• Protect the privacy of your health and treatment information.

• Provide you with this notice of our legal duty and privacy practices.

• Follow the practices described in this notice.

This notice describes the ways we may use and disclose information about your health in order to provide for your treatment, payments, health care options, and for other purposes as may be permitted or required by law. It also describes your rights and our duties regarding the records we keep about your health and treatment. Please also note the protections due to you as patients of CompDrug as provided in the Code of Federal Regulation (42CFR PART 2). This document is available at the CompDrug treatment facilities.

Please note that when you apply to receive treatment services from CompDrug for alcohol and/or other drug issues, you sign a release authorizing CompDrug to use the information required to receive payment for your services. We use and disclose limited information about your health and treatment for several reasons. Several laws and regulations allow us to use and/or disclose, specific and limited information, about your health and treatment to further your treatment, meet emergency medical needs, submit invoices for payment, or assist other network service providers with your joint care. For purposes beyond that, we must have your written, specific authorization to disclose, unless the laws specifically provide for exceptions. With the exception of specified reasons, we must use or disclose only the minimum necessary health information needed to accomplish the stated purpose of the disclosure.

If we disclose information about your health and/or treatment to another organization or care provider, in order for them to perform a function on your behalf, we must have a written agreement with them that extends the same degree of privacy protection to your information that we apply.

The following categories describe the different ways that we may use and disclose information about your health and/or treatment. For each category, we explain what it means and try to give you some representative examples. Not every possible use or disclosure within a category can be listed; however, all of the ways we are permitted to use or disclose information fall within one of them.

TREATMENT: We may use or disclose health or treatment information with other service providers, with whom we have a current agreement for cooperative services, in order to coordinate your health care between us. In the absence of a current agreement with the services provider, we will only disclose health and treatment information about you to authorized medical personnel in the declared event of a medical emergency. In the event of a declared medical emergency, only the information deemed necessary to respond to the emergency will be disclosed. As an example, if a hospital, EMT or Crisis Care Center were to contact us and declare that your status was a medical emergency, we would provide the minimum needed information to treat your emergency. This would usually be limited to medication dosages, allergies and diagnosed health conditions.

PAYMENT: CompDrug uses your health and treatment information with State, County and Local governments, and third party entities that you have identified, to determine your eligibility for publicly subsidized services. This information is needed to determine eligibility, provide for enrollment, produce billings, and generate statistical data required by law. This information is used only with the Medicaid Program and the Multi-Agency Community Services Information System (MACSIS), unless an alternative organization is identified by you. MACSIS is the State-wide program which issues the patient UCI Number that is used by our services. When you applied for services, you provided your permission for CompDrug to use your information for this specific purpose. All services for Alcohol and/or Other Drug Treatment require a signed authorization to bill for payment of services provided.

HEALTH CARE OPERATIONS: CompDrug is required to participate in a number of government programs that use your health and treatment information as part of overall statistics used to evaluate the services you receive. In addition, your information is part of the fiscal information reviewed in audit procedures. At no time are you identified outside the review system in an individual manner. Evaluation and audit reports do not include or retain the names of individual patients or disclose their identity in any manner. Health and treatment information may be shared with proper authorities, or shared-care providers, in order to resolve your complaints, grievances or service issues. If we disclose such information, it will be limited to that needed to specifically respond to the presented issue, nothing else.

LAW ENFORCEMENT & GOVERNMENT: CompDrug may use/disclose alcohol and other drug treatment information related to suspected serious criminal activity in response to a court order. In order to avoid a serious threat to the health or physical safety of you or others, we may disclose information about your health or treatment to law enforcement. We may disclose health or treatment information of military personnel or veterans in certain situations, to correctional facilities, to government benefit programs about eligibility and enrollments, or for national security reasons.

HEALTH OVERSIGHT ACTIVITIES: CompDrug may use/disclose information about your health or treatment for audits, inspections, advocacy, or other monitoring activities related to our legal and contractual responsibilities. We may also use/disclose such information as may be required for the reporting and/or investigation of abuse or major unusual incidents.

PUBLIC HEALTH: CompDrug may disclose information about your health or treatment to appropriate public officials where abuse, neglect or domestic violence has been substantiated. We may also disclose such information in cases of certain verified communicable diseases.

CORONERS: CompDrug may release information about your health or treatment to a coroner or coroner's investigation.

RESEARCH: CompDrug may use/disclose your health or treatment information for research purposes as may be established by regulatory guidelines. However, your personal identity may not be revealed in any reports or publications resulting from such research.

CompDrug may disclose a limited amount of your health and treatment information directly related to your care, if we inform you in advance and you do not specifically object:

• To family, friends, or those involved with your care about their direct involvement in your care or the payment for your care;

• Following previously expressed wishes, or if it is an emergency and you cannot be given a chance to object to the disclosure of information before treatment is given;

• To family, friends, or those involved with your care about your location, general condition, or death.

You have the following rights regarding the health and treatment information that we maintain on you.

TO REQUEST RESTRICTIONS: You have the right to ask that we limit how we use or disclose information about your health or treatment. We can not agree to restrict uses/disclosures that are required by law or regulations. We are not required to agree to your request for restrictions or limits. To the extent that we do agree, we will put it in writing and abide by it, except in bona-fide emergencies.

TO CHOOSE HOW WE CONTACT YOU: You have the right to request that we send you information at an alternate address, or by an alternate means. We must agree to your request, as long as it is reasonable for us to do so.

TO FIND OUT ABOUT DISCLOSURES: You have the right to get a list of when, to whom, for what reason, and the content of information about your health or treatment that has been released to others. Exceptions include the information that is normally used for treatment, payment, and health care operations; information released to you or those involved in your care; any information released in accordance with your written authorization; or releases made for national security purposes or to law enforcement or corrections officials. We will respond to your written request for this list within sixty days. Your request can relate to disclosures going as far back as six years. There is no charge for the first request, but charges will be applied to multiple copies or multiple requests.

TO INSPECT AND COPY: You have a right to see the health and treatment information we maintain about you. Usually, this includes billing information. You may make your request in writing, and we will respond within thirty days. If we deny your access, we will give you the reasons in writing. Usually, this would be because access to the information might reasonably endanger the life or physical safety of you or another person. You may ask that the denial be reviewed. If you want copies of your health or treatment information, you have a right to choose what parts of your information you want copied, and to have prior information on the cost of copying. The maximum charge allowed for copying is $0.50 per page.

TO REVOKE AN AUTHORIZATION: If you have signed an authorization for us to use/disclose information about your health, you may revoke it by notifying us in writing. You may not revoke those disclosures otherwise authorized by law or regulation. Such revocations are effective only after being received and may not state a retroactive time frame.

TO REQUEST AMENDMENT OF YOUR INFORMATION: If you believe that there is a mistake or missing information in our records, you may request, in writing, that we correct or add to the record. We will respond to your request within sixty days. We may deny the request if we find that the information:

• Is correct and complete.

• Was not created by us.

• Is not part of the information about your health or treatment that we keep.

• Is not part of the information about your health or treatment that you would be allowed to inspect and copy.

If we deny your request to amend the information we have about your health or treatment, we will tell you in writing what the reasons are. You have the right for your request, our denial, and any statement in response that you provide to be added to your records.

If we approve your request for amendment, we will change the information and inform you of the change. We will also tell others that may need to know about the change in your information.

We will take no retaliation against you if you make a complaint. If you believe your privacy rights have been violated by CompDrug, you may file a written complaint with: