Hamaspik of Kings County

("PLAN SPONSOR") HIPAA NOTICE OF PRIVACY PRACTICES
The Plan Sponsor is required by law to maintain the privacy of your PHI, provide you with certain rights with respect to your PHI, provide you with a copy of this Notice, and follow the terms of this Notice. The Plan Sponsor reserves the right to change the terms of this Notice and its practices regarding your PHI. If there is any material change to this Notice, the Plan Sponsor will provide you with a copy of the revised Notice of Privacy Practices. Use and Disclosure The Plan Sponsor may use or disclose your PHI under certain circumstances without your permission. All of these certain circumstances will fall within one of the categories listed below.

THIS NOTICE OF PRIVACY PRACTICES DESCRIBES HOW YOUR PLAN SPONSOR (YOUR EMPLOYER WHO SPONSORS YOUR GROUP HEALTH PLAN) CAN USE OR DISCLOSE YOUR MEDICAL INFORMATION AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

 • For Health Care Operations, • For Payment, • For Treatment, to facilitate medical treatment or services by providers including doctors, nurses, technicians, medical students, or other hospital personnel who are involved in taking care of you. to determine your eligibility for Plan benefits, to facilitate payment for the treatment or services you receive from health care providers, to determine benefit responsibility under the Plan, or to coordinate Plan coverage. uses and disclosures necessary to run the Plan. • Treatment Alternatives or Health-Related Benefits and Services that might be of interest to you. HAMASPIK KINGS, INC. UPDATED DATE: 1/1/2024 The Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH Act) place important restrictions on sharing your medical information and provide you with important privacy rights.
This Notice of Privacy Practices (the “Notice”) replaces all prior notices provided by the Plan Sponsor and is effective on the Date Distributed noted above. This Notice describes the legal obligations of the Plan Sponsor and your legal rights regarding your “protected health information” (“PHI”) held by your Plan Sponsor and Group Health Plan. This Notice describes how your PHI may be used or disclosed to carry out treatment, payment, or health care operations, or other purposes permitted by law. Generally, PHI includes your personal information collected from you or created by your Group Health Plan, or the Plan Sponsor on behalf of a Group Health Plan, that relates to your past, present, or future physical or mental health or condition; the provision of health care; or the past, present, or future payment for the provision of health care, and includes your elections to enroll in the Plan.
If you have any questions about this Notice or about our privacy practices, please contact your Privacy Officer identified below. The Plan Sponsor may retain agents, service providers and third-party administrators to administer all or part of your Group Health Plan such as claims payment and enrollment management. The term Plan Sponsor as used in this Notice includes all entities that provide services related to your Group Health Plan that have access to your PHI. The Plan Sponsor and contracted service providers are required by law to follow the terms of this Notice. • As Required by Law • To Business Associatesto perform various functions on our behalf or to provide certain types of services. A Business Associate will receive, create, maintain, transmit, use, and/or disclose your PHI, but only after they agree in writing with when required to do so by federal, state, or local law. the Plan Sponsor to implement appropriate safeguards regarding your PHI. HI-5130-030821 The information in this communication is confidential and may be used by the authorized recipient only for its intended purpose. Any other use or disclosure is prohibited. In addition, the following categories describe other ways that the Plan Sponsor may use and disclose your PHI without your specific authorization. All of the ways the Plan Sponsor is permitted to use and disclose information will fall within one of the categories. • To Avert a Serious Threat to Health or Safety to you, or the health and safety of the public, or another person, limited to someone able to help prevent the threat • Workers' Compensation • Military, • Organ and Tissue Donation, after your death to an organization that handles organ procurement or organ, eye, or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation. if you are a member of the armed forces, as required by military command authorities. The Plan Sponsor may or similar programs, but only as authorized by, and to the extent necessary to comply with, laws relating to workers' compensation and similar programs that provide benefits for work-related injuries or illness. also release PHI about foreign military personnel to the appropriate foreign military authority. for public health activities.
