Wheel Provider Group entities share PHI across their organized health care arrangement and govern staff with PHI access
Wheel Provider Group comprises seven telemedicine entities—Wheel Medical, P.C. (NJ), Wheel Medical, P.C. (NY), Wheel Medical of California, P.C. (CA), Wheel Medical, P.A. (FL), Wheel Care, LLC, Wheel Medical of Illinois, P.C. (IL), and Wheel Medical of Washington, P.C. (WA)—whose Wheel ACE members share Protected Health Information (PHI) with each other as necessary for treatment, payment, or health care operations of the organized health care arrangement; this Notice governs all healthcare professionals allowed to enter or access medical records and all employees, physicians, and Medical Staff professionals with access to medical, billing, or health information.
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This Notice describes the privacy practices of Wheel Provider Group (“we” or “us”), which is comprised of Wheel Medical, P.C. (NJ), Wheel Medical, P.C. (NY), Wheel Medical of California, P.C. (CA), Wheel Medical, P.A. (FL), Wheel Care, LLC, Wheel Medical of Illinois, P.C. (IL), and Wheel Medical of Washington, P.C. (WA), all of which provide healthcare services via telemedicine. The members of Wheel ACE will share protected health information with each other, as necessary to carry out treatment, payment, or health care operations relating to the organized health care arrangement. This Notice governs:
All healthcare professionals allowed to enter or access information in your medical record.
All employees and physicians and other health care professionals on the Medical Staff when they provide services in our facilities with access to your medical or billing records or health information about you (“Protected Health Information”).
Sharing & Disclosure · Company practice
PHI may be used and disclosed without written authorization for treatment, referrals, and care recommendations
Except where Section IV requires written authorization, Wheel Provider Group may use and disclose Protected Health Information without written authorization for Treatment, including providing clinical services, consulting with your physician, directing or recommending alternative treatments, therapies, providers, or care settings, describing health-related products or services, and disclosing PHI to other providers involved in your treatment.
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We may generally use and disclose your Protected Health Information without your written authorization for the purposes described below. In certain situations, which we describe in Section IV below, we must obtain your written authorization in order to use and/or disclose your Protected Health Information.
A. Treatment. We use and disclose your Protected Health Information to provide treatment and other services to you--for example, to provide clinical services or to consult with your physician about your care. We may use your information to direct or recommend alternative treatments, therapies, health care providers, or settings of care to you or to describe a health-related product or service. We may also disclose Protected Health Information to other providers involved in your treatment.
Qualifications & exceptions
In certain situations described in Section IV, written authorization must be obtained
Sharing & Disclosure · Company practice
PHI may be used and disclosed without authorization to obtain payment from payors or assist other providers' billing
Wheel Provider Group may use and disclose Protected Health Information without written authorization to obtain payment for health care services provided to you (such as claiming payment or verifying coverage with Medicare, Medicaid, health insurers, HMOs, or other payors) and to other health care providers when required for them to receive payment for services rendered to you.
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B. Payment. We may use and disclose your Protected Health Information to obtain payment for health care services that we provide to you--for example, disclosures to claim and obtain payment from Medicare, Medicaid, your health insurer, HMO, or other company or program that arranges or pays the cost of your health care (“Your Payor”) to verify that Your Payor will pay for the health care. We may also disclose Protected Health Information to your other health care providers when such Protected Health Information is required for them to receive payment for services they render to you.
Sharing & Disclosure · Company practice
PHI may be disclosed to Business Associates bound by law and contract to protect PHI under HIPAA
Wheel Provider Group may disclose Protected Health Information to Business Associates performing functions or services on its behalf (such as technology services, platform operations, analytics support, administrative/payment support, customer service, and data aggregation/de-identification), and Business Associates are required by law and contract to protect PHI privacy and security and use or disclose it only as permitted by HIPAA and their agreements.
