Notice of Privacy Practices

Whole Mind Therapy & Counseling, LLC

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

PLEASE REVIEW THIS NOTICE CAREFULLY.

Your health record contains personal information about you and your health.  This is information about you that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services is referred to as Protected Health Information (“PHI”). This Notice of Privacy Practices describes how we may use and disclose your PHI in accordance with applicable law, including the Health Insurance Portability and Accountability Act (“HIPAA”), regulations promulgated under HIPAA including the HIPAA Privacy and Security Rules.  It also describes your rights regarding how you may gain access to and control your PHI.

We are required by law to maintain the privacy of PHI and to provide you with notice of our legal duties and privacy practices with respect to PHI. We are required to abide by the terms of this Notice of Privacy Practices.  We reserve the right to change the terms of my Notice of Privacy Practices at any time.  Any new Notice of Privacy Practices will be effective for all PHI that I maintain at that time. We will provide you with a copy of the revised Notice of Privacy Practices when it is available via HIPAA compliant medical record portal.

I. USES AND DISCLOSURES FOR TREATMENT, PAYMENT AND HEALTH CARE OPERATIONS, REQUIRING CONSENT

We may use or disclose your PHI for treatment, payment, and health care operations purposes with your consent as discussed below:

For Treatment.  Your PHI may be used and disclosed by those who are involved in your care for the purpose of providing, coordinating, or managing your health care treatment and related services. This includes consultation with clinical supervisors or other treatment team members within our practice. We may disclose PHI to any other provider only with your authorization.

For Payment.  We may use and disclose PHI so that I can receive payment for the treatment services provided to you.  This will only be done with your consent. Examples of payment-related activities are: making a determination of eligibility or coverage for insurance benefits, processing claims with your insurance company, reviewing services provided to you to determine medical necessity, or undertaking utilization review activities.

For Health Care Operations.  We may use or disclose, as needed, your PHI in order to support our business activities including, but not limited to, quality assessment activities, and conducting or arranging for other business activities. For example, we may share your PHI with third parties that perform various business activities (e.g., billing) provided we have a written contract with the business that requires it to safeguard the privacy of your PHI.

II.            USES AND DISCLOSURES REQUIRING AUTHORIZATION

Uses and disclosures not specifically permitted by applicable law will be made only with your written authorization, which may be revoked at any time, except to the extent that we have already made a use or disclosure based upon your authorization.  The following uses and disclosures will be made only with your written authorization:

  • most uses and disclosures of psychotherapy notes which are separated from the rest of your medical record.

  • other uses and disclosures not described in this Notice of Privacy Practices.

  • uses and disclosures for marketing purposes when written authorization is required by HIPAA.

  • disclosures that constitute a sale of PHI under HIPAA, which require written authorization.

Additional Protections for Certain Substance Use Disorder Treatment Records (42 CFR Part 2)

If Whole Mind Therapy & Counseling, LLC receives or maintains substance use disorder treatment records protected by 42 CFR Part 2 from a program subject to that law, we will use or disclose those records only as permitted by Part 2 and other applicable law. Where permitted by a valid Part 2 consent or another applicable legal basis, these records may be used and disclosed for treatment, payment, and health care operations.

Records protected under Part 2, and testimony describing their contents, will not be used or disclosed in civil, criminal, administrative, or legislative investigations or proceedings against you without your specific written consent or a court order that satisfies Part 2 requirements, including any required notice and opportunity to be heard. A court order authorizing such use or disclosure must also be accompanied by a subpoena or another legal requirement compelling disclosure. These additional protections apply even when a disclosure might otherwise be permitted under HIPAA and described elsewhere in this Notice.

III.           USES AND DISCLOSURES WITH NEITHER CONSENT NOR AUTHORIZATION

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

·         Child Abuse: If we, in our professional capacity, have reasonable cause to believe that a minor child is suffering physical or emotional injury resulting from abuse inflicted upon him or her which causes harm or substantial risk of harm to the child's health or welfare (including sexual abuse), or from neglect, including malnutrition, we must immediately report such condition to the Massachusetts Department of Children and Families.

·         Elder Abuse: If we have reasonable cause to believe that an elderly person (age 60 or older) is suffering from or has died as a result of abuse, we must immediately make a report to the Massachusetts Department of Elder Affairs.

·         Abused of a Disabled Person: If we have reasonable cause to suspect abuse of an adult (ages 18-59) with mental or physical disabilities, we must immediately make a report to the Massachusetts Disabled Persons Protection Commission.

·   Health Oversight: If required, we may disclose PHI to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections. Oversight agencies seeking this information include government agencies and organizations that provide financial assistance to the program (such as third-party payors based on your prior consent) and peer review organizations performing utilization and quality control.

·         Judicial or Administrative Proceedings: If you are involved in a court proceeding and a request is made for information about your diagnosis and treatment and the records thereof, such information is privileged under state law and we will not release information without written authorization from you or your legally-appointed representative, or a court order.  The privilege does not apply when you are being evaluated for a third party or where the evaluation is court-ordered. You will be informed in advance if this is the case.

