Effective April 14, 2003

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.

A.  INTRODUCTION

This Notice of Privacy Practices is provided to you as a requirement of the Privacy Rule of the Health Insurance and Portability and Accountability Act (HIPAA).

During the course of providing services and care to you, Satellite Laboratory Services gathers, creates, and retains certain personal information about you that identifies who you are and relates to your past, present, or future physical or mental condition, the provision of health care to you, and payment for your health care services. This personal information is characterized as your “protected health information.”

Satellite understands that the protected health information about you and your health is personal. We are committed to protecting this information about you. At the same time, we need to use your medical and personal information to provide you with quality care and to comply with certain legal requirements.

This Notice of Privacy Practices describes how Satellite Laboratory Services maintains the confidentiality of your protected health information, and informs you about the possible uses and disclosures of such information. It also informs you about your rights with respect to your protected health information.

B. SATELLITE LABORATORY SERVICES’ RESPONSIBILITIES

Satellite Laboratory Services is required by federal and state law to maintain the privacy of your protected health information.

Satellite Laboratory Services is also required by law to provide you with this Notice of Privacy Practices that describes Satellite Laboratory Services’s legal duties and privacy practices with respect to your protected health information.

Satellite Laboratory Services will abide by the terms of this Notice of Privacy Practices. Satellite Laboratory Services reserves the right to change this or any future Notice of Privacy Practices and to make the new Notice provisions effective for all protected health information that it maintains, including protected health information already in its possession. If Satellite Laboratory Services changes its Notice of Privacy Practices, it will personally deliver or mail a revised notice to you at your current address.

C. USE AND DISCLOSURE WITH YOUR AUTHORIZATION

Satellite Laboratory Services will require a written authorization from you before it uses or discloses your protected health information, unless a particular use or disclosure is expressly permitted or required by law without your authorization. Satellite Laboratory Services has prepared an authorization form for you to use that authorizes Satellite Laboratory Services to use or disclose your protected health information for the purposes set forth on the form. You are not required to sign such a form as a condition to obtaining treatment or having your care paid for. If you sign an authorization, you may revoke it at any time by written notice. Satellite Laboratory Services then will not use or disclose your protected health information, except where it has already relied on your authorization.

D. HOW SATELLITE LABORATORY SERVICES MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION WITHOUT YOUR AUTHORIZATION

1.  Permissive Disclosures

In accordance with federal and state laws, Satellite Laboratory Services may, in its discretion, use or disclose your protected health without your written authorization in the following circumstances. These examples are not exhaustive.

a.  Your Care and Treatment

Satellite Laboratory Services may use or disclose your protected health information to provide you with or assist in your treatment, care and services. For example, Satellite Laboratory Services may disclose your health information to health care providers who are involved in your care to assist them in your diagnosis and treatment, as necessary. Satellite Laboratory Services may also disclose your protected health information to individuals who will be involved in your care if you leave Satellite.

b.  Billing and Payment

i.  Medicare, Medi-Cal and Other Public or Private Health Insurers – Satellite Laboratory Services may use or disclose your protected health information to public or private health insurers (including medical insurance carriers, HMOs, Social Security, Medicare, and Medi-Cal) in order to bill and receive payment for your treatment and services that you receive at Satellite. The information on or accompanying a bill may include information that identifies you, as well as your diagnosis, procedures, and supplies used.

ii.  Health Care Providers – Satellite Laboratory Services may also disclose your protected health information to health care providers in order to allow them to determine if they are owed any reimbursement for care that they have furnished to you and, if so, how much is owed.

c.  Health Care Operations

Satellite Laboratory Services may use your protected health information for health care operations at Satellite. These uses and disclosures are necessary to manage and to monitor our quality of services and care. For example, we may use your protected health information to review our services and to evaluate the performance of our staff in caring for you.

d.  Licensing, Accreditation and Funding

Satellite Laboratory Services may disclose your protected health information to any government or private agency, such as to the California Department of Health Services; the California Department of Social Services; Dialysis Councils, ESRD Network or the Center for Medicare and Medicaid Services (CMS), that is responsible for licensing, accrediting, statistical and/or funding purposes. These oversight and funding activities include audits, surveys and statistics gathering; civil, administrative, or criminal investigations; inspections; licensure or disciplinary actions; civil, administrative, or criminal proceedings or actions; or other activities necessary for appropriate oversight and funding.

