Your Information. Your Rights. Our Responsibilities.
This notice of privacy practices (“Notice”) describes how medical information about you, including a substance use disorder patient record, if applicable, may be used and disclosed and how you can get access to this information. It also describes our legal duties and privacy practices. Please review it carefully. The law requires us to maintain the privacy and security of your health information. Nobody without a need to know can access it. In the unlikely event that your medical information is not secure, we will notify you immediately. We will not use or disclose your health information except as described in this Notice unless you tell us in writing that we can do so. This Notice applies to all medical records generated during your treatment.
TO WHOM THIS NOTICE APPLIES
This Notice is a joint notice for Advanced Dermatology, PC, Advanced Dermatology of New Jersey, PC, Skincare Physicians of Fairfield County, LLC, and all other entities MD Alliance Solutions, LLC, manages, each of which follows the terms of this Notice and are referred to in this Notice as “we,” “us,” “our,” or “Provider.” A complete listing of all these entities and their respective locations covered by this Notice is available online at www.advanceddermatologypc.com, at the office where you receive care or by calling 516-506-0859. The list may change; however, a change to the list does not constitute a material change in the practices described in this Notice. In addition, this Notice applies to all our employees, management, contractors, student interns, and volunteers.
HOW WE USE YOUR INFORMATION: OUR USES AND DISCLOSURES
How do we typically use or share your health information? We typically use or share your health information in the following ways listed below. To the extent that we have substance use disorder patient records, subject to 42 CFR part 2, we will not share that information for investigations or legal proceedings against you without (1) your written consent or (2) a court order and a subpoena.
Treatment. We can use your health information in providing and coordinating your healthcare. We can share it with your referring physician (if applicable), consulting physician(s), nurses, and other healthcare providers who have a legitimate need for such information in your care and continued treatment.
Billing and Payment. We can use and share your health information to bill and get payment from health plans or other entities. For example, we give information about you to your health insurance plan so it will confirm eligibility for benefits and pay for services we provide to you. Claims forms include diagnosis, treatment, date of service, and other information payors require. Operations. We can use and share your health information to run our practice, improve your care, and contact you when necessary (for example, appointment reminders). This also includes case management and care coordination, outcome evaluation, and training programs.
Business Associates. We may contract with “business associates” for certain services, such as document destruction and document storage companies. Business associates are required by federal law to protect your health information.
Persons Involved in Your Care. We can disclose health information to authorized persons involved in your care, such as friends or family members you identify in writing. We may also give information to someone who pays for your care. You have the right to authorize and approve such disclosures, unless you are unable to function, or if there is an emergency.
How else can we use or share your health information? We can or must share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We must meet many conditions in the law before we can share your information for these purposes. In all cases, including those listed below, if we have substance use disorder patient records about you, subject to 42 CFR part 2, we cannot use or share information in those records in civil, criminal, administrative, or legislative investigations or proceedings against you without (1) your consent or (2) a court order and a subpoena.
Help with public health and safety issues. We can share health information about you for certain situations such as preventing disease; helping with product recalls; reporting adverse reactions to medication; reporting suspected abuse, neglect, or domestic violence; preventing or reducing a serious threat to anyone’s health or safety.
Research. We can use or share your information for health research. Research projects require special permission before they begin and may include asking you for authorization. But, in some situations, your medical information may be used or released without your authorization.
Comply with the law. We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to confirm that we’re complying with federal privacy law.
Respond to organ and tissue donation requests. We can share health information about you with organ procurement organizations.
Work with a medical examiner or funeral director. We can share health information with a coroner, medical examiner, or funeral director when someone dies.
Address workers’ compensation, law enforcement, and other government requests. We can use or share healthinformation about you:
- For workers’ compensation claims
- For law enforcement purposes or with a law enforcement official
- With health oversight agencies for activities authorized by law
- For special government functions such as military, national security, and presidential protective services
Respond to lawsuits and legal actions. We can share health information about you in response to a court or administrative order, or in response to a subpoena.
Inmates. If you are an inmate of a correctional institution, we may disclose your PHI to the institution or its agents for your health and the health and safety of other individuals.
Military and Veterans. If you are a member of the military or a veteran, we may release your health information to the proper authorities so that they may perform their duties under the law.
Marketing. We may use your health information to communicate about a product covered by your health plan, treatment alternatives related to your care coordination, or health-related services or benefits that may interest you. We may also use your health information for streamlined marketing communications. Authorization is not required for face-to-face communication.
YOUR RIGHTS
You have certain rights regarding your health information. This section explains your rights and some of our responsibilities to help you.
Get an electronic or paper copy of your medical record. You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this. We will provide a copy or a summary of your health information, usually within 30 days of your request. There may be a reasonable, cost-based fee.
Ask us to correct your medical record. You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this. Any request for amendment should be submitted in writing and state a reason in support. We may deny your request but will you why in writing within 60 days.
Request confidential communications. You can ask us to contact you in a specific way (for example, home, office, or cell phone) or to send mail to a different address. We will say “yes” to all reasonable requests.
