NOTICE OF PRIVACY POLICY

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE READ IT CAREFULLY.

The following is the privacy policy ("Privacy Policy") of William H. McMicken, M.D. Internal Medicine Associates, Inc., ("Covered "Entity") as described in the Health Insurance Portability and Accountability Act of 1996 and regulations promulgated there under, commonly known as HIPAA. HIPAA requires Covered Entity by law to maintain the privacy of your personal health information and to provide you with notice of Covered Entity's legal duties and privacy policies with respect to your personal health information. We are required by law to abide by the terms of this Privacy Notice.

Your Personal Health Information
We collect personal health information from you through treatment, payment and related healthcare operations, the application and enrollment process, and/or healthcare providers or health plans, or through other means, as applicable. Your personal health information that is protected by law broadly includes any information, oral, written or recorded, that is created or received by certain health care entities, including health care providers, such as physicians and hospitals, as well as, health insurance companies or plans. The law specifically protects health information that contains data, such as your name, address, social security number, and others, that could be used to identify you as the individual patient who is associated with that health information.

Uses or Disclosures of Your Personal Health Information
Generally, we may not use or disclose your personal health information without your permission. Further, once your permission has been obtained, we must use or disclose your personal health information in accordance with the specific terms that permission. The following are the circumstances under which we are permitted by law to use or disclose your personal health information.

Without Your Consent
Without your consent, we may use or disclose your personal health information in order to provide you with services and the treatment you require or request, or to collect payment for those services, and to conduct other related health care operations otherwise permitted or required by law. Also, we are permitted to disclose your personal health information within and among our workforce in order to accomplish these same purposes. However, even with your permission, we are still required to limit such uses or disclosures to the minimal amount of personal health information that is reasonably required to provide those services or complete those activities.
Examples of treatment activities include:
(a) the provision, coordination, or management of health care and related services by health care providers.
(b) consultation between health care providers relating to a patient.
(c) the referral of a patient for health care from one health care provider to another. This may apply to one or more of the physicians in the practice coverage group, which now includes Gregory DeRusso, M.D., Gary Lamsback, M.D., Dana Kerner, D.O., and David Zweiback, D.O.
Examples of payment activities include:
(a) billing and collection activities and related data processing.
(b) actions by a health plan or insurer to obtain premiums or to determine or fulfill its responsibilities for coverage and provision of benefits under its health plan or insurance agreement, determinations of eligibility or coverage, adjudication or subrogation of health benefit claims.
(c) medical necessity and appropriateness of care reviews, utilization review activities.
(d) disclosure to consumer reporting agencies of information relating to collection of premiums or reimbursement.

Examples of health care operations include:
(a) development of clinical guidelines.
(b) contacting patients with information about treatment alternatives or communications in connection with case management or care coordination.
(c) reviewing the qualifications of and training health care professionals.
(d) underwriting and premium rating.
(e) medical review, legal services, and auditing functions
(f) general administrative activities such as customer service and data analysis.

As Required By Law
We may use or disclose your personal health information to the extent that such use or disclosure is required by law and the use or disclosure complies with and is limited to the relevant requirements of such law.

Examples of instances in which we are required to disclose your personal health information include:
a) public health activities including, preventing or controlling disease or other injury, public health surveillance or investigations, reporting adverse events with respect to food or dietary supplements or product defects or problems to the Food and Drug Administration, medical surveillance of the workplace or to evaluate whether the individual has a work-related illness or injury in order to comply with Federal or state law.
b) disclosures regarding victims of abuse, neglect, or domestic violence including, reporting to social service or protective services agencies.
c) health oversight activities including, audits, civil, administrative, or criminal investigations, inspections, licensure or disciplinary actions, or civil, administrative, or criminal proceedings or actions, or other activities necessary for appropriate oversight of government benefit programs.
d) judicial and administrative proceedings in response to an order of a court or administrative tribunal, a warrant, subpoena, discovery request, or other lawful process.
e) law enforcement purposes for the purpose of identifying or locating a suspect, fugitive, material witness, or missing person, or reporting crimes in emergencies, or reporting a death.
f) disclosures about decedents for purposes of cadaveric donation of organs, eyes or tissue.
g) for research purposes under certain conditions.
h) to avert a serious threat to health or safety.
i) military and veterans
j) national security and intelligence activities, protective services of the President and others.
k) medical suitability determinations by entities that are components of the Department of State.
l) correctional institutions and other law enforcement custodial situations
m) covered entities that are government programs providing public benefits, and for workers' compensation.

 All Other Situations, With Your Specific Authorization
Except as otherwise permitted or required, as described above, we may not use or disclose your personal health information without your written authorization. Further, we are required to use or disclose your personal health information consistent with the terms of your authorization. You may revoke your authorization to use or disclose any personal health information at any time, except to the extent that we have taken action in reliance on such authorization, or, if you provided the authorization as a condition of obtaining insurance coverage, other law provides the insurer with the right to contest a claim under the policy.

Miscellaneous Activities, Notice
We may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you. We may need to contact you to inform you of results of laboratory, x-ray, or other diagnostic study results. We will not routinely give this information to anyone other than you unless you have given permission, in writing, to inform another person. No personal health information will be relayed via voice mail or answering machines. If you wish to have personal health information provided to you via email, we will require your specific written permission to contact you in this way.