e.  Individuals Involved in Your Care or Payment for Your Care

Unless you specifically object, Satellite Laboratory Services may disclose to a family member, other relative, a close personal friend, or to any other person identified by you, all protected health information directly relevant to such person’s involvement with your care or directly relevant to payment related to your care. Satellite Laboratory Services may also disclose your protected health information to these same individuals to assist in notifying them of your location, general condition, or death.

f.  Provision of Basic Information about Patients

Unless you notify Satellite Laboratory Services that you object, it will disclose your name, your unit or location in the unit, and your general condition to anyone who asks for you by name. Similarly, Satellite may disclose your name, your unit or location in the unit, your general condition, and your religious affiliation to members of the clergy.

g.  Disaster Relief

Unless you specifically object, Satellite Laboratory Services may disclose your protected health information to a public or private entity authorized to assist in disaster relief efforts.

h.  Disclosures of certain general patient information within dialysis unit

Unless you specifically object, Satellite Laboratory Services may disclose certain general information about you (e.g., past activities, present interests, birthday, and location if hospitalized) to other patients and members if its staff, by means such as newsletter or bulletin board. Satellite’s use and disclosure of this information is helpful in its pursuit of its general administrative and management objective of fostering a sense of community and nurturing care environment.

i.  Business Associates

Satellite Laboratory Services may contract with certain individuals or entities to provide services on its behalf. Examples include data processing, quality assurance, legal, or accounting services. Satellite Laboratory Services may disclose your protected health information to a business associate, as necessary, to allow the business associate to perform its functions on Satellite’s behalf. Satellite Laboratory Services will require every business associates to sign a contract that obligates it to maintain the confidentiality of your protected health information.

j.  Research

Satellite Laboratory Services may disclose your protected health information for research purposes, provided that an outside Institutional Review Board overseeing the research has reviewed the research proposal and has established protocols to ensure the privacy of your protected health information.

k.  Peer Review

Satellite Laboratory Services may disclose your protected health information to hospital or medical staffs to aid in the credentialing of applicants and in the peer review of medical staff members.

l.  Organ Procurement

If you are an organ donor, Satellite Laboratory Services may disclose your protected health information following your death to an organ procurement agency or tissue bank in order to aid in using your organs or tissues in transplantation.

m.  Appointment Reminders

Satellite Laboratory Services may use or disclose your protected health information to remind you about appointments.

n.  Treatment Alternatives or Health-Related Benefits and Services

Satellite Laboratory Services may use or disclose your protected health information to inform you about treatment alternatives or health-related benefits and services that may be of interest to you.

o.  Workforce

It is Satellite Laboratory Services’ policy to allow members of its workforce to share patients’ protected health information with one another to the extent necessary to permit them to perform their legitimate functions on Satellite Laboratory Services’s behalf. The term “workforce” includes all employees, volunteers, trainees, and board and committee members. It does not include independent contractors such as consultants or vendors.

At the same time, Satellite Laboratory Services will work with and train its workforce to ensure that there are no unnecessary or extraneous communications that will violate the rights of its patients to have the confidentiality of their protected health information maintained.

p.  Veterans

Satellite Laboratory Services may use and disclose to components of the Department of Veterans Affairs medical information about you to determine whether you are eligible for certain benefits.

q.  Food and Drug Administration, Public Health and other required reporting

Satellite may disclose health information to the extent that is required by law or the requesting agency, and is in the best interest of the patient. The disclosure may be necessary to do the following:

*  Prevent or control disease, injury, or disability

*  Report births or deaths

*  Report reactions to medications or problems with products

*  As permitted by law, notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease

*  Notify appropriate government authority if we believe a patient has been the victim of abuse, neglect or domestic abuse

r.  Workers’ Compensation

Satellite Laboratory Services may use or disclose your protected health information to comply with laws relating to workers’ compensation or similar programs.

s.  Inmates

If you are an inmate of a correctional institution or under the custody of a law enforcement official, Satellite may release medical information about you to the correctional institution or law enforcement official. This release would be necessary (1) for the institutions to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) for the safety and security of the correctional institution.

