MIR NEUROLOGY

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. IF YOU HAVE ANY QUESTIONS ABOUT THIS NOTICE, PLEASE CONTACT US AT (301) 797-7600.

This Notice of Privacy Practices outlines how we may utilize and disclose your protected health information (PHI) to facilitate your treatment, billing processes, and the operational functions of our practice. It also delineates circumstances under which PHI may be disclosed to comply with various legal requirements. PHI includes information identifying you and pertaining to your past, present, or future physical or mental health, related health care services, and genetic information. We are obligated by law to maintain the privacy of PHI and to provide you with this Notice of Privacy Practices regarding our utilization and disclosure of your PHI.

We reserve the right to modify the terms of this Notice of Privacy Practices at any time, with the revised notice being effective for all PHI we maintain at that time. Updated notices will be accessible on our website at www.mirneurology.com. Alternatively, you may request a paper copy of the revised Notice of Privacy Practices by contacting our office.

1. Uses and Disclosures of Protected Health Information

We do not engage in the sale, sharing, or disclosure of your PHI without obtaining your explicit consent.

Your PHI may be utilized and disclosed by our physicians, office staff, and other involved parties for purposes of providing health care services, billing for those services, and supporting the operational functions of our practice. We adhere to the principle of limiting our use and disclosure of PHI to the minimum necessary to accomplish the intended purpose.

The following is a summary of circumstances under which and purposes for which your PHI may be used and disclosed without your specific authorization:

Uses and Disclosures of Protected Health Information for Treatment, Payment, and Healthcare Operations:

Treatment: Your PHI may be used to provide, coordinate, or manage your health care and related services. It may also be disclosed to other treating physicians with your consent and exchanged for e-prescribing purposes.

Payment: Your PHI may be utilized as necessary to obtain payment for health care services provided to you. This includes activities such as determining eligibility for insurance benefits and reviewing services for medical necessity.

Healthcare Operations: PHI may be used or disclosed to support the business activities of our practice, including but not limited to quality assessment, patient safety activities, training, and compliance reviews.

Others Involved in Your Healthcare: Unless you object, we may disclose your PHI to individuals directly involved in your care, including family members or close friends.

SMS consent is not shared with any third party.

Other Permitted and Required Uses and Disclosures of Protected Health Information for Public Policy Purposes:

Required By Law: We may use or disclose your PHI as required by law.

Public Health: PHI may be disclosed for public health activities and purposes to authorized entities.

Communicable Diseases: Disclosure of PHI may occur if authorized by law for disease control purposes.

Health Oversight: PHI may be disclosed to health oversight agencies as authorized by law.

And so forth, detailing permissible uses and disclosures in accordance with applicable laws.

Abuse or Neglect: We may disclose your PHI to a public health authority that is authorized by law to receive reports of child abuse or neglect. In addition, we may disclose your PHI if we believe that you have been a victim of abuse, neglect or domestic violence to the governmental entity or agency authorized to receive such information.

Food and Drug Administration: We may disclose your PHI to a person or company required by the Food and Drug Administration to report adverse events, product defects or problems, biologic product deviations, track products; to enable product recalls; to make repairs or replacements, or to conduct post marketing surveillance, as required.

Legal Proceedings: We may disclose PHI about you in the course of any judicial or administrative proceeding, or in response to an order of a court or administrative tribunal to the extent such disclosure is expressly authorized. We may also disclose PHI about you in response to a subpoena, discovery request or other lawful process, provided appropriate steps have been taken to notify you or to get a protective order from the court to safeguard your PHI.

Law Enforcement: We may disclose PHI for law enforcement purposes, such as: (1) legal processes and otherwise required by law, (2) pertaining to victims of a crime, (3) suspicion that death has occurred as a result of criminal conduct, (4) in the event that a crime occurs on the premises of the practice, and (5) medical emergency (not on the Practice’s premises) and it is likely that a crime has occurred.

Coroners, Funeral Directors, and Organ Donation: We may disclose PHI to a coroner, medical examiner, or funeral director for identification purposes, as appropriate.

Research: We may disclose your PHI to researchers doing studies based on existing medical records or using existing records to plan a study involving patient treatment when their research has been approved by an institutional review board, which has reviewed the research proposal and established protocols to ensure the privacy of your PHI. If you agree to participate in research involving treatment, you will also be asked to sign an authorization to allow the researcher to use PHI gathered in the study.

Imminent Threats: Consistent with applicable federal and state laws, we may disclose your PHI, if we believe that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public.

Military Activity and National Security: When the appropriate conditions apply, we may use or disclose PHI of individuals who are Armed Forces personnel for activities deemed necessary by appropriate military and security purposes.

Workers’ Compensation: We may disclose your PHI as authorized to comply with workers’ compensation laws and other similar legally-established programs.

Inmates: We may use or disclose your PHI if you are an inmate of a correctional facility and your physician created or received your PHI in the course of providing care to you.

Disclosures to the U.S. Department of Health and Human Services: Under the law, we must make disclosures on request to the Secretary of the Department of Health and Human Services (“HHS”) to help HHS determine whether we are operating in compliance with federal laws that protect the privacy of your health information.

Other Uses and Disclosures of Protected Health Information:

Any other uses and disclosures of your PHI not otherwise described in this Notice of Privacy Practices, including the sale of your PHI or the use of your PHI for marketing purposes, will be made only with your written authorization. You may revoke an authorization at any time, in writing, prospectively.

2. Your Rights

Your rights regarding your PHI include:

• Right to Inspect and Copy PHI
• Right to Request Restrictions on PHI Use or Disclosure
• Right to Confidential Communications
• Right to Request Amendment of PHI
• Right to Receive an Accounting of Disclosures
• You have the right to obtain a paper copy of this Notice of Privacy Practices at any time.

The request should specify the time period for the accounting. Accounting requests may not be made for periods of time in excess of six (6) years or three (3) years for disclosures related to treatment, payment or health care operations made by or through an Electronic Health Record. We will provide the first accounting you request during any 12-month period without charge. Subsequent accounting requests may be subject to a reasonable cost-based fee.

3. Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or the relevant regulatory authority. We will not retaliate against you for filing a complaint. For further information or to file a complaint, please contact us at (301) 797-7600.

Contact Information:

MIR NEUROLOGY

11110 Medical Campus Rd #151

Hagerstown, MD 21742, United States

Phone: (301) 797-7600