·         Serious Threat to Health or Safety: If you communicate an explicit threat to kill or inflict serious bodily injury upon an identified person and you have the apparent intent and ability to carry out the threat, we must take reasonable precautions.  Reasonable precautions may include warning the potential victim, notifying law enforcement, or arranging for your hospitalization.  we must also do so if we know you have a history of physical violence and we believe there is a clear and present danger that you will attempt to kill or inflict bodily injury upon an identified person.  Furthermore, if you present a clear and present danger to yourself and refuse to accept further appropriate treatment, and we have a reasonable basis to believe that you can be committed to a hospital, we must seek said commitment and may contact members of your family or other individuals if it would assist in protecting you.

·         Worker’s Compensation: If you file a workers’ compensation claim, your records relevant to that claim will not be confidential to entities such as your employer, the insurer and the Division of Worker’s Compensation.

·         Specialized Government Functions.  We may review requests from U.S. military command authorities if you have served as a member of the armed forces, authorized officials for national security and intelligence reasons and to the Department of State for medical suitability determinations, and disclose your PHI based on your written consent, mandatory disclosure laws and the need to prevent serious harm.

·         Public Health.  If required, we may use or disclose your PHI for mandatory public health activities 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, or if directed by a public health authority, to a government agency that is collaborating with that public health authority.

·         Public Safety. We may disclose your PHI if necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public. If information is disclosed to prevent or lessen a serious threat it will be disclosed to a person or persons reasonably able to prevent or lessen the threat, including the target of the threat

IV.          YOUR RIGHTS AND OUR OBLIGATIONS

Patient’s Rights:

You have the following rights regarding PHI I maintain about you:

  • Right of Access to Inspect and Copy.  You have the right, which may be restricted only in exceptional circumstances, to inspect and copy PHI that is maintained in a “designated record set.” A designated record set contains mental health/medical and billing records and any other records that are used to make decisions about your care. Your right to inspect and copy PHI will be restricted only in those situations where there is compelling evidence that access would cause serious harm to you or if the information is contained in separately maintained psychotherapy notes. We may charge a reasonable, cost-based fee for copies. If your records are maintained electronically, you may also request an electronic copy of your PHI. You may also request that a copy of your PHI be provided to another person.

  • Right to Amend. If you feel that the PHI we have about you is incorrect or incomplete, you may ask us to amend the information although we are not required to agree to the amendment. If we deny your request for amendment, you have the right to file a statement of disagreement. We may prepare a rebuttal to your statement and will provide you with a copy.

  • Right to an Accounting of Disclosures.  You have the right to request an accounting of PHI for which you have neither provided authorization nor consent.  On request, we will discuss with you the details of the accounting process.

  • Right to Request Restrictions.  You have the right to request a restriction or limitation on the use or disclosure of your PHI for treatment, payment, or health care operations.  We are not required to agree to your request unless the request is to restrict disclosure of PHI to a health plan for purposes of carrying out payment or health care operations, and the PHI pertains to a health care item or service that you paid for out of pocket. In that case, We are required to honor your request for a restriction.

  • Right to Receive Confidential Communications.  You have the right to request that we communicate with you about health matters in a certain way. we will accommodate reasonable requests.

  • Breach Notification.  If there is a breach of unsecured PHI concerning you, we may be required to notify you of this breach, including what happened and what you can do to protect yourself.

  • Right to a Paper Copy of this Notice.  You have the right to a paper copy of this notice upon request, even if you have agreed to receive the notice electronically.

Our Obligations:

  • We are required by law to maintain the privacy of PHI and to provide you with a notice of our legal duties and privacy practices with respect to PHI.

  • We reserve the right to change the privacy practices described in this Notice.  Unless we notify you of such changes, however, we are required to comply with the terms currently in effect.

  • If we revise our privacy practices, we will send you a new Notice of Privacy Practices via HIPAA compliant medical record portal.

  • We are required to notify affected individuals following a breach of unsecured PHI, as required by law.

  • We will make this Notice available upon request and prominently accessible through our website. Revised Notices will be made available as required by law.

V.            COMPLAINTS

If you believe I have violated your privacy rights or you disagree with a decision we made about access to your records, you may talk with us further about this matter. You may also send a written complaint to the Secretary of Health and Human Services at 200 Independence Avenue, S.W.  Washington, D.C. 20201 or by calling (202) 619-0257.

Privacy Contact and Complaints to Our Practice: To ask questions about this Notice, obtain further information about our privacy practices, or file a privacy complaint with Whole Mind Therapy & Counseling, LLC, call our Privacy Contact at (781) 384-5447. We will not retaliate against you for filing a complaint. You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights online at https://www.hhs.gov/hipaa/filing-a-complaint/index.html or by calling 1-877-696-6775.

VI.          EFFECTIVE DATE OF PRIVACY PRACTICES

The updated effective date of this Notice of Privacy Practices is November 1, 2026.