Notice of Privacy Practices

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Our Commitment to Your Privacy

Empire Medical & Rehabilitation PC is committed to protecting the privacy of your protected health information ("PHI") as required by the Health Insurance Portability and Accountability Act of 1996 ("HIPAA") and applicable state law. This Notice describes how we may use and disclose your PHI and your rights regarding that information.

How We Use and Disclose Your PHI

We may use and disclose your PHI without your specific authorization for the following purposes:

Treatment

We use your PHI to provide and coordinate medical care. This includes sharing information with other healthcare providers involved in your care, such as specialists, labs, pharmacies, and hospitals.

Payment

We use and disclose your PHI to bill and receive payment for the services we provide. This may include sharing information with your insurance company to verify coverage, obtain authorizations, and submit claims.

Healthcare Operations

We use your PHI to operate our practice, including quality assessment, staff training, licensing, and other administrative activities.

Other Uses Permitted or Required by Law

We may also use or disclose your PHI without your authorization in the following situations:

• Public health activities and reporting
• Reports of abuse, neglect, or domestic violence
• Health oversight activities and audits
• Judicial and administrative proceedings (in response to court orders or subpoenas)
• Law enforcement purposes as required by law
• To coroners, medical examiners, and funeral directors
• For organ and tissue donation purposes
• To prevent a serious threat to health or safety
• For specialized government functions such as military, national security, or workers' compensation

Uses Requiring Your Authorization

Most uses and disclosures of PHI for marketing purposes, sales of PHI, and most disclosures of psychotherapy notes require your written authorization. You may revoke an authorization at any time in writing, except to the extent we have already acted in reliance on it.

Your Rights

You have the following rights with respect to your PHI:

• Right to Access: You may request to inspect and obtain a copy of your medical records.
• Right to Amend: You may request that we amend PHI you believe is incorrect or incomplete.
• Right to an Accounting of Disclosures: You may request a list of certain disclosures we have made of your PHI.
• Right to Request Restrictions: You may request restrictions on certain uses and disclosures of your PHI. We are not required to agree to all such requests.
• Right to Confidential Communications: You may request that we communicate with you in a specific way (for example, by mail rather than phone, or at a specific address).
• Right to a Paper Copy of This Notice: You may request a paper copy at any time, even if you previously agreed to receive it electronically.
• Right to Be Notified of a Breach: You have the right to be notified following a breach of your unsecured PHI.

How to Exercise Your Rights

To exercise any of the rights described above, please submit a written request to our office at the address below. We will respond to your request within the timeframes required by law.

Filing a Complaint

If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint.

Empire Medical & Rehabilitation PC complaints may be directed to:
Privacy Officer
Empire Medical & Rehabilitation PC
2965 Ocean Pkwy, 6th Floor
Brooklyn, NY 11235
Phone: (718) 750-2001

Changes to This Notice

We reserve the right to change this Notice at any time. Revised Notices will be posted in our office and on our website at empiremedicalpc.com/hipaa. The revised Notice will apply to all PHI we maintain, whether created before or after the change.

Effective Date

This Notice is effective as of the "Last updated" date shown at the top of this page.