Modern Breastfeeding + Education’s HIPAA Notice of Privacy Practice

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.

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law designed to protect your privacy whenever your health care providers, like the International Board Certified Lactation Consultant (IBCLC), have to discuss your case, or send information about you to different offices. Modern Breastfeeding + Education is required to keep a file to record our consult, but the private, protected health information (PHI) in it will be kept confidential. IBCLCs within the Modern Breastfeeding + Education group can freely share all the details of your personal health information for purposes of “treatment, payment and health care operations.” That means the IBCLC can talk to you about your situation and discuss it with your other health care providers. If you are referred to other specialists, the IBCLC can send the information on to them. The IBCLC can also share information with your health insurance company if they need it. The law also requires Modern Breastfeeding + Education to share your information under other, very precise situations: for example, if a subpoena has been served on this office to turn over medical records or a federal agency is investigating a complaint that we have not been protecting your privacy. Any other time the IBCLC or Modern Breastfeeding + Education shares your personal health information must be with your specific, written authorization first. For example, you may want Modern Breastfeeding + Education to send information about your consultation to the Human Resources Dept. at your place of employ so they can pay you back under their corporate lactation support program. When you give Modern Breastfeeding + Education permission to turn over information about you, we can give out only the minimum amount of information needed to get the job done.

In the event that there are other instances where the IBCLC may wish to share your information, you will be asked to consent to each instance separately, and you may choose not to consent to any or all of this additional sharing. Under HIPAA, the IBCLC can call or write you to remind you to come back for an appointment or to tell you how you can get a product or service that might interest you and your family.

You have four rights under HIPAA:

1. Access: you can ask the IBCLC to see all of your protected health information (PHI) on file

2. Amendment: you can ask the IBCLC to change her files to amend inaccurate PHI

3. Disclosure Accounting: you can ask to whom the IBCLC has given your PHI

4. Restriction Request: you can put limits on the IBCLCʼs use and sharing of your PHI.

Modern Breastfeeding + Education’s duty under HIPAA is to give you this notice, so you understand that we have promised to keep your private health information confidential.

If this notice is amended in the future, we will make a new copy available. Gillian Foreman is the owner and Privacy Officer in this business and will answer your questions or concerns about how your privacy is protected. Her phone number is 214.208.5535.

You can complain if you think your privacy hasn’t been protected, and we have a duty to attempt to address the situation. If the Privacy Officer does not address your complaint adequately, you can go to the Office for Civil Rights (OCR) of the federal Health and Human Services Dept., to ask that a formal investigation be made. You cannot be penalized for making a complaint. You can get all the details from them by calling (toll free) 1- 800-368-1019 or file a complaint at: http://www.hhs.gov/ocr/privacy/hipaa/complaints/index.html

The consent form you sign at a Lactation Consultation appointment, or at the Lactatiojn Clinic acknowledges that you have access to this HIPAA Notice of Privacy Practice and have read and understood it.

Links to those forms are provided here, or you may ask for a copy of the one you signed at any time:

Consent for Lactation Consultation – consent-for-lactation-consultation

Consent for Lactation Clinic – consent-for-lactation-clinic

This form is for Returning Members. New Attendees should register using the form on this page.