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B. Business Associates. We may disclose Protected Health Information to our Business Associates that perform functions or services on our behalf (such as technology services, platform operations, analytics support, administrative services, payment support, customer service, and other operational services), including data aggregation and de-identification activities described below, as permitted by HIPAA. Our Business Associates are required by law and contract to protect the privacy and security of Protected Health Information and may use or disclose it only as permitted by HIPAA and their agreements with us.
Sharing & Disclosure · Company practice
Aggregated or de-identified data may be created from PHI and shared for analytics, research, and commercial purposes
Wheel Provider Group and its Business Associates may create aggregated and/or de-identified information from PHI under HIPAA, use and disclose it for lawful purposes (including analytics, research, quality improvement, benchmarking, product/service and technology development, and other lawful commercial purposes), and share it with third parties, while maintaining reasonable safeguards against re-identification and prohibiting third parties from attempting to re-identify it.
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C. Data aggregation and de-identification. As part of our health care operations and as permitted by law, we (and our Business Associates acting on our behalf) may create aggregated and/or de-identified information from Protected Health Information in accordance with applicable law, including HIPAA. De-identified information is not Protected Health Information under HIPAA. We may use and disclose aggregated and/or de-identified information for lawful purposes, including analytics, research, quality improvement, benchmarking, product and service development, improving and operating our technology and services, and = other lawful commercial purposes permitted by applicable law. We may share such aggregated and/or de-identified information with third parties consistent with applicable law. We maintain reasonable safeguards designed to prevent re-identification of de-identified information, and we prohibit third parties from attempting to re-identify such information, as required by applicable law.
Sharing & Disclosure · Company practice
PHI may be disclosed to relatives, friends, or caregivers involved in your care and when required by law
Wheel Provider Group may disclose directly relevant PHI to a family member, relative, close personal friend, or other identified caregiver when you are present/available and agree, do not object, or are reasonably inferred not to object, or when you are unavailable if professional judgment determines disclosure is in your best interests; PHI may also be used and disclosed when required by federal, state, or local law.
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D. Disclosure to Relatives, Close Friends and Other Caregivers. We may use or disclose your Protected Health Information to a family member, other relative, a close personal friend or any other person identified by you when you are present for, or otherwise available prior to, the disclosure, if: (1) we obtain your agreement or provide you with the opportunity to object to the disclosure and you do not object; or (2) we reasonably infer that you do not object to the disclosure. If you are not present for or unavailable prior to a disclosure (e.g., when we receive a telephone call from a family member or other caregiver), we may exercise our professional judgment to determine whether a disclosure is in your best interests. If we disclose information under such circumstances, we would disclose only information that is directly relevant to the person’s involvement with your care.
E. As Required by Law. We may use and disclose your Protected Health Information when required to do so by any applicable federal, state or local law.
Sharing & Disclosure · Company practice
PHI may be disclosed without authorization for public health, abuse or domestic violence reporting, and health oversight
Wheel Provider Group may disclose Protected Health Information without written authorization for public health activities (disease/injury control, child abuse/neglect reports, FDA product reporting, communicable disease exposure alerts, and legally required workplace illness/injury or medical surveillance reporting to employers), to government authorities when reasonably believing you are a victim of abuse, neglect, or domestic violence, and to health oversight agencies ensuring compliance with programs like Medicare or Medicaid.
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F. Public Health Activities. We may disclose your Protected Health Information: (1) to report health information to public health authorities for the purpose of preventing or controlling disease, injury or disability; (2) to report child abuse and neglect to a government authority authorized by law to receive such reports; (3) to report information about products under the jurisdiction of the U.S. Food and Drug Administration; (4) to alert a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading a disease or condition; and (5) to report information to your employer as required under laws addressing work-related illnesses and injuries or workplace medical surveillance.
G. Victims of Abuse, Neglect or Domestic Violence. We may disclose your Protected Health Information if we reasonably believe you are a victim of abuse, neglect or domestic violence to a government authority authorized by law to receive reports of such abuse, neglect, or domestic violence.
