NOTICE TO CONSUMERS
Medical doctors are licensed and regulated by the Medical Board of California.
Ivana Viani, MD
Board Certified Psychiatrist
NOTICE OF PRIVACY PRACTICES
I. 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.
II. YOUR DOCTOR HAS A LEGAL DUTY TO SAFEGUARD YOUR PROTECTED HEALTH INFORMATION (PHI).
Your doctor is legally required to protect the privacy of your PHI, which includes information that can be used to identify you that your doctor has created or received about your past, present, or future health or condition, the provision of health care to you, or the payment of this health care. Your doctor must provide you with this Notice about your doctor's privacy practices, and such Notice must explain how, when, and why your doctor will "use" and "disclose" your PHI. A "use" of PHI occurs when your doctor shares, examines, utilizes, applies, or analyzes such information within your doctor's practice; PHI is "disclosed" when it is released, transferred, has been given to, or is otherwise divulged to a third party outside of your doctor's practice. With some exceptions, your doctor may not use or disclose any more of your PHI than is necessary to accomplish the purpose for which the use or disclosure is made. And, your doctor is legally required to follow the privacy practices described in this Notice.
However, your doctor reserves the right to change the terms of this Notice and your doctor's privacy policies at any time. Any changes will apply to PHI on file with your doctor already. Before your doctor makes any important changes to their policies, they will promptly change this Notice and post a new copy of it on their website. You can also request a copy of this Notice from your doctor at any time.
III. HOW YOUR DOCTOR MAY USE AND DISCLOSE YOUR PHI.
Your doctor may use and disclose your PHI for many different reasons. For some of these uses or disclosures, your doctor will need your prior authorization; for others, however, your doctor does not. Listed below are the different categories of uses and disclosures along with some examples of each category.
A. Uses and Disclosures Relating to Treatment, Payment, or Health Care Operations Do Not Require Your Prior Written Consent. Your doctor can use and disclose your PHI without your consent for the following reasons:
For treatment. Your doctor can disclose your PHI to physicians, psychiatrists, psychologists, and other licensed health care providers who provide you with health care services or are involved in your care. This is usually done for care coordination.
To obtain payment for treatment. Your doctor can use and disclose your PHI to bill and collect payment for the treatment and services provided by your doctor to you. For example, your doctor may provide your PHI to their business associates, such as billing companies, claims processing companies, and others that process health care claims.
For health care operations. Your doctor can disclose your PHI to operate their practice. For example, your doctor might use your PHI to evaluate the quality of health care services that you received. Your doctor may also provide your PHI to their accountants, attorneys, consultants, and others to make sure your doctor is complying with applicable laws.
Other disclosures. Your doctor may also disclose your PHI to others without your consent in certain situations. For example, your consent isn't required if you need emergency treatment, as long as your doctor tries to get your consent after treatment is rendered, or if your doctor tries to get your consent but you are unable to communicate (for example, if you are unconscious or in severe pain) and your doctor thinks that you would consent to such treatment if you were able to do so.
B. Certain Uses and Disclosures Do Not Require Your Consent. Your doctor can use and disclose your PHI without your consent or authorization for the following reasons:
When disclosure is required by federal, state or Iocal law; judicial or administrative proceedings; or, law enforcement. For example, doctors may make a disclosure to applicable officials when a law requires them to report information to government agencies and law enforcement personnel about victims of abuse or neglect; or when ordered in a judicial or administrative proceeding.
For public health activities. For example, your doctor may have to report information about you to the county medical examiner.
For health oversight activities. For example, your doctor may have to provide information to assist the government when it conducts an investigation or inspection of a health care provider or organization.
For research purposes. In certain circumstances, your doctor may provide PHI in order to conduct medical research.
To avoid harm. In order to avoid a serious threat to the PHI to law enforcement personnel or persons able to prevent or lessen such harm.
For specific government functions. Your doctor may disclose PHI of military personnel and veterans in certain situations. Your doctor may disclose PHI for national security purposes, such as protecting the President of the United States or conducting intelligence operations.
For workers' compensation purposes. Your doctor may provide PHI in order to comply with workers' compensation laws.
Appointment reminders and health related benefits or services. Your doctor may use PHI to provide appointment reminders or give you information about treatment alternatives, or other doctor’s health care services or benefits they offer.
C. Certain Uses and Disclosures Require You to Have the Opportunity to Object. Disclosures to family, friends, or other.
Your doctor may provide your PHI to a family member, friend, or another person that you indicate is involved in your care or the payment for your health care, unless you object in whole or in part. The opportunity to consent may be obtained retroactively in emergency situations.
