NEW ENGLAND OB/GYN ASSOCIATES, INC.

CONFIDENTIALITY/PRIVACY POLICY

New England OB/GYN Associates, Inc. (NEOGA) is legally required to maintain the privacy of your protected information. This notice describes how your medical information may be used and disclosed, and how you can get access to this information. Please read it carefully.

Information shared in treatment or obtained through tests is confidential and will not be disclosed to any party outside NEOGA, without your written consent/authorization. *Exceptions regarding treatment, payment, operations, and others permitted by law, are listed below.

Your written authorization may be revoked by you at any time, except to the extent that action has been taken in reliance on it.

*The exceptions to this policy are:

• when authorized and/or allowed by Federal or State authorities; for example, in the areas of public health, communicable disease, FDA, coroners, national security, and others where Federal and/or State law permits;

- to report to a public health authority, authorized by law, to collect or receive such information for the purpose of preventing or controlling disease, injury, or disability, including, but not limited to, the reporting of disease, injury, vital events such as birth or death, and the conduct of public health surveillance, public health investigations, and public health interventions; or, at the direction of a public health authority, to an official of a foreign government agency that is acting with a public health authority;

- to report adverse events, product defects or problems, or biological product deviations if the disclosure is made to the person required or directed to report such information to the Food and Drug Administration;

- to report to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading a disease or condition, if the covered entity or public health authority is authorized by law to notify such person as necessary in the conduct of a public health intervention or investigation;

- to report to an employer if the covered entity is a covered health care provider who is a member of the workforce of such employer or who provides a health care to the individual at the request of the employer; and if the Protected Health Information that is disclosed consists of findings concerning a work-related illness or injury or a workplace-related medical surveillance;

- to coroners and medical examiners for the purpose of identifying a deceased person, determining the cause of death, or other duties as authorized by law;

- to funeral directors to carry out their duties with respect to the decedent;

- to armed forces personnel for activities deemed necessary by appropriate military command;

- to authorized officials for the purpose of national security and intelligence activities;

- to correctional institutions and other law enforcement custodial situations for the purpose of health care, health and safety of officers or employees, and other situations allowed by law; • when insurance carriers are allowed by law to review information for evaluation, audit, or other purposes;

• if disclosure is necessary to protect you or someone else from serious physical harm;

• when there appears to be child, elderly and/or handicapped abuse/neglect; to report to a public health authority or other appropriate government authority authorized by law to receive reports of child, elderly and/or handicapped abuse or neglect;

• if a court subpoenas your record; in response to an order of a court or administrative tribunal, discovery request, or other lawful process;

• when required by law for law enforcement purposes; victims of a crime, and limited information for identification and location purposes; reporting a crime;

• when required for treatment, payment, or health care operations ** **Information you share with your doctor may be discussed with others if it is considered useful for your treatment. Treatment is defined as the provision, coordination and management of health care and related services by one or more health care providers, including management or coordination of providers’ provision of care by a third party as well as consultations between providers and referrals between providers. At times, we may contact you to remind you of your appointment and/or prescription refill(s). To provide you with information regarding treatment alternatives or other health-related services and benefits, we may mail you a newsletter or other marketing material. For research projects, we will follow de-identification guidelines. Health care operations include disclosures of your protected health information to support our financial and business activities. To receive payment, information is released to third party payers such as insurance companies, workers’ compensation, and federal and state agencies, etc. As part of our operations, we may use the services provided by business associates, such as a billing or transcription service. To protect your information, we require the business associate to appropriately safeguard your information. Using our best judgment and unless you object, we may disclose to a family member, other relative, close personal friend or other person you identify, health information directly relevant to the person’s involvement of your care or payment related to your care.

Your treatment record is the property of NEOGA, but you may submit a request in writing at any time to review your record under supervision and have clarifying statements entered into it. You may also receive a copy of your records, except for psychotherapy notes, information compiled in reasonable anticipation of, or for use in, a civil, criminal, or administrative action or proceeding, protected health information maintained by a covered entity such as Clinical Laboratory Improvement Amendments (CLIA) or other acceptable, reasonable denials stated in the Privacy Rule. The fee for copies may be determined by the rate of copying expenses. You may request restrictions on the use or disclosure of protected information. NEOGA has the option to refuse such requests.

NEOGA reserves the right to make amendments to this policy which will apply to all patients. Updated notices are posted in the office reception area. Upon request, you may obtain a paper copy of the updated notice.

You have the right to file a complaint either verbally or in writing to the Privacy Officer or the Department of Health and Human Services. Our office will not retaliate against you if you file a complaint.

Please feel free to discuss any issues regarding confidentiality with your doctor or the Privacy Officer Lisa Zajac at 617-731-3400 x115.

Thank you