HIPAA Privacy Notice
Last Revised: 05/14/2026
Notice of Privacy Practices
This Notice is provided pursuant to the privacy regulations enacted under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”).
THIS NOTICE OF PRIVACY PRACTICES DESCRIBES HOW YOUR MEDICAL INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS YOUR INFORMATION.
This Notice applies to all protected health information (“PHI”) created or maintained by Livingston Pediatrics PA (“Practice,” “we,” “our,” or “us”).
PLEASE REVIEW THIS NOTICE CAREFULLY.
A. OUR COMMITMENT TO YOUR PRIVACY
The terms of this Notice apply to all Protected Health Information (“PHI”) created or maintained by the Practice.
We reserve the right to change this Notice at any time. Any revised Notice will apply to all PHI we currently maintain, as well as any PHI we may receive in the future. The current version of this Notice will be available:
On our website:
https://livpeds.com/At all Practice locations
Upon request from the Privacy Officer listed below
This Notice is not an authorization. Instead, it explains how we, our business associates, and their subcontractors may use and disclose your PHI for treatment, payment, healthcare operations, and other purposes permitted or required by law.
“Protected Health Information” (“PHI”) means information that identifies you individually and relates to your past, present, or future physical or mental health condition and/or healthcare services.
B. PERSONS/ENTITIES COVERED BY THIS NOTICE
This Notice applies to:
Livingston Pediatrics PA
Its physicians, providers, employees, staff, volunteers, trainees, and contractors
Business associates and subcontractors acting on behalf of the Practice
If the Practice participates in an Organized Health Care Arrangement (“OHCA”) and/or Affiliated Covered Entity (“ACE”), PHI may be shared among participating providers for treatment, payment, and healthcare operations as permitted by HIPAA.
Although affiliated providers may agree to follow this Notice, each provider remains independently responsible for their own professional services and legal obligations.
C. CONTACT FOR QUESTIONS
If you have questions regarding this Notice or our privacy practices, please contact:
Livingston Pediatrics PA
Phone: (281) 592-6000
D. USE AND DISCLOSURE OF YOUR PHI
1. Treatment
We may use and disclose your PHI to provide, coordinate, and manage your healthcare and related services.
Examples include sharing information with:
Physicians and specialists
Pharmacies
Laboratories
Hospitals
Rehabilitation providers
Home health agencies
Durable medical equipment providers
If you participate in telehealth services, your information may be shared electronically through secure systems.
2. Payment
We may use and disclose your PHI to bill and collect payment for services provided to you.
Examples include disclosures to:
Health insurance plans
Medicare or Medicaid
Collection agencies
Other parties responsible for payment
3. Healthcare Operations
We may use and disclose your PHI for healthcare operations necessary to run our Practice and improve patient care.
Examples include:
Quality improvement activities
Care coordination
Staff training
Accreditation and licensing
Auditing and compliance
Customer service and complaint resolution
We may also use de-identified information or limited data sets where permitted by law.
4. Appointment Reminders and Results
We may contact you regarding:
Appointment reminders
Test results
Follow-up care
Billing matters
Messages may be left using the minimum necessary information.
5. Treatment Alternatives and Health-Related Services
We may use your PHI to inform you about:
Treatment alternatives
Health-related products or services
Wellness programs
Disease management programs
Other providers or services that may benefit your care
6. Disclosures to Family and Friends
We may disclose PHI to individuals involved in your care or payment for your care unless you object.
If you are incapacitated, we may disclose information to your legally authorized representative.
7. Disclosures Required by Law
We will disclose PHI when required by federal, state, or local law.
Examples include:
Reporting abuse or neglect
Public health reporting
Court orders
Certain law enforcement requests
E. SPECIAL CIRCUMSTANCES
We may disclose PHI in certain special circumstances, including:
Public health reporting
Health oversight activities
Judicial and administrative proceedings
Law enforcement requests
Organ and tissue donation
Research activities
Serious threats to health or safety
Military or national security activities
Workers’ compensation claims
Correctional institution requirements
F. YOUR PRIVACY RIGHTS
1. Right to Inspect and Copy Records
You may request access to your medical and billing records.
We may charge a reasonable fee for copies.
2. Right to Request Confidential Communications
You may request that we communicate with you in a certain way or at a specific location.
3. Right to Request Amendments
You may request corrections to your PHI if you believe information is incorrect or incomplete.
4. Right to an Accounting of Disclosures
You may request a list of certain disclosures made outside of treatment, payment, and healthcare operations.
5. Right to Request Restrictions
You may request restrictions on how we use or disclose your PHI.
We are not always required to agree to requested restrictions.
If you pay out-of-pocket in full for a service, you may request that we not disclose that information to your health plan.
6. Right to Opt Out of Health Information Exchange (HIE)
You may request to opt out of participation in applicable Health Information Exchange programs, where permitted by law.
7. Right to Breach Notification
You have the right to receive notice if your unsecured PHI is breached.
8. Right to a Paper Copy
You may request a paper copy of this Notice at any time.
9. Right to File a Complaint
You may file a complaint if you believe your privacy rights have been violated.
Complaints may be filed with:
U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
Phone: 1-877-696-6775
Website: www.hhs.gov/ocr/privacy/hipaa/complaints/
You will not be retaliated against for filing a complaint.
G. ADDITIONAL INFORMATION
1. Patient Portal
Portal URL: __________________________
2. Contact Information
You are responsible for notifying us of changes to your:
Address
Phone number
Email address
Emergency contacts
3. Email and Electronic Communication
Electronic communications may not always be secure.
If you request unencrypted communication, you acknowledge associated risks.
4. Sensitive Health Information
Certain categories of health information may receive additional protections under applicable federal or state law.
5. Business Associates
We may disclose PHI to business associates who perform services on our behalf.
These parties are required to protect your information.
6. Authorizations
Uses and disclosures not described in this Notice require your written authorization.
You may revoke an authorization in writing at any time.
H. HEALTH INFORMATION EXCHANGE (HIE)
The Practice may participate in Health Information Exchange (“HIE”) networks that allow healthcare providers and other authorized entities to securely share medical information electronically for treatment, payment, and healthcare operations purposes, as permitted by law.
You may have the right to opt out of certain HIE participation programs where permitted by applicable law.
I. NO WAIVER OF RIGHTS
The Practice will not require any individual to waive rights under HIPAA or applicable privacy laws as a condition of receiving treatment.
J. SUBSTANCE USE DISORDER (SUD) RECORDS ADDENDUM
Certain substance use disorder treatment records may be protected under additional federal confidentiality laws, including 42 CFR Part 2.
Where applicable, disclosures of these records will be made only as permitted or required by law.
K. CONTACT/COMPLAINT INFORMATION
If you have questions or complaints regarding this Notice or your privacy rights, contact:
Livingston Pediatrics PA
Phone: (281) 592-6000
You may also contact the U.S. Department of Health and Human Services Office for Civil Rights.