D. Other Uses and Disclosures Require Your Prior Written Authorization. In any other situation not described in sections III A, B, and C above, your doctor will ask for your written authorization before using or disclosing any of your PHI. If you choose to sign an authorization to disclose your PHI, you can later revoke such authorization in writing to stop any future uses and disclosures (to the extent that the doctor hasn't taken any action in reliance on such authorization) of your PHI.
IV. WHAT RIGHTS YOU HAVE REGARDING YOUR PHI
You have the following rights with respect to your PHI:
A. The Right to Request Limits on Uses and Disclosures of Your PHI. You have the right to ask that your doctor limits how they use and disclose your PHI. Your doctor will consider your request, but they are not legally required to accept it. If your doctor accepts your request, they will put any limits in writing and abide by them except in emergency situations. You may not limit the uses and disclosures that the doctor is legally required or allowed to make.
B. The Right to Choose How Your Doctor Sends PHI to You. You have the right to ask that your doctor sends information to you to at an alternate address (for example, sending information to your work address rather than your home address) or by alternate means (for example, e-mail instead of regular mail). The doctor must agree to your request so long as they can easily provide the PHI to you in the format you requested.
C. The Right to See and Get Copies of Your PHI. In most cases, you have the right to look at or get copies of your PHI that your doctor has, but you must make the request in writing. If your doctor doesn't have your PHI but knows who does, they will tell you how to get it. They will respond to you within 30 days of receiving your written request. In certain situations, they may deny your request. If they do, they will tell you, in writing, their reasons for the denial and explain your right to have their denial reviewed. If you request copies of your PHI, your doctor will charge you not more than $0.25 for each page. Instead of providing the PHI you requested, your doctor may provide you with a summary or explanation of the PHI as long as you agree to that and to the cost in advance.
D. The Right to Get a List of the Disclosures Your Doctor Has Made.
You have the right to get a list of instances in which your doctor has disclosed your PHI. The list will not include uses or disclosures that you have already consented to, such as those made for treatment, payment, or health care operations, directly to you, or to your family. The list also won't include uses and disclosures made for national security purposes, to corrections or law enforcement personnel, or disclosures made before January 1, 2023.
Your doctor will respond to your request for an accounting of disclosures within 60 days of receiving your request. The list your doctor will give you will include disclosures made in the last six years unless you request a shorter time. The list will include the date of the disclosure, to whom PHI was disclosed (including their address, if known), a description of the information disclosed, and the reason for the disclosure. Your doctor will provide the list to you at no charge, but if you make more than one request in the same year, your doctor may charge you a reasonable cost-based fee for each additional request.
E. The Right to Correct or Update Your PHI. If you believe that there is a mistake in your PHI or that a piece of important information is missing, you have the right to request that your doctor corrects the existing information or add the missing information. You must provide the request and your reason for the request in writing. Your doctor will respond within 60 days of receiving your request to correct or update your PHI. Your doctor may deny your request in writing if the PHI is (i) correct and complete, (ii) not created by the doctor, (iii) not allowed to be disclosed, or (iv) not part of the doctor’s records. Your doctor’s written denial will state the reasons for the denial and explain your right to file a written statement of disagreement with the denial. If you don't file one, you have the right to request that your request and your doctor’s denial be attached to all future disclosures of your PHI. If your doctor approves your request, the doctor will make the change to your PHI, tell you that they have done it, and tell others that need to know about the change to your PHI.
F. The Right to Get This Notice by E-Mail. You have the right to get a copy of this notice by e-mail. Even if you have agreed to receive notice via e-mail, you also have the right to request a paper copy of it.
V. HOW TO COMPLAIN ABOUT YOUR DOCTOR’S PRIVACY PRACTICES
If you think that your doctor may have violated your privacy rights, or you disagree with a decision your doctor made about access to your PHI, you may send a written complaint to the Secretary of the Department of Health and Human Services at 200 Independence Avenue S.W., Washington, D.C. 20201. Your doctor will take no retaliatory action against you if you file a complaint about the doctor’s privacy practices. The Office of the Attorney General of the State of California is another great resource: https://oag.ca.gov/privacy/facts/medical-privacy/patient-rights.
VII. EFFECTIVE DATE OF THIS NOTICE
This notice went into effect on January 1, 2023.
OPEN PAYMENTS NOTICE
For informational purposes only, a link to the federal Centers for Medicare and Medicaid Services (CMS) Open Payments web page is provided here. The federal Physician Payments Sunshine Act requires that detailed information about payment and other payments of value worth over ten dollars ($10) from manufacturers of drugs, medical devices, and biologics to physicians and teaching hospitals be made available to the public: https://openpaymentsdata.cms.gov/.