These activities generally include the following: • to prevent or control disease, injury, or disability; • to notify the appropriate government authority if the Plan Sponsor believes that a patient has been the victim of abuse • to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a • to notify people of recalls of products they may be using; • to report reactions to medications or problems with products; • to report child abuse or neglect; • to report births and deaths; disease or condition; abuse, neglect, or domestic violence. The Plan Sponsor will only make this disclosure if you agree, or when required or authorized by law. • Health Oversight Activities for activities authorized by law. For example, audits, investigations, inspections, and licensure. in response to a court or administrative order, including a response to a lawful subpoena, discovery request, or other process by someone involved in a legal dispute, but only if efforts have been made to tell you about the request or to obtain a court or administrative order protecting the information requested. • Law Enforcement if asked to do so by a law-enforcement official: • in response to a court order, subpoena, warrant, summons, or similar process; • about criminal conduct. • about a death that the Plan Sponsor believes may be the result of criminal conduct; and • about the victim of a crime if, under certain limited circumstances, the Plan Sponsor is unable to obtain the • to identify or locate a suspect, fugitive, material witness, or missing person; victim's agreement; • Lawsuits and Disputes • Public Health Risks HI-5130-030821 The information in this communication is confidential and may be used by the authorized recipient only for its intended purpose. Any other use or disclosure is prohibited. • Inmates • National Security and Intelligence Activities • Coroners, Medical Examiners, and Funeral Directors, for example, to identify a deceased person or determine the cause of death. The Plan Sponsor may also release medical information about patients to funeral directors, as necessary to to authorized federal officials for intelligence, counterintelligence, and other of a correctional institution or in the custody of a law-enforcement official, to the correctional institution or carry out their duties. law-enforcement official if necessary for the institution to provide you with health care; to protect your health and • Disclosures to You
• Government Audits to the Security of the United States Department of Health and Human Services when the Secretary is investigating or determining our compliance with the HIPAA privacy rule. On your request, the portion of your PHI that contains medical records, billing records, and any other records used to make decisions regarding your health care benefits. Other Disclosures The Plan Sponsor may disclose your PHI to:
• Personal Representatives authorized by you, or to an individual designated as your personal representative, or attorney-in-fact. You must provide a written notice/authorization and supporting documents such as a power of attorney. The Plan Sponsor does not have to disclose information to a personal representative if the Plan Sponsor has a reasonable belief that you have been, or may be, subjected to domestic violence, abuse, or neglect by such person; or treating such person as your personal representative could endanger you; or in the exercise of professional judgment, it is not in your best interest to treat the person as your personal representative. Privacy Rights
• Right to Inspect and Copy. You have the right to inspect and copy certain PHI that may be used to make decisions about national security activities authorized by law. safety or the health and safety of others; or for the safety and security of the correctional institution. • Research, to researchers when the individual identifiers have been removed; or when an institutional review board or privacy board has reviewed the research proposal and established protocols to ensure the privacy of the requested information, and approves the research. Required Disclosures The Plan Sponsor is required to disclose your PHI to:
• Comply with your Authorization. Other uses or disclosures of your PHI not described above will only be made with your written authorization. The Plan Sponsor may deny a request to disclose your psychiatric notes. The Plan Sponsor will not use or disclose your PHI for marketing; or sell your PHI, unless you provide written authorization. You may revoke written authorizations at any time, so long as the revocation is in writing. Once the Plan Sponsor receives your written revocation, it will only be effective for future uses and disclosures. It will not be effective for any information that may have been used or disclosed in reliance upon the written authorization and prior to receiving your written revocation. your Plan benefits. If the information you request is maintained electronically, and you request an electronic copy, the Plan Sponsor will provide a copy in the electronic form and format you request, if the information can be readily produced in that form and format; if the information cannot be readily produced in that form and format, the Plan Sponsor will work with you to come to an agreement on form and format or provide you with a paper copy.
To inspect and copy your PHI, you must submit your request in writing to the Privacy Officer identified below. The Plan Sponsor may charge a reasonable fee for the costs of copying, mailing, or other supplies associated with your request. The Plan Sponsor may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to your medical information, you may request that the denial be reviewed by submitting a written request to the Privacy Officer identified below. HI-5130-030821 The information in this communication is confidential and may be used by the authorized recipient only for its intended purpose. Any other use or disclosure is prohibited. The accounting will not include (1) disclosures for purposes of treatment, payment, or health care operations; (2) disclosures made to you; (3) disclosures made pursuant to your authorization; (4) disclosures made to friends or family in your presence or because of an emergency; (5) disclosures for national security purposes; and (6) disclosures incidental to otherwise permissible disclosures.
To request this list or accounting of disclosures, you must submit your request in writing to the Privacy Officer identified below. Your request must state the time period you want the accounting to cover, which may not be longer than six years before the date of the request. Your request should indicate in what form you want the list (for example, paper or electronic).
