Stonebridge Distribution Inc.
Notice of Privacy Practices

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

If you have any questions about this Notice, please contact: Edward Dodge, V.P. Operations, at the number provided below.

This Notice of Privacy Practices describes how we may use and disclose your protected health information to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. “Protected health information” is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services. Your protected health information includes things like your medical record and billing
records.

We are required to abide by the terms of this Notice of Privacy Practices. We may change the terms of our notice, at any time. The new notice will be effective for all protected health information that we maintain at that time. Upon your request, we will provide you with any revised Notice of Privacy Practices by calling the office and requesting that a revised copy be sent to you in the mail or asking for one at the time of your next appointment.

Uses and Disclosures of Your Protected Health Information

The Health Information Portability and Accountability Act of 1996 (“HIPAA”) established a national set of standards to protect the privacy and security of your health information. Under those Standards we may use or disclose your health information for the purposes described below. However, when a state law exists that provides you with greater protection of your privacy rights, HIPAA requires us to comply with those laws. By way of example, some state laws may require us to notify you or seek your approval before using or disclosing your health information, especially when it contains mental health records, alcohol or substance abuse records, HIV/AIDS information or genetic information. Other state laws may also give you greater access to your health information. When such other state laws apply, we will make every effort to ensure that it complies with its requirements. This means your privacy rights will always be afforded The greatest level of protection. Moreover, we will continue to monitor the development of other state laws to ensure that your privacy rights are adequately protected.

We may use and disclose your health information for treatment.

For example, we may use and disclose your health information to provide you with medical devices and supplies. Information obtained by us may be used by us or disclosed to your health care provider to determine the best course of treatment for you.

We may use and disclose your health information in order to collect payment for the medical goods and supplies provided to you.

For example, we may send a bill to Medicare, Medicaid or another third-party payer. The information on or accompanying the bill may include information that identifies you and your diagnosis, as well as the medical devices provided to you.

We may use and disclose your health information for regular health operations.

We may use and disclose your health information in connection with running and managing our business. For example, we may use and disclose your health information to conduct training programs; become accredited, certified, or licensed to provide medical devices; or to assess the outcomes and effectiveness of the medical devices provided to you.

We may use and disclose your health information to Business associates:

Some services in our organization may be provided through contacts with business associates. Examples can include billing services, consultants, and attorneys. When we contract for these services, we may disclose your health information to our business
associates so that they can perform the job we’ve asked them to do. To protect your health information, however, we require all business associates to appropriately safeguard your information.

We may disclose your health information to a family member:

Using our best judgment, we may disclose to a family member, other relative, close personal friend or any other person you identify, health information relevant to that person’s involvement in your care or payment related to your care.

We may disclose your health information to the Food and Drug Administration (FDA):

We may disclose to the FDA health information relative to adverse events with respect to food, supplements, product and product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement.

We may use and disclose your health information as required by law:

We may use and disclose your health information as required by law, including for use in judicial or administrative proceedings. This can include uses or disclosures required by state workers’ compensation laws.

We may disclose your health information for purposes of Public health:

As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.

We may disclose your health information for purposes of National security:

We may disclose your health information to military authorities for the purposes of lawful intelligence, counter-intelligence and other national security purposes.

We may disclose your health information for purposes of Law enforcement:

We may disclose health information for law enforcement purposes as required by law in response to a valid subpoena, or to correctional institutions, or law enforcement officials retaining custody over you.

We may use and disclose your health information to your written authorization:

In addition to those purposes described above, we may use and disclose your health information as permitted, in writing, by you. You may revoke such permission at any time. Without your written authorization, we are not permitted to use or disclose your health information, except as described in this notice or as permitted or required by law.

Your Health Information Rights

Although your medical record is the physical property of the healthcare practitioner or facility that compiled it, the information belongs to you. Accordingly, you have the right to:
  • Request a restriction on certain uses and disclosures of your health information
  • Obtain a paper copy of the notice of privacy practices upon request
  • Inspect and obtain a copy of your health record
  • Amend your health record
  • Obtain an accounting of disclosures of your health information
  • Request that communications of your health information be delivered to you by alternative means or at alternative locations (such as by email or fax delivered to your office)
  • Revoke authorization to use or disclose health information except to the extent that action has already been taken

Our Responsibilities

We are required to:

  • Maintain the privacy of your health information
  • Provide you with a notice as to our legal duties and privacy practices with respect to information we collect and maintain about you
  • Abide by the terms of this notice
  • Notify you if we are unable to agree to a requested restriction
  • Accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations.

We will not use or disclose your health information without your authorization, except as described in this notice. If you believe your privacy rights have been violated, you can file a complaint with our Privacy Officer, Edward Dodge, or with the Secretary of Health and Human Services. There will be no retaliation for filing a complaint. You may contact our Privacy Officer, Edward Dodge at (914) 738-9400 x201 or edodge@stonebridgemedical.com for further information about the complaint process.

This notice was published and becomes effective on April 14, 2003.

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