VIP MEDICAL GROUP AFFILIATED COVERED ENTITY
HIPAA NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
This Notice of Privacy Practices (“Notice”) applies to the VIP Medical Group Affiliated Covered Entity (“ACE”). The VIP Medical Group ACE is a group of covered entities under common control or ownership that have designated themselves as a single covered entity for purposes of complying with the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”). Participants in the VIP Medical Group ACE may share health information with each other. This is done for the purposes described in this Notice and as permitted by HIPAA. A complete list of the participants of the VIP Medical Group ACE may be found www.vipmedicalgroup.com/affiliated-clinic-entities.
Our Responsibilities
The VIP Medical Group ACE is required by law to maintain the privacy of your health information, to provide you with notice of our legal duties and privacy practices with respect to health information, and to notify affected individuals following a breach of their health information. We must follow the privacy practices that are described in this Notice while it is in effect. In the event that state law provides greater protections than the HIPAA protections in this Notice, we will follow the requirements of state law.
We reserve the right to change our privacy practices and the terms of this Notice at any time, provided the changes are allowed under the law, and to make new Notice provisions apply to all health information that we maintain. When we make significant changes to our privacy practices, we will update this Notice and post the new Notice clearly and prominently at our clinic sites and on our websites, and we will provide copies of the new Notice upon request.
The privacy of your health information is important to us. We are committed to protecting the privacy of the health information that we receive and maintain about you. You may request a copy of this Notice at any time. For more information about our privacy practices, or for additional copies of this Notice, please contact us using the information listed at the end of this Notice.
Your Rights
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you. You have a right to:
Get an electronic or paper copy of your medical record
- You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
- We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
Ask us to correct your medical record
- You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
- We may say “no” to your request, but we’ll tell you why in writing within 60 days.
Request confidential communications
- You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
Ask us to limit what we use or share
- You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.
- If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.
Get a list of those with whom we’ve shared information
- You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
- We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
Get a copy of this privacy notice
You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
Choose someone to act for you
- If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
- We will make sure the person has this authority and can act for you before we take any action.
File a complaint if you feel your rights are violated
- You can complain if you feel we have violated your rights by contacting us using the information in the contact section at the end of this Notice.
- You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
- We will not retaliate against you for filing a complaint.
Your Choices
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to:
- Share information with your family, close friends, or others involved in your care
- Share information in a disaster relief situation
If you are not able to tell us your preference, for example if you are unconscious, we may share your information if we believe it is in your best interest.
We may also share your information when needed to lessen a serious and imminent threat to health or safety.
In these cases, we will not share your information unless you give us written permission:
- Marketing purposes
- Sale of your information
In the case of fundraising:
- We may contact you for fundraising efforts, but you can tell us not to contact you again.
Our Uses and Disclosures
How do we typically use or share your health information?
We typically use or share your health information in the following ways:
Treat you
We can use your health information and share it with other professionals who are treating you. We may use or share your health information to direct your treatment, coordinate services you need, such as prescriptions, lab work, x-rays, or other tests.
Example: A doctor treating you for vein disease asks another doctor about your overall health condition.
Run our organization
We can use and share your health information to run our practice, improve your care, and contact you when necessary. We can also share your health information with third parties that perform services on our behalf. These parties are known as business associates. When we contract for services, we may disclose your health information to our business associates so that they can perform the job we asked them to do. To protect your information, we require all business associates to safeguard your information and comply with HIPAA.
Examples: We use health information about you to manage your treatment and services. We can use your health information to send appointment reminders and help you find different treatment options that may interest you.
Bill for your services
We can use and share your health information to bill and get payment from health plans, from you, or from other entities.
Examples: We give information about you to your health insurance plan so it will pay for your services. We may contact your health plan to verify your benefits, to obtain prior authorization, and to share your medical records if needed for us to be paid for the services you receive.
How else can we use or share your health information?
We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
Help with public health and safety issues
We can share health information about you for certain situations such as:
- Preventing disease
- Helping with product recalls
- Reporting adverse reactions to medications
- Reporting suspected abuse, neglect, or domestic violence
- Preventing or reducing a serious threat to anyone’s health or safety
Do research
We can use or share your information for health research that is approved through a special review process to protect patient safety, welfare, and confidentiality.
Comply with the law
We will share information about you if state or federal laws require it, including with the U.S. Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
Create de-identified health information
We can use or disclose your health information to create “de-identified” information that is no longer identifiable to you. Once data is de-identified, it is no longer protected by HIPAA, and we can share the de-identified data with third parties.
Respond to organ and tissue donation requests
If you are a potential organ donor, we can share health information about you with organizations that handle organ procurement or transplantation, or to an organ bank as needed to help with organ procurement, transplantation, or donation.
Work with a medical examiner or funeral director
We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
Address workers’ compensation, law enforcement, and other government requests
We can use or share health information about you:
- For workers’ compensation claims
- For law enforcement purposes or with a law enforcement official
- With health oversight agencies for activities authorized by law
- For special government functions such as military, national security, and presidential protective services
Respond to lawsuits and legal actions
We can share health information about you in response to a court or administrative order, or in response to a subpoena.
With your written permission
We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
Other Information / Instructions
Effective Date of Notice
The original effective date of our Notice was 09/08/2022. This version of our Notice takes effect as of 07/15/2025 and will remain in effect until we replace it.
Questions or Complaints
If you have questions, would like further information about this Notice, or would like to request a copy of your records, please contact:
Privacy Officer
VIP Medical Group
290 Madison Avenue, Suite 202
New York, NY 10017
Ph: (646) 631-3516
E: compliance@vipmedicalgroup.com