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.

I. Who We Are

This Notice of Privacy Practices (“Notice”) describes the privacy practices of OCLI Vision, Inc. and its subsidiaries and affiliates, including, but not limited to, its practices and ambulatory surgery centers (collectively, “OCLI,” “we” or “us”). OCLI receives certain management and business support services from Spectrum Vision Partners, LLC and its subsidiaries and affiliates.

II. Our Privacy Obligations

We understand that your health information (“Protected Health Information”) is personal, and we are committed to protecting your privacy. In addition, we are required by law to maintain the privacy of your Protected Health Information, provide you with this Notice of our legal duties and privacy practices with respect to your Protected Health Information, and notify you in the event of a breach of your unsecured Protected Health Information. When we use or disclose your Protected Health Information, we are required to abide by the terms of this Notice.

III. Permissible Uses and Disclosures Without Your Written Authorization

In certain situations, which we will describe below, we must obtain your written authorization in order to use and/or disclose your Protected Health Information. In all other cases, we may use and disclose your Protected Health Information without your written authorization for the following purposes:

Treatment. We use and disclose your Protected Health Information to provide treatment and other services to you—for example, to form a diagnosis and treatment plan, consult with other health care providers about your care, dedicate tasks to staff, call in prescriptions to your pharmacy, schedule lab work for you, etc. We may use your information to direct or recommend alternative treatments, therapies, health care providers, or settings of care to you or to describe a health-related product or service.
Payment. We may use and disclose your Protected Health Information to obtain payment for health care services that we provide to you—for example, disclosures to claim and obtain payment from Medicare, Medicaid, your health insurer, HMO, or other company or program that arranges or pays the cost of your health care (“Your Payor”) to verify that Your Payor will pay for the health care. We may also disclose Protected Health Information to your other health care providers when such Protected Health Information is required for them to receive payment for services they render to you.
Health Care Operations. We may use and disclose your Protected Health Information for our health care operations, which include internal administration and planning and various activities that improve the quality and cost effectiveness of the care that we deliver to you. For example, we may use Protected Health Information to evaluate the quality and competence of our health care professionals, provide customer service, or perform other activities to run our business and operations. We may also share your Protected Health Information with individuals or organizations we hire to help us perform health care operations activities.
Disclosure to Relatives, Close Friends and Other Caregivers. We may disclose your Protected Health Information to a family member, other relative, a close personal friend or any other person identified by you when you are present for, or otherwise available prior to, the disclosure, if: (1) we obtain your agreement or provide you with the opportunity to object to the disclosure and you do not object; or (2) we reasonably infer that you do not object to the disclosure. If you are not present for or unavailable prior to a disclosure (e.g., when we receive a telephone call from a family member or other caregiver), we may exercise our professional judgment to determine whether a disclosure is in your best interests. If we disclose information under such circumstances, we will disclose only information that is directly relevant to the person’s involvement with your care.
Incidental Disclosures. We will take reasonable steps to protect the privacy of your Protected Health Information. However, certain limited disclosures of your Protected Health Information may occur as a result of permitted uses and disclosures that cannot be reasonably prevented. For example, your discussion with your provider may be overheard by other individuals in the treatment area.
As Required by Law. We may use and disclose your Protected Health Information when required to do so by any applicable federal, state or local law.
Public Health Activities. We may disclose your Protected Health Information: (1) to report health information to public health authorities for the purpose of preventing or controlling disease, injury or disability; (2) to report child abuse and neglect to a government authority authorized by law to receive such reports; (3) to report information about products under the jurisdiction of the U.S. Food and Drug Administration; (4) to alert a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading a disease or condition; and (5) to report information to your employer as required under laws addressing work-related illnesses and injuries or workplace medical surveillance.
Victims of Abuse, Neglect or Domestic Violence. We may disclose your Protected Health Information if we reasonably believe you are, or another individual is, a victim of abuse, neglect or domestic violence to a government authority authorized by law to receive reports of such abuse, neglect, or domestic violence.
Health Oversight Activities. We may disclose your Protected Health Information to an agency that oversees the health care system and is charged with responsibility for ensuring compliance with the rules of government health programs such as Medicare or Medicaid.
Judicial and Administrative Proceedings. We may disclose your Protected Health Information in the course of a judicial or administrative proceeding in response to a legal order or other lawful process.
Law Enforcement Officials. We may disclose your Protected Health Information to the police or other law enforcement officials as required by law or in compliance with a court order.
Organ, Eye, and Tissue Procurement. We may disclose your Protected Health Information to organizations that facilitate organ, eye, or tissue procurement, banking or transplantation.
Clinical Trials and Other Research Activities. We may use and disclose your Protected Health Information for research purposes pursuant to a valid authorization from you or when an institutional review board or privacy board has waived the authorization requirement. Under certain circumstances, your Protected Health Information may be disclosed without your authorization to researchers preparing to conduct a research project, for research or decedents or as part of a data set that omits your name and other information that can directly identify you.
Health or Safety. We may use or disclose your Protected Health Information 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 use and disclose your Protected Health Information to units of the government with special functions, such as the U.S. military or the U.S. Department of State under certain circumstances.
Workers’ Compensation. We may disclose your Protected Health Information as authorized by and to the extent necessary to comply with state law relating to workers’ compensation or other similar programs.
Disaster Relief Efforts. We may disclose your Protected Health Information to an organization such as the American Red Cross so that your family can be notified about your condition, status, and location in the event of a disaster. We will try to obtain your permission first if we can reasonably do so while trying to respond to the emergency.
Appointment Reminders. We may use and disclose your Protected Health Information to contact you by mail, phone, text message, or email regarding appointment reminders and other issues related to your appointments. We will use the contact information you gave us when we contact you.
Communications About Products and Services. We use and disclose your ProtectedHealth Information to send you communications about health-related products and services that may be of interest to you without your written authorization. We also may provide refill reminders or communicate with you about a drug or biologic that is currently prescribed to you so long as any payment we receive for making the communication is reasonably related to our cost of making the communication. In addition, we may communicate with you about products and services that may be of interest to you in a face-to-face encounter and give you promotional gifts of nominal value without your written authorization.
Fundraising Communications. We may use your Protected Health Information to contact you for fundraising purposes, including to request your charitable contributions to support our programs, research, and other activities. We may share with our fundraising staff your demographic information (such as your name, address and phone number), dates on which we provided health care to you, the department that treated you or the names of your treating providers, information regarding the outcome of your treatment, and your health insurance status. If you do not want to receive any fundraising requests in the future, you may contact our Privacy Officer identified below.

