Applicability of this Notice

Tandem is providing you with this Notice because it is required by the Health Insurance Portability and Accountability Act (HIPAA) and because we are committed to protecting the privacy and security of your personal data. This Notice applies to individuals whose electronic health data we collect, use, or disclose in relation to our diabetes products and services. This Notice is meant to be read in addition to, and not in the place of, the information provided in Tandem’s Notice of Privacy Practices. Please review our Notice of Privacy Practices.

 
Your Rights

You have the right to:

• With some exceptions, get a copy of your paper or electronic health information
• Correct your paper or electronic health information
• Request confidential communication
• Ask us to limit the information we share
• Get a list of those with whom we’ve shared your information
• Get a copy of this privacy Notice
• Choose someone to act for you
• File a complaint if you believe your privacy rights have been violated

Your Choices

You have some choices in the way that we use and share information, in the event we:

• Tell family and friends about your condition
• Market our services and sell your information
• Contact you about our fundraising activities

Our Uses and Disclosures

We may use and share your information as we:

• Assist your health care providers in your medical treatment
• Run our organization
• Process insurance reimbursement
• Fulfill product orders
• Help with public health and safety issues
• Do research
• Comply with the law
• Work with a medical examiner or funeral director
• Address workers’ compensation, law enforcement, and other government requests
• Respond to lawsuits and legal actions

Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you, and provides details to the summary included above.

 
Get an electronic or paper copy of your health information

You can send us a written request to the address listed below asking to see or get an electronic or paper copy of the health information we have about you. We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

 
Ask us to correct your health information

You can send us a written request to the address listed below asking us to correct or amend your health information that you think is incorrect or incomplete. We may say “no” to your request, but we’ll tell you why in writing within 60 days.

 
Request confidential communications

You can send us a written request to the address listed below asking us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will say “yes” to all reasonable requests. Please submit all requests in writing to the address listed below.

 
Ask us to limit what we use or share

You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care. If you pay for a Tandem product or service out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.

 
Get a list of those with whom we’ve shared information

You can ask for a list of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why. We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another within 12 months.

 
Get a copy of this privacy notice

You can ask for a paper copy of this Notice at any time, even if you have agreed to receive the Notice electronically. We will provide you with a paper copy promptly.

 
Choose someone to act for you

If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action.

 
File a complaint if you feel your rights are violated

You can complain if you feel we have violated your rights by contacting us at compliance@tandemdiabetes.com or sending a letter to Tandem Diabetes Care, Legal Department, 11075 Roselle Street, San Diego, CA 92121

You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, visiting www.hhs.gov/hipaa/filing-a-complaint/what-to-expect/index.html, or calling (877) 696-6775. We will not retaliate against you for filing a complaint.

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Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

• Share information with your family, close friends, or others involved in your care
• Share information in a disaster relief situation

If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In these cases we never share your information unless you give us written permission:

• Marketing purposes, other than communications from us about out own products or services
• Sale of your information
• Most sharing of psychotherapy notes

In the case of fundraising: We may contact you for fundraising efforts, but you can tell us not to contact you again.

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Our Uses and Disclosures

How do we typically use or share your health information?

We typically use or share your health information in the following ways:

To assist in your treatment:
We can use your health information and share it with health professionals who are treating you. Example: A doctor treating you asks us about your diabetes pump data.

Run our organization:
We can use and share your health information to run our business, improve your diabetes care, and contact you when necessary. Example: We use health information about you to manage and improve the services and products we provide to you.

Bill for the products we provide:
We can use and share your health information to bill and get payment from health plans or other entities. Example: We give information about you to your health insurance plan so it will pay for your equipment.

 
How else can we use or share your health information?

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/index.html

Help with public health and safety issues:
We can share health information about you for certain situations such as:

• Preventing disease
• Helping with product recalls
• Reporting product defects or product recalls
• Reporting suspected abuse, neglect, or domestic violence
• Preventing or reducing a serious threat to anyone’s health or safety

Do research:
We can use or share your information for health research.

Comply with the law:
We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.

Work with a medical examiner or funeral director:
We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

Address workers’ compensation, law enforcement, and other government requests:
We can use or share health information about you:

• For workers’ compensation claims
• For law enforcement purposes or with a law enforcement official
• With health oversight agencies for activities authorized by law
• For special government functions such as military, national security, and presidential protective services

Respond to lawsuits and legal actions:
We can share health information about you in response to a legal action you initiate, a court or administrative proceeding or order, or in response to a subpoena.

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Our Responsibilities

• We are required by law to maintain the privacy and security of your protected health information.
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in this Notice and give you a copy of it.
• We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

For more information see: www.hhs.gov/hipaa/for-individuals/notice-privacy-practices/index.html

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