HIPPA NOTICE OF PRIVACY PRACTICES

This Notice, which is effective July 1, 2026, describes your Protected Health Information (“PHI”) and how it may be used and disclosed and how you can get access to this information.  Please review this notice carefully and let us know if you have questions.

YOUR RIGHTS: When it comes to your PHI, you have certain rights. This section explains your rights in some of our responsibilities to help you. You have the right to:

Get an electronic or paper copy of your PHI:

You may request an electronic or paper copy of any PHI that we have about you.  We will provide a copy or summary of this information, usually within 15 days of your request.  We may charge a reasonable, cost-based fee to provide the requested information.

Ask us to correct your PHI:

You may ask us to correct PHI about you that you think is incorrect or incomplete.  We may deny your request but will explain why in writing within 15 business days.

Request confidential communications:

You may ask us to contact you by phone or in writing in a specific way (e.g., at your office instead of your home).  We will consider all reasonable requests and will not ask for the reason for your request.

Ask us to limit what we use or share:

You may ask us not to use or share certain PHI for treatment, payment, or our health care operations, including with someone who is involved in your care or payment of your care.  We may deny your request if it would affect your care.  We are only required to agree to your request when you have asked us not to share information for payment or business purposes with a health plan, we are not required by law to share the information with the health plan, and the service was paid for without using the health plan.

Get a list of those with whom we have shared PHI:

You may request an accounting of the times that we have shared your PHI for six years prior to the date of your request.  We must tell you what information we shared, with whom we shared it, and why.  We will provide all disclosures except for those about treatment, payment, and health care operations, and certain other disclosures, such as any that you asked us to make or exceptions required by law.  You may receive one accounting per year for free but will be charged for others.  We will notify you of the cost involved and you may choose to withdraw or modify your request before any costs are incurred.

Get a physical copy of this privacy notice:

You may 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 legally authorized someone else to communicate with us on your behalf, such as by giving them a medical power of attorney, or if someone is your legal guardian, that person may exercise your rights and make choices about your PHI.  We must make sure that the person has this authority to act for you before we take any action.

File a complaint if you feel that your rights have been violated.

You may complain if you feel that we have violated your rights.  You may file a complaint with the United States Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue S.W., Washington, D.C. 20201; by calling (877) 696-6775; or by visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.  We will not retaliate against you for filing a complaint.

YOUR CHOICES: for certain PHI, 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, tell us what they are and we will follow your instructions.

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

● Share information with your family, close friends, or others involved in your care

● Share information in a disaster relief situation

● Include your information in a hospital directory

● Contact you for fundraising efforts

If you are unable to tell us your preference (e.g., if you are unconscious), we may share your PHI if we believe that it is in your best interests to do so.  We may also share your information when needed to lessen a serious and imminent threat to the health or safety of you or someone else.

In these cases, we will never share your PHI unless you give us your written permission:

● Marketing purposes

● Sale of your PHI

In the case of fundraising:

We may contact you for fundraising efforts, but you can tell us not to contact you again.

Our typical uses and disclosures: we typically use or share your PHI in the following ways.

We use your PHI to treat you:

We may use or share your PHI to treat you and may share it with other professionals who are treating you (e.g., with another physician who is providing care to you for a particular illness or injury and asks for information about your overall health condition).

We use your PHI to run our practice:

We may use and share your PHI to run our medical practice, improve your care, and contact you when necessary.

We use your PHI to bill for your services:
We may use and share your PHI to bill you, submit medical claims on your behalf, and get paid by health plans for services rendered to you.  

Other uses and disclosures: we may use or share your health information and other ways, too.

We may share your PHI in ways that contribute to the public good, such as for public health matters, such as:

● Preventing or controlling disease, injury, or disability;

● Reporting births and deaths;

● Helping with product recalls;

● Reporting adverse reactions to medications;

● Reporting suspected abuse, neglect, or domestic violence;

● Preventing or reducing a serious threat to any person’s health or safety.

Under the law, we must meet many conditions before we can share your PHI for these purposes.   

We may use your PHI to do research:

We may use or share your PHI for health research, subject to additional regulations that govern the privacy of research data.

We must use your PHI to comply with the law:

We will share your PHI if state or federal laws require it, including with the United States Department of Health and Human Services if it wants to confirm that we are complying with federal privacy laws.

We may respond to organ and tissue donation requests:

We can share your PHI with organ procurement organizations, subject to regulations governing research data.

We may work with a coroner/medical examiner or funeral director:

We can share PHI with a coroner, medical examiner, or funeral director when an individual dies (e.g., to identify a deceased person).

We may address governmental requests for PHI, such as:

● For workers’ compensation claims; 

● For law enforcement purposes such as reporting certain threats to third parties, a suspicious  

    death, or criminal conduct at our offices;

● With health oversight agencies for lawful activities; and

● For special government functions such as military, national security, and presidential protective 

    services.

We may respond to lawsuits and legal actions.

We may share your PHI in response to a court or administrative order or a subpoena, unless it involves AIDS/HIV testing, genetic information, mental health, or substance use disorder, in which case we will require your  written consent or a court order.

If you authorize us to share your information with a person other than someone who has a written agreement to protect your information and who is not a medical provider, health plan, or health care clearinghouse, then none of the protections described in this Notice apply to your health information after the disclosure, and the recipient of such information may redisclose it.  However, if your information relates to substance abuse counseling notes and you have given written permission to use or disclose those notes, any person who receives them will continue to be required to protect that information according to the terms of the consent you have given.

Our responsibilities:

● We are required by law to maintain the privacy and security of your PHI.

● We will let you know promptly if a breach occurs that may have compromised the privacy or 

     security of your PHI.

● We must follow the duties and privacy practices described in this Notice and give you a copy of 

    it.

● We will not use or disclose any PHI that we receive from a substance use disorder treatment 

    program, or testimony that describes those records, for any civil, criminal, administrative, or  

    legislative proceedings against the person who is the subject of those records, unless we have 

    written consent or a court order that requires us to disclose them.

● We will not use or share your PHI other than as described here unless you authorize us in writing 

    to do so.  You may change your mind at any time, but you must advise us in writing if you change 

    your mind, which will stop any further use or disclosure of your information for the purposes 

    covered by your written authorization. For more information, see:  

    www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.

Who will follow this notice:

● Any health care professional who is authorized to enter PHI into your health record;

● All employees, staff, and other personnel; and

● Any business associates with which we contract to conduct services on our behalf;

All these persons and entities follow the terms of this Notice and may share your PHI with each other for treatment, payment, or health care operations as described in this Notice.

Changes to the terms of this notice:

We can change the terms of this Notice.  If we make changes, they will apply to all PHI we have about you.  The new Notice will be available upon request, in our office, and on our website.

Contact information:

If you have questions or need additional information regarding this Notice, please contact our Privacy Officer, James Fojt, DO, at jfojt@prospercomprehensivecare.com.