De-Identified Information and Limited Data Sets. We may use Protected Health Information to create de-identified health information and limited data sets. De-identified health information is health information that cannot reasonably be used to identify you. Once health information has been appropriately de-identified under HIPAA and other applicable law, we may use and share the de-identified health information for any purpose. Limited data sets are Protected Health Information that do not include certain direct identifiers about you, such as your name or phone number. We may use and share limited data sets for purposes of research, health care operations, or public health activities as described in this Notice after entering into a HIPAA-compliant agreement with the recipient.

Coroners, Medical Examiners, and Funeral Directors. We may disclose your Protected Health Information to a coroner or medical examiner as necessary to identify a deceased person or to determine the cause of death. We also may disclose your Protected Health Information to funeral directors so they can carry out their duties.

Inmates. If you are an inmate of a correctional facility or in the custody of a law enforcement official, we may disclose your Protected Health Information to the correctional facility or law enforcement official as authorized or required by law. This includes sharing information that is necessary to protect the health and safety of other inmates or individuals involved in supervising or transporting inmates.

IV. Uses and Disclosures Requiring Your Written Authorization

For any purpose other than the ones described above, we only use or disclose your Protected Health Information when you give us your written authorization.

Marketing. We must obtain your written authorization prior to using your Protected Health Information for purposes that are “marketing” as defined by HIPAA. For example, we will not accept any payments from other organizations or individuals in exchange for making communications to you about treatments, therapies, health care providers, settings of care, case management, care coordination, products or services unless you have given us your authorization to do so or the communication is permitted by law.
Sale of Protected Health Information. We will not make any disclosure of Protected Health Information that is a sale of Protected Health Information without your written authorization.
Uses and Disclosures of Your Highly Confidential Information. Federal and state law requires special privacy protections for certain health information about you (“Highly Confidential Information”), including substance use disorder records and other health information that is given special privacy protection under applicable state or federal laws other than HIPAA. We must obtain your authorization to disclose any Highly Confidential Information for a purpose other than those permitted by law.
Revocation of Your Authorization. You may revoke your authorization, except to the extent that we have taken action in reliance upon it, by delivering a written revocation statement to the Privacy Officer identified below.