The first list you request within a 12-month period will be provided free of charge. For additional lists, the Plan Sponsor may charge you for the costs of providing the list. The Plan Sponsor will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.
• Right to an Accounting of Disclosures You have the right to request an "accounting" of certain disclosures of your PHI. information. You have the right to request an amendment for as long as the information is kept by or for the Plan. To request an amendment, your request must be made in writing and submitted to the Privacy Officer identified below. In addition, you must provide a reason that supports your request. the Plan Sponsor may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, the Plan Sponsor may deny your request if it:
• Right to Amend. If you feel that your PHI is incorrect or incomplete, you may ask the Plan Sponsor to amend the • is not part of the medical information kept by or for the Plan; • is already accurate and complete. • is not part of the information that you would be permitted to inspect and copy; or • was not created by the Plan, unless the person or entity that created the information is no longer available to make the amendment; If your request is denied, you have the right to file a statement of disagreement with the Plan Sponsor and any future disclosures of the disputed information will include your statement.
• Right to Request Restrictions or limitation on your PHI that the Plan Sponsor uses or discloses for treatment, payment, or health care operations. You also have the right to request a limit on your PHI that is disclosed to someone who is involved in your care or the payment for your care, such as a family member or friend. Except as provided in the next paragraph, the Plan Sponsor is not required to agree to your request. However, the Plan Sponsor will comply with any restriction request if (1) except as otherwise required by law, the disclosure is to a health plan for purposes of carrying out payment or health care operations (and is not for purposes of carrying out treatment); and (2) the PHI pertains solely to a health care item or service for which the health care provider involved has been paid in full by you or another person. To request restrictions, you must make your request in writing to the Privacy Officer identified below. In your request, you must state (1) what information you want to limit; (2) whether you want to limit our use, disclosure, or both; and (3) to whom you want the limits to apply - for example, disclosures to your spouse. If the Plan Sponsor honors the request, it will stay in place until you revoke it or the Plan Sponsor notifies you.
• Right to Request Confidential Communications about medical matters in a certain way or at a certain location. For example, you can ask that the Plan Sponsor only contact you at work or by mail. Your request must be made in writing to the Privacy Officer identified below and specify how or where you wish to be contacted. The Plan Sponsor will accommodate all reasonable requests.
• Right to Be Notified of a Breach in the event that the Plan Sponsor (or a Business Associate) discover a breach of unsecured PHI.
• Right to a Paper Copy of This Notice. You may request a paper copy of this notice at any time from the Privacy Officer identified below, even if you have agreed to receive this notice electronically. HI-5130-030821 The information in this communication is confidential and may be used by the authorized recipient only for its intended purpose. Any other use or disclosure is prohibited. Company: Title:
Complaints If you believe that your privacy rights have been violated, you may file a complaint with the Plan or with the Office for Civil Rights of the United States Department of Health and Human Services. To file a complaint with the Plan, contact: Address: All complaints must be submitted in writing. You will not be penalized, or in any other way retaliated against, for filing a complaint with the Office for Civil Rights or with us. Phone: Privacy Officer HAMASPIK CARE, INC. 5 Perlman Drive 845-503-0803 Spring Valley, NY 10977 HI-5130-030821 The information in this communication is confidential and may be used by the authorized recipient only for its intended purpose. Any other use or disclosure is prohibited.
Information collection, use, and sharing:
HOW WE SHARE YOUR INFORMATION: Mobile Phone Numbers. Your phone number will not be shared with third parties/affiliates for marketing/promotional purposes. Hamaspik of Kings County may share your phone number with certain third-parties for the limited purpose of assisting us with providing the automated communications to you. All other categories exclude text messaging originator opt-in data and consent; this information will not be shared with any third parties.
OPT IN CONSENT TO MOBILE MESSAGING: By submitting your phone number, you are authorizing Hamaspik of Kings County to send informational text messages, multimedia messages, and/or telephone calls using an automatic telephone dialing system or an artificial or prerecorded voice to the phone number you have provided. Your consent is not a condition of doing business with or making a purchase of any goods/services from Hamaspik of Kings County. Message/data rates may apply.
OPTING OUT OF TEXT MESSAGE COMMUNICATIONS: You may unsubscribe or opt-out from receiving future automated communications from Hamaspik of Kings County at any time. If you wish to stop receiving text messages from us, reply STOP, QUIT, CANCEL, OPT-OUT, or UNSUBSCRIBE to any text message sent from us.