Notice of Privacy Practices

Effective Date: February 8, 2025

Sunrise Pediatrics Las Vegas ("Sunrise Pediatrics," "we," "us," or "our") is required by law to maintain the privacy of your protected health information (PHI), to provide you with this Notice of Privacy Practices describing our legal duties and privacy practices with respect to your PHI, and to notify you following a breach of unsecured PHI.

We are required to abide by the terms of this Notice currently in effect. We reserve the right to change the terms of this Notice and to make the new Notice provisions effective for all PHI we maintain. If we make material changes to this Notice, we will post the revised Notice on our website and make copies available at our offices.

I. Uses and Disclosures of Protected Health Information

A. Uses and Disclosures for Treatment, Payment, and Healthcare Operations

We may use and disclose your PHI for the following purposes:

Treatment

We may use your PHI to provide, coordinate, or manage your healthcare and related services. This includes the coordination or management of your healthcare with a third party. For example:

• We may disclose PHI to physicians, nurses, or other healthcare providers who are involved in your care
• We may disclose PHI to pharmacies to fill prescriptions
• We may disclose PHI to laboratories for testing
• We may disclose PHI to specialists for referrals and consultations
• We may share PHI with hospitals when your child requires admission

Payment

We may use and disclose your PHI to bill and collect payment for services we provide to you. For example:

• We may contact your health insurance company to verify coverage and obtain payment
• We may disclose PHI to obtain pre-authorization for treatment
• We may provide information to billing companies that assist us in obtaining payment
• We may disclose PHI to collection agencies if your account becomes delinquent

Healthcare Operations

We may use and disclose your PHI for our healthcare operations, which include:

• Quality assessment and improvement activities
• Reviewing the competence and qualifications of healthcare professionals
• Training medical students, residents, and staff
• Business planning and development
• Customer service and resolution of complaints
• Compliance activities and audits

B. Uses and Disclosures Without Your Authorization

We may use or disclose your PHI without your authorization in the following circumstances:

As Required by Law

We will disclose PHI when required to do so by federal, state, or local law.

Public Health Activities

We may disclose PHI to public health authorities for purposes such as:

• Preventing or controlling disease, injury, or disability
• Reporting births and deaths
• Reporting child abuse or neglect
• Reporting adverse reactions to medications or products
• Notifying persons of recalls of products they may be using
• Notifying a person who may have been exposed to a disease or may be at risk of contracting or spreading a disease

Victims of Abuse, Neglect, or Domestic Violence

We may disclose PHI to government authorities, including social services or protective services agencies, authorized by law to receive reports of abuse, neglect, or domestic violence.

Health Oversight Activities

We may disclose PHI to health oversight agencies for activities authorized by law, such as audits, investigations, inspections, and licensure.

Judicial and Administrative Proceedings

We may disclose PHI in response to a court order, subpoena, discovery request, or other lawful process.

Law Enforcement

We may disclose PHI to a law enforcement official for purposes such as:

• Responding to a court order, warrant, or subpoena
• Identifying or locating a suspect, fugitive, missing person, or witness
• Reporting certain types of wounds or injuries
• Reporting a crime that occurred on our premises

Coroners, Medical Examiners, and Funeral Directors

We may disclose PHI to a coroner or medical examiner for purposes such as identifying a deceased person, determining a cause of death, or as otherwise authorized by law.

Organ and Tissue Donation

We may disclose PHI to organ procurement organizations or other entities engaged in procurement, banking, or transplantation of organs, eyes, or tissue.

Research

We may use or disclose PHI for research purposes under certain conditions, such as when the research has been approved by an Institutional Review Board.

Serious Threat to Health or Safety

We may use or disclose PHI when necessary to prevent or lessen a serious and imminent threat to a person's or the public's health or safety.

Specialized Government Functions

We may disclose PHI for specialized government functions, such as military and veterans' activities, national security and intelligence activities, and protective services for the President.