VI. Your Individual Rights

For Further Information; Complaints. If you desire further information about your privacy rights, are concerned that we have violated your privacy rights or disagree with a decision that we made about access to your Protected Health Information, you may contact our Privacy Officer. You may also file written complaints with the U.S. Department of Health and Human Services, Office for Civil Rights (OCR). Upon request, the Privacy Officer will provide you with OCR’s contact information. We will not retaliate against you if you file a complaint with us or OCR.
Right to Request Additional Restrictions. You may request restrictions on our use and disclosure of your Protected Health Information (1) for treatment, payment and health care operations, (2) to individuals (such as a family member, other relative, close personal friend or any other person identified by you) involved with your care or with payment related to your care, or (3) to notify or assist in the notification of such individuals regarding your location and general condition. While we will consider all requests for additional restrictions carefully, we are not required to agree to a requested restriction unless the request is to restrict our disclosure to a health plan for purposes of carrying out payment or health care operations, the disclosure is not required by law and the information pertains solely to a health care item or service for which you (or someone on your behalf other than the health plan) have paid us out of pocket in full. If you wish to request additional restrictions, please obtain a request form from our Privacy Officer and submit the completed form to the Privacy Officer. We will send you a written response.
Right to Receive Communications by Alternative Means or at Alternative Locations. You may request, and we will accommodate, any reasonable written request for you to receive your Protected Health Information by alternative means of communication or at alternative locations.
Right to Inspect and Copy Your Health Information. You may request access to your medical record file and billing records maintained by us in order to inspect and request copies of the records. Under limited circumstances, we may deny you access to a portion of your records. If you desire access to your records, please obtain a record request form from the Privacy Officer and submit the completed form to the Privacy Officer. If you request copies, we may charge you a reasonable copy fee.
Right to Amend Your Records. You have the right to request that we amend your Protected Health Information maintained in your medical record file or billing records. If you desire to amend your records, please obtain an amendment request form from the Privacy Officer and submit the completed form to the Privacy Officer. We will comply with your request unless we believe that the information that would be amended is accurate and complete or other special circumstances apply.
Right to Receive an Accounting of Disclosures. Upon request, you may obtain an accounting of certain disclosures of your Protected Health Information made by us during any period of time prior to the date of your request provided such period does not exceed six years. If you request an accounting more than once during a twelve (12) month period, we may charge you a reasonable fee for the accounting.
Right to Receive Paper Copy of this Notice. Upon request, you may obtain a paper copy of this Notice, even if you agreed to receive such notice electronically. ⁴

VII. Effective Date and Duration of This Notice

Effective Date. This Notice is effective on December 12, 2023.
Right to Change Terms of this Notice. We may change the terms of this Notice at any time. If we change this Notice, we may make the new notice terms effective for all your Protected Health Information that we maintain, including any information created or received prior to issuing the new notice. If we change this Notice, we will post the updated notice on our website. You also may obtain any new notice by contacting the Privacy Officer.

VIII. Applicability of Notice

All OCLI facilities that provide care to the public will follow this Notice of Privacy Practices. These facilities include, but are not limited to:

Connecticut:
Ophthalmic Consultants of Connecticut, New Vision Cataract Center

New Jersey:
EyeCare 20/20, Morristown Ophthalmology Associates

New York:
Ophthalmic Consultants of Long Island, The Mackool Eye Institute, NY Vision Group,
Comprehensive Eye MD, Stahl Eyecare Experts, Rockland Eye Physicians and Surgeons,
Hudson Valley Eye Associates, Island Eye Surgicenter, Stahl Eyecare Experts, Retina
Consultants of Western New York, Ophthalmology Associates of Western New York,
Buffalo Niagara Retina Associates, Eye Institute of New York, Glaucoma Consultants of Long Island

Pennsylvania:
Bausch Eye Associates, Lehigh Valley Eye Center, Associates in Ophthalmology, Dailey
Harvey Eye Associates, Crossroads

West Virginia:
Associates in Ophthalmology

IX. Privacy Officer

You may contact the Privacy Officer, who sits within the Department of Corporate Compliance, by email at [email protected], by telephone at 833-254-4274, or online at spectrumvisionpartners.ethicspoint.com.