H. Health Oversight Activities. We may disclose your Protected Health Information to an agency that oversees the health care system and is charged with responsibility for ensuring compliance with the rules of government health programs such as Medicare or Medicaid.
Sharing & Disclosure · Company practice
PHI may be disclosed for judicial/administrative proceedings, law enforcement, coroners, and organ/tissue procurement
Wheel Provider Group may disclose Protected Health Information without written authorization in judicial or administrative proceedings in response to a legal order or other lawful process, to police or other law enforcement officials as required by law or court order, to a coroner or medical examiner as authorized by law, and to organizations facilitating organ, eye, or tissue procurement, banking, or transplantation.
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I. Judicial and Administrative Proceedings. We may disclose your Protected Health Information in the course of a judicial or administrative proceeding in response to a legal order or other lawful process.
J. Law Enforcement Officials. We may disclose your Protected Health Information to the police or other law enforcement officials as required by law or in compliance with a court order.
K. Decedents. We may disclose your Protected Health Information to a coroner or medical examiner as authorized by law.
L. Organ and Tissue Procurement. We may disclose your Protected Health Information to organizations that facilitate organ, eye or tissue procurement, banking or transplantation.
Sharing & Disclosure · Company practice
PHI may be used and disclosed for research with authorization, an IRB waiver, or in limited or preparatory data sets
Wheel Provider Group may use and disclose Protected Health Information for research purposes pursuant to a valid patient authorization or when an institutional review board (IRB) or privacy board has waived authorization, and under certain circumstances may disclose PHI without authorization to researchers preparing to conduct a research project, for research on decedents, or as part of a data set omitting your name and other direct identifiers.
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M. Clinical Trials and Other Research Activities. We may use and disclose your Protected Health Information for research purposes pursuant to a valid authorization from you or when an institutional review board or privacy board has waived the authorization requirement. Under certain circumstances, your Protected Health Information may be disclosed without your authorization to researchers preparing to conduct a research project, for research or decedents or as part of a data set that omits your name and other information that can directly identify you.
Sharing & Disclosure · Company practice
PHI may be disclosed for serious health/safety threats, military/State Department functions, and workers' compensation
Wheel Provider Group may use or disclose Protected Health Information without written authorization to prevent or lessen a serious and imminent threat to a person's or the public's health or safety, to government units with special functions (such as the U.S. military or U.S. Department of State) under certain circumstances, and as authorized by and necessary to comply with state laws relating to workers' compensation or similar programs.
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N. Health or Safety. We may use or disclose your Protected Health Information to prevent or lessen a serious and imminent threat to a person’s or the public’s health or safety.
O. Specialized Government Functions. We may use and disclose your Protected Health Information to units of the government with special functions, such as the U.S. military or the U.S. Department of State under certain circumstances.
P. Workers’ Compensation. We may disclose your Protected Health Information as authorized by and to the extent necessary to comply with state law relating to workers’ compensation or other similar programs.
Sharing & Disclosure · Restriction or exception
Written authorization is required for non-Section III uses and HIPAA marketing, with narrow exceptions
Wheel Provider Group only uses or discloses PHI for purposes outside Section III—including HIPAA marketing or third-party-funded communications about treatments, providers, or products—with your written authorization, except it may provide refill reminders or communications about currently prescribed drugs/biologics (if any payment is reasonably related to cost) and conduct face-to-face marketing or give nominal-value promotional gifts without authorization.
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For any purpose other than the ones described above in Section III, we only use or disclose your Protected Health Information when you give us your written authorization.
A. Marketing. We must obtain your written authorization prior to using your Protected Health Information for purposes that are marketing under the HIPAA privacy rules. For example, we will not accept any payments from other organizations or individuals in exchange for making communications to you about treatments, therapies, health care providers, settings of care, case management, care coordination, products or services unless you have given us your authorization to do so or the communication is permitted by law. We may provide refill reminders or communicate with you about a drug or biologic that is currently prescribed to you so long as any payment we receive for making the communication is reasonably related to our cost of making the communication. In addition, we may market to you in a face-to-face encounter and give you promotional gifts of nominal value without obtaining your written authorization.