Workers' Compensation

We may disclose PHI as authorized by workers' compensation laws.

Inmates

We may disclose PHI about an inmate to a correctional institution or law enforcement official having lawful custody of the inmate.

C. Uses and Disclosures Requiring Your Authorization

Except as outlined above, we will not use or disclose your PHI without your written authorization. These include:

• Most uses and disclosures of psychotherapy notes (if applicable)
• Uses and disclosures for marketing purposes
• Disclosures that constitute a sale of PHI
• Other uses and disclosures not described in this Notice

You may revoke your authorization at any time in writing, except to the extent that we have already taken action based on your authorization.

D. Uses and Disclosures to Family Members and Others

We may disclose PHI about you to a family member, close friend, or other person you identify as involved in your care or payment for your care. We may also use or disclose PHI to notify a family member or other person responsible for your care of your location, general condition, or death.

E. Special Provisions for Minors

• Parents and legal guardians generally have the right to access and control the PHI of their minor children
• Under Nevada law, minors may have certain rights to consent to specific types of healthcare, and in those cases, we may be required to protect the confidentiality of that care
• When minors reach the age of majority (18 in Nevada), they gain control over their own PHI
• We follow state and federal laws regarding the disclosure of minor's health information in cases involving abuse, neglect, or danger to the minor or others

II. Your Rights Regarding Your PHI

A. Right to Access

You have the right to inspect and obtain a copy of your PHI that is contained in a designated record set. Your request must be in writing. We may charge a reasonable fee for copying, mailing, or other supplies associated with your request. We may deny your request in certain circumstances, and if we do, you may request a review of the denial.

B. Right to Amend

You have the right to request an amendment to your PHI if you believe it is incorrect or incomplete. Your request must be in writing and must include a reason for the amendment. We may deny your request under certain circumstances, and if we do, we will provide you with a written explanation of the denial.

C. Right to an Accounting of Disclosures

You have the right to receive an accounting of certain disclosures of your PHI made by us during the six years prior to your request. The accounting will not include disclosures:

• For treatment, payment, or healthcare operations
• Made to you or your personal representative
• Made with your authorization
• To persons involved in your care or for other notification purposes
• For national security or intelligence purposes
• To correctional institutions or law enforcement officials

D. Right to Request Restrictions

You have the right to request restrictions on certain uses and disclosures of your PHI. We are not required to agree to your request except in limited circumstances. If we agree to a restriction, we will comply with it unless the information is needed for emergency treatment.

Special Rule: If you pay for a service or item out-of-pocket in full and request that we not disclose PHI related to that service or item to your health plan for payment or healthcare operations purposes, we are required to honor that request.

E. Right to Request Confidential Communications

You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you may request that we contact you only at work or by mail. We will accommodate reasonable requests.

F. Right to a Paper Copy of This Notice

You have the right to a paper copy of this Notice, even if you have agreed to receive this Notice electronically.

III. Our Responsibilities

We are required to:

• Maintain the privacy of your PHI as required by law
• Provide you with this Notice of our legal duties and privacy practices with respect to your PHI
• Abide by the terms of the Notice currently in effect
• Notify you if we cannot accommodate a requested restriction or request
• Notify you following a breach of unsecured PHI

IV. Breach Notification

If a breach of your unsecured PHI occurs, we will notify you as required by law. We will also notify the U.S. Department of Health and Human Services and, in some cases, the media, as required by law.

V. Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services Office for Civil Rights.

To file a complaint with us, contact:

To file a complaint with the U.S. Department of Health and Human Services:

You will not be retaliated against for filing a complaint.

VI. Contact Information

If you have questions about this Notice or would like to exercise any of your rights, please contact:

VII. Changes to This Notice

We reserve the right to change this Notice at any time. Changes will apply to PHI we already have about you, as well as any information we receive in the future. The new Notice will be available upon request, posted in our offices, and posted on our website.