal health information. The “accounting of disclosures” will not include the disclosures that are allowed in the Privacy Rule as described above. These include, but are not limited to, disclosures made for purposes of treatment, payment, or health care operations, and disclosures made to the individual themselves.

6. Each individual has the right to receive a paper copy of this notice upon request.


You have the right to complain to Key Rehabilitation, or to the Secretary of the US Department of Health and Human Services, if you feel that Key Rehab has violated your privacy rights. If you feel that your privacy rights have been violated, and you wish to complain to Key Rehabilitation, please contact Key Rehabilitation’s Privacy Officer to file your complaint. You will not be retaliated against in any way for filing a complaint.

Contact Person:

If you have a question about any part of Key Rehab’s Privacy Notice please contact our Privacy Officer listed below.

Michael Gorman, Privacy Officer

Key Rehabilitation

1335 NW Broad Street

Murfreesboro, TN 37129

TEL: 888-362-87004 extension 264

FAX: 888-355-1811

E-mail: Mgorman@KeyRehab.com