NOTICE OF PRIVACY PRACTICES
GenieMD Medical Group Affiliated Covered Entity

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

This Notice of Privacy Practices (the “Notice”) describes how GenieMD Medical Group,MO, P.C. and the members of its Affiliated Covered Entity (collectively “we” or “our”)may use and disclose your protected health information to carry out treatment, paymentor business operations and for other purposes that are permitted or required by law. AnAffiliated Covered Entity is a group of health care providers under common ownershipor control that designates itself as a single entity for purposes of compliance with theHealth Insurance Portability and Accountability Act (“HIPAA”). The members of theGenieMD Medical Group Affiliated Covered Entity will share protected healthinformation with each other for the treatment, payment, and health care operations ofthe GenieMD Medical Group Affiliated Covered Entity and as permitted by HIPAA andthis Notice of Privacy Practices. For a complete list of the members of the GenieMDMedical Group Affiliated Covered Entity, please contact the GenieMD Medical Group Privacy Office.

“Protected health information” or “PHI” is information about you, including demographicinformation, that may identify you and that relates to your past, present or futurephysical health or condition, treatment or payment for health care services. This Noticealso describes your rights to access and control your protected health information

USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION:

Your protected health information may be used and disclosed by our health careproviders, our staff, and others outside of our office that are involved in your care andtreatment for the purpose of providing health care services to you, to support ourbusiness operations, to obtain payment for your care, and any other use authorized orrequired by law.

TREATMENT:

We will use and disclose your protected health information to provide, coordinate, ormanage your health care and any related services. This includes the coordination ormanagement of your health care with a third party. For example, your protected healthinformation may be provided to a health care provider to whom you have been referredto ensure the necessary information is accessible to diagnose or treat you.

PAYMENT:

Your protected health information may be used to bill or obtain payment for your healthcare services. This may include certain activities that your health insurance plan mayundertake before it approves or pays for your services, such as: making a determinationof eligibility or coverage for insurance benefits and reviewing services provided to youfor medical necessity.

HEALTH CARE OPERATIONS:

We may use or disclose, as needed, your protected health information in order tosupport the business activities of this office. These activities include, but are not limitedto, improving quality of care, providing information about treatment alternatives or otherhealth-related benefits and services, development or maintaining and supportingcomputer systems, legal services, and conducting audits and compliance programs,including fraud, waste and abuse investigations.

USES AND DISCLOSURES THAT DO NOT REQUIRE YOUR AUTHORIZATION:

We may use or disclose your protected health information in the following situationswithout your authorization. These situations include the following uses and disclosures:as required by law; for public health purposes; for health care oversight purposes; forabuse or neglect reporting; pursuant to Food and Drug Administration requirements; inconnection with legal proceedings; for law enforcement purposes; to coroners, funeraldirectors and organ donation agencies; for certain research purposes; for certaincriminal activities; for certain military activity and national security purposes; for workers’compensation reporting; relating to certain inmate reporting; and other required usesand disclosures. Under the law, we must make certain disclosures to you upon yourrequest, and when required by the Secretary of the Department of Health and HumanServices to investigate or determine our compliance with the requirements of the HealthInsurance Portability and Accountability Act (HIPAA). State laws may further restrictthese disclosures.

USES AND DISCLOSURES THAT REQUIRE YOUR AUTHORIZATION:

Other permitted and required uses and disclosures will be made only with your consent,authorization or opportunity to object unless permitted or required by law. Without yourauthorization, we are expressly prohibited from using or disclosing your protected healthinformation for marketing purposes. We may not sell your protected health informationwithout your authorization. Your protected health information will not be used forfundraising. If you provide us with an authorization for certain uses and disclosures ofyour information, you may revoke such authorization, at any time, in writing, except tothe extent that we have taken an action in reliance on the use or disclosure indicated inthe authorization.

YOUR RIGHTS WITH RESPECT TO YOUR PROTECTED HEALTH INFORMATION:

You have the right to inspect and copy your protected health information.

You may request access to or an amendment of your protected health information.

You have the right to request a restriction on the use or disclosure of your protectedhealth/personal information. Your request must be in writing and state the specificrestriction requested and to whom you want the restriction to apply. We are not requiredto agree to a restriction that you may request, except if the requested restriction is on adisclosure to a health plan for a payment or health care operations purpose regarding aservice that has been paid in full out-of-pocket.

You have the right to request to receive confidential communications from us byalternative means or at an alternate location. We will comply with all reasonablerequests submitted in writing which specify how or where you wish to receive thesecommunications.

You have the right to request an amendment of your protected health information. If we deny your request for amendment, you have the right to file a statement ofdisagreement with us. We may prepare a rebuttal to our statement and we will provideyou with a copy of any such rebuttal.You have the right to receive an accounting of certain disclosures of your protectedhealth information that we have made, paper or electronic, except for certaindisclosures which were pursuant to an authorization, for purposes of treatment,payment, healthcare operations (unless the information is maintained in an electronichealth record); or for certain other purposes.

You have the right to receive an accounting of certain disclosures of your protectedhealth information that we have made, paper or electronic, except for certaindisclosures which were pursuant to an authorization, for purposes of treatment,payment, healthcare operations (unless the information is maintained in an electronichealth record); or for certain other purposes.You have the right to obtain a paper copy of this Notice, upon request, even if you havepreviously requested its receipt electronically by e-mail.

REVISIONS TO THIS NOTICE:

We reserve the right to revise this Notice and to make the revised Notice effective forprotected health information we already have about you as well as any information wereceive in the future. You are entitled to a copy of the Notice currently in effect. Anysignificant changes to this Notice will be posted on our web site. You then have the rightto object or withdraw as provided in this Notice.

BREACH OF HEALTH INFORMATION:

We will notify you if a reportable breach of your unsecured protected health informationis discovered. Notification will be made to you no later than 60 days from the breachdiscovery and will include a brief description of how the breach occurred, the protectedhealth information involved and contact information for you to ask questions.

COMPLAINTS:

Complaints about this Notice or how we handle your protected health information shouldbe directed to our HIPAA Privacy Officer. If you are not satisfied with the manner inwhich a complaint is handled you may submit a formal complaint to the Department ofHealth and Human Services, Office for Civil Rights by sending a letter to 200Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, orvisiting www.hhs.gov/ocr/privacy/hipaa/complaints/. We will not retaliate against you forfiling a complaint.

We must follow the duties and privacy practices described in this Notice. We willmaintain the privacy of your protected health information and to notify affectedindividuals following a breach of unsecured protected health information. If you haveany questions about this Notice, please contact us at 925-460-9191 or Compliance@GenieMD.com ask to speak with our HIPAA Privacy Officer