Member Rights and Responsibilities

 

Statement

Omada Health, Inc. (together with its subsidiaries and affiliates, collectively, “Omada Health” or “Omada”) is committed to a framework of “shared decision-making” between Omada as your healthcare provider, and you as our Member.  Shared decision-making can occur when the Member has an understanding of their rights and responsibilities and is active in decision-making regarding their care.

Member’s Rights and Responsibilities

If you receive services from Omada, regardless of the source of payment, you have the right to:

  1. Considerate and respectful care in a safe setting. You have the right to respect for your cultural, psychosocial, spiritual, and personal values, beliefs and preferences free from mental, physical, sexual or verbal abuse and neglect, exploitation or harassment of any kind by Omada Health staff. 
  2. To appoint a designee(s), if you desire, to speak on your behalf and to make decisions on your behalf as it pertains to your enrollment and participation in the Omada program.
  3. Know the name of the health care practitioner(s) and professionals acting within the scope of his or her professional licensure, credential or role who has primary responsibility for coordinating your care, and the names and professional relationships of other members of your Care Team who will be involved in your care and treatment.
  4. Reasonable continuity of care and to have in advance information about appointments as well as the identity of the persons providing the care.
  5. Be supported by Omada to make healthcare decisions interactively with your care team members.
  6. Receive information in a way that is understandable to you regarding:
    1. Omada Health’s ownership and control, such as services/products we provide directly or by contract;
    2. Any specific charges for supplies to be paid by you in addition to those charges covered by insurance third party payment or public benefit programs;
    3. Billing policies, payment procedures and any changes in the information provided at the time of initial enrollment in the Omada Program.
    4. Instructions and any warranties available for products: 
      1. Who to contact, when and how to communicate problems with Omada products or service availability;
      2. If you’re receiving services as part of a Medicare or Medicare Advantage plan or program: The purpose and appropriate use of Medicare Hotline numbers. Medicare’s Toll Free number is 1-800-633-4227 and is available during standard business hours;
      3. Information regarding Omada Health’s liability insurance upon request; and
      4. Applicable Omada Health policy for accessing and disclosure of your records. This is available in Omada’s HIPAA Notice of Privacy Practices at https://www.omadahealth.com/hipaa-notice, or by emailing privacy@omadahealth.com;
    5. Be notified in advance of any available product options, and who to contact with delivery questions or concerns about your devices.
  7. You have the right to effective communication and to participate in the development and implementation of your plan of care. You have the right to participate in ethical decisions  that arise in the course of your care, including issues of conflict resolution.
  8. Receive and access services consistently in a timely manner in accordance with our operational policy and without regard to race, religion, gender, age, handicap, sexual orientation or gender identity, or veteran status, as is described in section 24 of Omada’s Terms of Use.
  9. Receive information about your health status, diagnosis, and outcomes of care (including unanticipated outcomes) in terms you can understand. 
  10. Make informed decisions with your Care Team regarding your care, and receive as much information about any proposed care plan and the use of any supplies we supplied to you.  
  11. Request or refuse care, to the extent permitted by law. However, you do not have the right to demand inappropriate or medically unnecessary services. 
  12. You have the right to request to be promptly unenrolled in the Omada program, and must inform Omada if your intent is to withdraw from the program.
  13. Upon your request, be referred to another organization if Omada Health is unable to meet your needs or if you are not satisfied with the products or services you are receiving;
    1. Participate in the selection of options for alternatives or referral to other organizations, as indicated by your need for care;
    2. Receive disclosure information regarding any beneficial relationship between Omada Health and any organizations to which Omada refers you upon your request;
  14. Be given the opportunity to opt-into research projects as outlined by Omada’s HIPAA Notice of Privacy Practices.
  15. Have your personal privacy respected. You have the right to be told the reason for the presence of any individual involved in your care. 
    1. Confidentiality of your records as required by law.  Please see our Privacy Policy and our HIPAA Notice of Privacy Practices for details on how we maintain the confidentiality of your records.
    2. Confidential treatment of all communications and records pertaining to your care. Upon enrollment into the Omada Program, you will receive a separate Notice of Privacy Practices that explains your privacy rights in detail and how we may use and disclose your protected health information.
  16. Reasonable responses to any reasonable requests made for service.
  17. Know which Omada terms of use apply to your conduct while a Member of Omada. 
  18. Examine and receive an explanation of Omada’s charges regardless of the source of payment.
  19. Exercise any of these rights without regard to sex, economic status, educational background, race, color, religion, ancestry, national origin, sexual orientation or gender identity, disability, medical condition, marital status, registered domestic partner status, or the source of payment for care.
  20. If you believe that we have failed to provide these services as expected or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance by contacting: Omada Health Civil Rights Coordinator, Legal Department, 500 Sansome Street, Suite 200, San Francisco, CA 94111, by phone at 888-987-8337, or by email to support@omadahealth.com. You can file a grievance in person or by mail or email. If you need help filing a grievance the Omada Health Civil Rights Coordinator is available to help you. You are entitled to a response regarding the investigation and resolution of complaints

    You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at OCR Complaint Portal Assistance, or by contacting the office via mail or phone at:

    U.S. Department of Health and Human Services

    200 Independence Avenue, SW

    Room 509F, HHH Building

    Washington, D.C 20201

    1-800-368-1019, 800-537-7697 (TDD)

    Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html

  21. Direct questions or concerns regarding the performance of your equipment, supplies and/or service to Omada Health at 1-888-409-8687 or at support@omadahealth.com
    1. Omada’s support desk is available between the following hours Monday through Friday: 5:00am PST - 6:00pm PST.
    2. Please be advised that Omada Health is responsible for resolving your questions or concerns, and it is the company’s goal to respond to questions and concerns in a timely manner.
  22. You may direct any questions or concerns regarding Omada Health to Omada Health’s accreditor for medical equipment, the Community Health Accreditation Partner (CHAP), an independent non-profit accrediting body, at 800-656-9656. Business hours for CHAP are 8:00 A.M. to 5:00 P.M., Monday through Friday. A twenty-four-hour hotline is available by dialing the same phone number after normal business hours.
  23. The products and/or services provided to you by Omada Health are subject to the supplier standards contained in the Federal regulations shown at 42 Code of Federal Regulations Section 424.57(c). These standards concern business professional and operational matters (e.g. honoring warranties and hours of operation). The full text of these standards can be obtained at http://www.ecfr.gov. Upon request we will furnish you a written copy of the standards.  In addition, if Omada supplies you with your glucometer and it is a digital glucometer of any type, Omada has negotiated additional terms about that glucometer, as is described in Omada’s main Terms Of Use under User Submitted Data.