HIPAA Notice of Privacy Practices

Effective: January 1, 2026

This is the Notice of Privacy Practices for the practice of Andre Panossian, M.D. A signed copy is provided to patients at the time of their first appointment. This web version is provided for your reference; the signed acknowledgment is completed in our office.

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

I. My Pledge Regarding Health Information

Andre Panossian, MD, understands that health information about you and your health care is personal. I am committed to protecting health information about you. I create a record of the care and services you receive from me. I need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by this practice. This notice will tell you about the ways in which I may use and disclose health information about you. I also describe your rights to the health information I keep about you, and describe certain obligations I have regarding the use and disclosure of your health information.

I am required by law to: make sure that protected health information (“PHI”) that identifies you is kept private; give you this notice of my legal duties and privacy practices with respect to health information; and follow the terms of the notice that is currently in effect. I can change the terms of this Notice, and such changes will apply to all information I have about you. The new Notice will be available upon request, in my office, and on my website.

II. How I May Use and Disclose Health Information About You

For Treatment, Payment, or Health Care Operations: Federal privacy rules allow health care providers who have a direct treatment relationship with the patient to use or disclose the patient’s personal health information without written authorization, to carry out treatment, payment, or health care operations. I may also disclose your PHI for the treatment activities of any health care provider. For example, if a health care provider consults with another licensed provider about your condition, I would be permitted to use and disclose your otherwise-confidential information to assist in the diagnosis and treatment of your condition. Disclosures for treatment purposes are not limited to the minimum necessary standard, because providers need access to the full record to provide quality care. “Treatment” includes coordination and management of care with a third party, consultations between providers, and referrals.

Lawsuits and Disputes: If you are involved in a lawsuit, I may disclose health information in response to a court or administrative order. I may also disclose health information in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain a protective order.

III. Certain Uses and Disclosures Require Your Authorization

1. Visit Notes. I keep “Notes,” and any use or disclosure of such notes requires your Authorization unless the use or disclosure is:

• For my use in treating you.
• For my use in training or supervising clinical staff to help them improve their clinical skills.
• For my use in defending myself in legal proceedings instituted by you.
• For use by the Secretary of Health and Human Services to investigate my compliance with HIPAA.
• Required by law, and the use or disclosure is limited to the requirements of such law.
• Required by law for certain health oversight activities pertaining to the originator of the notes.
• Required by a coroner who is performing duties authorized by law.
• Required to help avert a serious threat to the health and safety of others.

2. Marketing Purposes. I will not use or disclose your PHI for marketing purposes.

3. Sale of PHI. I will not sell your PHI in the regular course of my business.

IV. Certain Uses and Disclosures Do Not Require Your Authorization

Subject to certain limitations in the law, I can use and disclose your PHI without your Authorization for the following reasons:

• When disclosure is required by state or federal law, and the use or disclosure complies with and is limited to the relevant requirements of such law.
• For public health activities, including reporting suspected child, elder, or dependent adult abuse, or preventing or reducing a serious threat to anyone’s health or safety.
• For health oversight activities, including audits and investigations.
• For judicial and administrative proceedings, including responding to a court or administrative order (although my preference is to obtain an Authorization from you first).
• For law enforcement purposes, including reporting crimes occurring on my premises.
• To coroners or medical examiners performing duties authorized by law.
• For research purposes, including studying and comparing patients who received different forms of care for the same condition.
• Specialized government functions, including ensuring the proper execution of military missions; protecting the President; conducting intelligence or counterintelligence operations; or helping ensure the safety of those within correctional institutions.
• For workers’ compensation purposes, in order to comply with workers’ compensation laws.
• For appointment reminders and health-related benefits or services, including contacting you about appointments, treatment alternatives, or other health care services or benefits I offer.

V. Certain Uses and Disclosures Require You to Have the Opportunity to Object

Disclosures to family, friends, or others. I may provide your PHI to a family member, friend, or other person that you indicate is involved in your care or the payment for your health care, unless you object in whole or in part. The opportunity to consent may be obtained retroactively in emergency situations.

VI. Your Rights With Respect to Your PHI

• The Right to Request Limits on Uses and Disclosures of Your PHI. You may ask me not to use or disclose certain PHI for treatment, payment, or health care operations. I am not required to agree, and I may decline if I believe it would affect your health care.
• The Right to Request Restrictions for Out-of-Pocket Expenses Paid in Full. You may request restrictions on disclosures of your PHI to health plans for payment or operations if the PHI pertains solely to an item or service you have paid for out-of-pocket in full.
• The Right to Choose How I Send PHI to You. You may ask me to contact you in a specific way or at a different address, and I will agree to all reasonable requests.
• The Right to See and Get Copies of Your PHI. Other than “notes,” you may get an electronic or paper copy of your medical record. I will provide a copy, or a summary if you agree, within 30 days of your written request, and may charge a reasonable, cost-based fee.
• The Right to Get a List of the Disclosures I Have Made. You may request a list of disclosures of your PHI made for purposes other than treatment, payment, or operations, or for which you provided Authorization. I will respond within 60 days; the list will cover the last six years unless you request a shorter period. The first list each year is free; additional requests may incur a reasonable, cost-based fee.
• The Right to Correct or Update Your PHI. If you believe there is a mistake or that important information is missing, you may request a correction or addition. I may decline, but I will tell you why in writing within 60 days.
• The Right to Get a Paper or Electronic Copy of This Notice. You may get a paper copy of this Notice, or a copy by e-mail; even if you have agreed to e-mail delivery, you may still request a paper copy.

Medical Records

Patient records, including clinical notes, operative reports, pre- and post-operative photographs, and diagnostic imaging, are maintained securely in accordance with federal and state privacy standards. These records do not contain “psychotherapy notes” as defined under 45 C.F.R. § 164.501.

Effective Date

This notice went into effect on January 1, 2026. For questions, please contact (626) 765-6885. Andre Panossian, MD, serves as privacy officer.