Notice of Privacy Practices (HIPAA)

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.

1. Our Pledge Regarding Medical Information

At Makis Health Clinic, we understand that medical information about you and your health is highly personal. We are deeply committed to protecting medical information about you. We create a record of the care and services you receive at our facility or through our telemedicine platforms. We need this record to provide you with quality care and to comply with certain legal requirements.

This Notice of Privacy Practices applies to all of the records of your care generated by Makis Health Clinic, whether made by clinical personnel, doctors, or administrative staff. This notice will tell you about the ways in which we may use and disclose medical information about you. It also describes your rights and certain obligations we have regarding the use and disclosure of medical information.

2. Our Legal Duty

We are required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and applicable state laws to:

• Make sure that medical information that identifies you is kept private and secure.
• Give you this notice of our legal duties and privacy practices with respect to medical information about you.
• Follow the terms of the notice that is currently in effect.
• Notify you following a breach of unsecured protected health information.

3. How We May Use and Disclose Medical Information About You

The following categories describe different ways that we use and disclose medical information. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.

For Treatment

We may use medical information about you to provide you with medical treatment or services. We may disclose medical information about you to doctors, nurses, technicians, medical students, or other personnel who are involved in taking care of you. For example, Dr. Makis may need to share your pathology reports with our laboratory technicians or your primary care physician to coordinate your intratumoral immunotherapy protocol.

For Payment

We may use and disclose medical information about you so that the treatment and services you receive may be billed to and payment may be collected from you, an insurance company, or a third party. For example, we may need to give your health plan information about the consultations you received so your health plan will reimburse you (via a superbill).

For Health Care Operations

We may use and disclose medical information about you for our health care operations. These uses and disclosures are necessary to run the clinic and make sure that all of our patients receive quality care. For example, we may use medical information to review our treatment and services and to evaluate the performance of our staff in caring for you.

Business Associates

There are some services provided in our organization through contacts with business associates. Examples include cloud storage providers for medical records, billing software vendors, and secure email providers. When these services are contracted, we may disclose your health information to our business associates so that they can perform the job we've asked them to do. To protect your health information, however, we require the business associate to appropriately safeguard your information through a Business Associate Agreement (BAA).

Individuals Involved in Your Care

We may release medical information about you to a friend or family member who is involved in your medical care, unless you object. We may also give information to someone who helps pay for your care.

As Required By Law

We will disclose medical information about you when required to do so by federal, state, or local law, including public health authorities, the Food and Drug Administration (FDA), and law enforcement agencies.

4. Your Rights Regarding Medical Information About You

You have the following rights regarding medical information we maintain about you:

• Right to Inspect and Copy: You have the right to inspect and copy medical information that may be used to make decisions about your care. Usually, this includes medical and billing records. To inspect and copy medical information, you must submit your request in writing to our Privacy Officer. We may charge a fee for the costs of copying, mailing, or other supplies associated with your request.
• Right to Amend: If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for the clinic.
• Right to an Accounting of Disclosures: You have the right to request an "accounting of disclosures." This is a list of the disclosures we made of medical information about you for purposes other than treatment, payment, health care operations, and certain other exceptions.
• Right to Request Restrictions: You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment, or health care operations. We are not required to agree to your request unless you are asking us to restrict the use and disclosure of your Protected Health Information to a health plan for payment or health care operation purposes and such information you wish to restrict pertains solely to a health care item or service for which you have paid us "out-of-pocket" in full.
• Right to Request Confidential Communications: You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail.
• Right to a Paper Copy of This Notice: You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time.

5. Changes to This Notice

We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future. We will post a copy of the current notice on our website and in our facility.

6. Complaints

If you believe your privacy rights have been violated, you may file a complaint with the clinic or with the Secretary of the Department of Health and Human Services. To file a complaint with the clinic, contact our Privacy Officer in writing. You will not be penalized for filing a complaint.

7. Contact Information

For further information about this Privacy Notice, or to exercise your rights, please contact:

Makis Health Clinic
ATTN: HIPAA Privacy Officer
123 Medical Innovation Way, Suite 400
San Francisco, CA 94158
Phone: +1-863-451-9755
Email: compliance@makis-health.com