Ask us to limit what we use or share. You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no,” for example, if it could affect your care or if we have legal obligations. If we agree to your request, we may still share this information if you need emergency treatment. If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless the law or a regulation requires us to share that information.
Get a list of those with whom we’ve shared information. You can ask for a list (accounting) of the times we’ve shared your health information for 6 years before the date you ask, who we shared it with, and why. We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
Get a copy of this privacy notice. You can ask for a paper copy of this notice at any time, even if you have agreed to receive it electronically. We will provide you with a paper copy promptly. You can request a revised copy of the Notice by calling 516-506-0859 or emailing [email protected]. It will also be made available at each of our service locations and on the website.
Choose someone to act for you. If someone has authority to act as your personal representative, such as a medical power of attorney or legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action. Right to Revoke Authorization; Subsequent Disclosures. You have the right to revoke a prior authorization to use or disclose your health information, except to the extent that action has already been taken in reliance on your authorization. A request to exercise any of these rights must be submitted, in writing, to MD Alliance Solutions, LLC – Attn: Privacy Officer, 6 Lowell Ave., New Hyde Park, NY 11040. We cannot control what happens to your health information after we have acted in reliance on your authorization. Health information disclosed in accordance with HIPAA may be redisclosed by the recipient and may no longer be protected by HIPAA.
File a complaint if you feel your rights are violated. You can complain if you feel we have violated your rights by contacting us using the information in this notice. You can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting https://www.hhs.gov/hipaa/filing-a-complaint/index.html. We will not retaliate against you for filing a complaint.
YOUR CHOICES
Controlling Disclosures. For certain health information, you can tell us your choices about what we share and how we do it. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions where we can. In these cases, you have both the right and choice to tell us to:
- Share information with your family, close friends, or others involved in your care or payment for your care
- Share information in a disaster relief situation
- Include your information in a hospital directory
If you cannot tell us your preference (for example, you are unconscious), we may go ahead and share your information if we believe it is in your best interest. We may also share your information when necessary to reduce a serious and imminent threat to health or safety. In the following cases we would never share your information unless you give us written permission:
- Marketing purposes
- Sale of your information
- Most sharing of psychotherapy notes
Fundraising; Opting Out. If your health information is used or disclosed for fundraising purposes, you will have a clear and conspicuous opportunity to opt out of future fundraising communications. If you tell us not to contact you again for fundraising, we will honor your instructions.
Substance Use Disorder Records. If we have any substance use disorder patient records, subject to 42 CFR part 2, we will give you clear and obvious notice in advance and a choice about whether to receive fundraising communications that use your Part 2 information.
Acknowledgment of receipt of Notice of Privacy Practices. We will request you to sign a separate form acknowledging that you were offered or received a copy of this Notice. If you elect not to sign it, staff will sign attesting that you received the Notice and declined to sign. A copy of the acknowledgment will be kept in your patient record.
OUR RESPONSIBILITIES; OTHER INFORMATION
Privacy and Security; Breach Notification. Federal and state laws and regulations require us to maintain the privacy and security of your protected health information. We will inform you if there is a breach that may have compromised the privacy or security of your information.
Privacy Practices. We must follow the duties and privacy practices described in this notice and give you a copy of it.
Restrictions on Use of Information. We will not use or share your information other than as described in this notice unless you tell us we can in writing. If you do, you may change your mind at any time. Just let us know in writing. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
Changes to the Terms of this Notice. We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our website.
Video Monitoring. We may utilize HIPAA-compliant cameras in open areas of a facility to monitor patient safety. Video recordings are never distributed, sold, or played on the internet, social media, or YouTube for general viewing. Videos will not be part of the medical record.
Sale of Personal Information. We do not market or sell personal health information.
Most Restrictive Laws. In addition to federal laws and regulations, the practices operate in various states, respectively. Where a state law or federal law that places stricter limits on disclosures of health information (such as laws about mental health treatment) we will not share your health information or treatment records without your written consent unless it is for treatment or another law requires us to do so.
More Information; Reporting Problems. If you have questions about this Notice or would like more information, please contact our Privacy Officer at 6 Lowell Ave., New Hyde Park, NY 11040, or email [email protected].
If you believe your privacy rights have been violated, you may file a complaint with the Office of Civil Rights, US Department of Health and Human Services, by sending a letter to 200 Independence Ave. S.W., Washington, D.C. 20201, call 1.877.696.6775 or visit www.hhs.gov/ocr/privacy/hipaa/complaint. You may also file a complaint with us by contacting our office or that of the Provider.
All complaints must be submitted in writing. There will be no retaliation for filing a complaint.
Privacy Officer. Our Privacy Officer is Jonathan Fennell, Esq. You can reach him at [email protected],
[email protected], or by calling 516-506-0859
Effective Date. This revised Notice is effective February 16, 2026. We reserve the right to amend, change, or eliminate provisions in our privacy practices and access practices and to enact new provisions regarding the health information we maintain within the scope of federal and state privacy laws. If our information practices change, we will amend our Notice. Any changes we make in our privacy practices will affect all health information we maintain.