Our practice is committed to maintaining the Privacy and Security of your Protected Health Information (PHI), while providing high quality medical care. In accordance with the HIPAA regulations you are receiving a full written notice of our privacy practices at your first office visit after April 14, 2003.

This notice will explain:

We may use and disclose your PHI for treatment, payment, and health care operations (TPO) as well as other times in order to provide you with excellent service. You have the right to inspect, copy, and amend your PHI. You have the right to request restrictions on the use of your PHI. You have the right to an accounting of the disclosures of our PHI for other than TPO. You have the right to complain about alleged violation to this practice’s privacy officer, Thomas Gavin, and the U.S. Department of Health and Human Services. We are required by law to maintain the privacy of your medical information and to provide you with notice of our legal duties and privacy practices. We are required to abide by the terms of the Notice of Privacy Practices currently in effect. We reserve the right to change those terms and any changes made will be effective for all medical information we maintain. A copy of a revised notice will be available upon written request.

DISCLOSURES WITHOUT YOUR AUTHORIZATION:

We may disclose medical information about you, without your specific authorization:

Disclosures required by law:

We may be required by federal, state, or local law to disclose your medical information.

Public Health Activities:

We may disclose your medical information to a public agency, such as the Food and Drug Administration (FDA), if you experience an adverse effect from any of the supplies or equipment we use.

Victims of Abuse, Neglect, or Domestic Violence:

We may be required to disclose your medical information if we feel that you have been abused or neglected.

Health Oversight Activities:

We may be required to disclose your medical information to Medicare or a related agency if they select your case for a medical review

Judicial and Administrative Proceedings:

We may have to disclose your medical information if we receive a subpoena from a judge or administrative tribunal.

Law Enforcement:

We may have to disclose your medical information in conjunction with a criminal investigation by a federal, state, or law enforcement agency.

Serious Threats to Health or Safety:

We may be required to disclose your medical information if, in our opinion, doing so will help avert a serious threat to the public.

Military Personnel:

We may disclose your medical information to the appropriate command authorities. Worker’s Compensation: We may disclose your medical information to comply with laws regarding worker’s compensation. You have certain rights with respect to your medical information.

HIPAA Policy PDF