2.  Mandatory Disclosures

Satellite Laboratory Services will disclose protected health information to outside persons or entities without your written authorization as required by law in the following circumstances:

a.  Court Order; Order of Administrative Tribunal

Satellite Laboratory Services will disclose protected health information in accordance with an order of a court or of an administrative tribunal of a government agency.

b.  Subpoena

Satellite Laboratory Services will disclose protected health information in accordance with a valid subpoena issued by a party to adjudication before a court, an administrative tribunal, or a private arbitrator. Reasonable efforts will be made to notify you of the subpoena, or of efforts to obtain an order or agreement protecting your protected health information.

c.  Law Enforcement Agencies

Satellite Laboratory Services will disclose protected health information to law enforcement agencies in accordance with a search warrant, a court order or court-ordered subpoena, or an investigative subpoena or summons.

d.  Coroner

Satellite Laboratory Services will disclose protected health information to a coroner when the coroner requests the information to identify a decedent; to notify next of kin; or to investigate deaths that may involve public health concerns, suspicious circumstances, elder abuse, or organ or tissue donation.

e.  National Security and Intelligence Activities, Protected Services for the Patient and Others

Satellite Laboratory Services will disclose protected health information about a patient to authorized federal officials conducting national security and intelligence activities or as needed to provide protection to citizens of the United States, certain other persons or foreign heads of states, or to conduct certain special investigations.

f.  Other Disclosures Required by Law

Satellite Laboratory Services will disclose protected health information about a patient when otherwise required by law.

E.  YOUR RIGHTS REGARDING PROTECTED HEALTH INFORMATION

You have the following rights with respect to your protected health information. To exercise these rights, contact your Satellite Laboratory Services facility secretary.

a.  Right to Request Access

You have the right to inspect and copy your protected health information in the “designated record set”. A designated record set contains medical, billing and other records that Satellite uses for making decisions about you. In certain limited circumstances, Satellite Laboratory Services may deny your request as permitted by law. However, you may be given an opportunity to have such denial reviewed by an independent licensed health care professional, who may be a Satellite Laboratory Services employee.

This right of access does not apply to the following records: psychotherapy notes; information compiled in reasonable anticipation of, or use in a civil, criminal or administrative proceeding; and other health information that is subject to law that prohibits access to protected health information.

b.  Right to Request Amendment

You have the right to submit a written request to amend your protected health information maintained by Satellite Laboratory Services. If your request for an amendment is denied, you will receive a written denial, including the reasons for such denial, and an opportunity to submit a written statement disagreeing with the denial.

Satellite may deny your request for an amendment if it does not include a reason to support the request. In addition, we may deny your request if you ask to amend information that:

*  Was not created by Satellite, unless the person or entity that created the information is no longer available to make the amendment

*  Is not a part of the medical information kept by Satellite

*  Is not a part of the information which you would be permitted to inspect or copy

*  Is accurate and complete

To request an amendment, contact your Satellite Laboratory Services facility secretary for an appropriate form.

c.  Right to Request Restriction

You have the right to request restrictions on the use and disclosure of your protected health information for (1) treatment, payment or health care operations, or (2) providing information regarding your identity and status to persons inquiring about you or who are involved in your care. Satellite Laboratory Services is not required to grant your request, but if it does, it will comply with your request, except in an emergency situation or until the restriction is terminated by you or Satellite Laboratory Services.

d.  Right to Request Confidential Communications

You have the right to request that Satellite Laboratory Services communicate protected health information to the recipient by alternative means or at alternative locations. Satellite will not ask you the reason for your request. Satellite will accommodate reasonable requests when possible.

e.  Right to an Accounting

You have the right to receive an “accounting of disclosures”. This is a list of certain disclosures of information we have made about you. The accounting request must specify a time period that may reach up to six years prior to the date of your request but only for those disclosures made after April 14, 2003. Satellite Laboratory Services is not required to provide an accounting of the following disclosures:

*  To carry out treatment, payment, and health care operations

*  To respond to your requests for access to protected health information

*  To respond to requests for which you have signed an Authorization form

*  To aid in the identification or care of a patient

*  To any recipient prior to April 14, 2003 or for protected health information created more than six years before the date of your equest for an accounting.

f.  Right to Receive a Copy of the Notice of Privacy Practices

You have the right to request and receive a copy of Satellite Laboratory Services’s Notice of Privacy Practices for Protected Health Information in written or electronic form.

G.  COMPLAINTS

If you believe that your privacy rights have been violated, you may file a complaint with your dialysis unit, Attention: Contact Person, Patient Privacy. You also have the right to submit a complaint to the Secretary of the U.S. Department of Health and Human Services, 50 United Nations Plaza – Room 322, San Francisco, CA 94102, Attention OCR Regional Manager. Satellite Laboratory Services will not retaliate against you if you file a compliant.

H.  FURTHER INFORMATION

You may obtain a paper copy of this Notice of Privacy Practices from your Satellite Laboratory Services facility secretary.

If you have questions about this Notice of Privacy Practices or would like further information about your privacy rights, contact your Satellite Laboratory Services facility secretary.The effective date of this Notice of Privacy Practices is April 14, 2003.

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