request. However, such accounting need not include disclosures made: (1) to carry out treatment, payment or health care operations; (2) to individuals about their own protected health information; (3) prior to the compliance date; or (4) pursuant to an in dividual’s authorization. If the accounting cannot be provided within 60 days, an additional 30 days is allowed if the individual is given a written statement of the reasons for the delay and the date by which the accounting will be provided. If you request more than one accounting within a 12-month period, the group health plan may charge a reasonable fee for each subsequent accounting. 20. The Right to Receive a Paper Copy of This Notice Upon Request : If you are receiving this Notice in an electronic format, then you have the right
to receive a written copy of this Notice free of charge by contacting the Privacy Official (see section 23).
21. Changes in the Privacy Practice . Each group health plan reserves the right to change its privacy practices from time to time by action of the Privacy Official. You will be provided with an advance notice of any material change in the plan’s privacy practices. Your Right to File a Complaint with the Group Health Plan or the Department of Health and Human Services : If you believe that your privacy rights have been violated, you may complain to the group health plan in care of the HIPAA Privacy Official (see section 23). You may also file a complaint with the Secretary of the U.S. Department of Health and Human Services, Hubert H. Humphrey Building, 200 Independence Avenue S.W., Washington, D.C. 20201. The group health plan will not retaliate against you for filing a complaint. 22. 23. Person to Contact at the Group Health Plan for More Information : If you have any questions regarding this Notice or the subjects addressed in it, you may contact the Privacy Official.
Privacy Official The Plan’s Privacy Official, the person responsible for ensuring compliance with this notice, is:
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