Qualifications & exceptions
Refill reminders/currently prescribed drug communications (with cost-related payment), face-to-face marketing, and nominal gifts do not require written authorization
Sale of PHI and use or disclosure of psychotherapy notes require written authorization, with narrow exceptions
Wheel Provider Group will not make any disclosure of PHI that constitutes a sale of PHI without your written authorization, and will not use or disclose psychotherapy notes without your authorization except for treatment by the mental health professional who created them, mental health training programs, or defending itself in a legal action or proceeding brought by you.
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B. Sale of Protected Health Information. We will not make any disclosure of Protected Health Information that is a sale of Protected Health Information without your written authorization.
C. Psychotherapy Notes. We will not use or disclose psychotherapy notes about you without your authorization except for use by the mental health professional who created the notes to provide treatment to you, for our mental health training programs or to defend ourselves in a legal action or other proceeding brought by you.
Qualifications & exceptions
Except for creator treatment use, mental health training programs, or defense in a legal proceeding brought by you
Sharing & Disclosure · Restriction or exception
42 CFR Part 2 SUD records require written consent for use/disclosure, and SUD counseling notes need separate consent
When handling Substance Use Disorder (SUD) records protected under 42 CFR Part 2, Wheel Provider Group may use and disclose them for treatment, payment, and health care operations only with your single written consent (or under a broad Part 2 consent or Part 2 exception such as a court order or medical emergency), will not use or disclose them for other purposes without specific written consent, a qualifying court order, or another Part 2 exception, and requires separate, specific consent for SUD Counseling Notes.
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D. Uses and Disclosures of Substance Use Disorder (SUD) Records.
When we create, receive, maintain, or transmit your SUD records protected under 42 CFR Part 2, we handle them as follows:
How We May Use and Disclose Your Part 2 SUD Records. We may use and disclose your Part 2 records for treatment, payment, and health care operations purposes only if you provide a single written consent authorizing such uses and disclosures (or under another Part 2 exception, such as a court order or medical emergency).
If you give broad consent to a Part 2 program for these purposes, and we receive your records under that consent, we may use and disclose them for treatment, payment, and health care operations as described elsewhere in this Notice.
We will not use or disclose your Part 2 records for other purposes without your specific written consent, a qualifying court order (after notice and opportunity to object where required), or another Part 2-permitted exception.
SUD Counseling Notes (notes separately maintained by an SUD or mental health professional documenting or analyzing private/group/family counseling sessions) require separate, specific consent and cannot be covered under a general consent for treatment, payment, or operations.
Qualifications & exceptions
Or under another Part 2 exception, such as a qualifying court order or medical emergency
Sharing & Disclosure · Restriction or exception
Part 2 SUD records are restricted in proceedings against you, and HIPAA recipients may redisclose them after consent
Part 2 SUD records generally cannot be used or disclosed in civil, criminal, administrative, or legislative proceedings against you without your written consent or a qualifying Part 2 court order. If Part 2 records are disclosed to a HIPAA covered entity or business associate after your consent, that recipient may redisclose them under HIPAA and Part 2 protections may no longer apply, though Wheel Provider Group includes a notice prohibiting redisclosure where required by Part 2.
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Restrictions on Uses in Legal Proceedings. Your Part 2 records generally may not be used or disclosed in civil, criminal, administrative, or legislative proceedings against you without your written consent or a court order meeting Part 2 requirements (including notice to you and an opportunity to be heard in many cases).
Redisclosure Risks. If we disclose your Part 2 records to another entity (such as under HIPAA rules after your consent), that recipient may redisclose them according to HIPAA (if they are a HIPAA covered entity or business associate), and Part 2 protections may no longer apply. We will include a notice prohibiting redisclosure where required by Part 2.