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.

If you have any questions about this notice,
please contact:

Privacy Official

Address: 501 N Riverpoint Ste 325

Spokane WA 99202

Phone: (509) 363-7797

This Notice of Privacy Practices describes how we may use and disclose your protected health information to carry out treatment, payment, or health care operations, and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. Please review it carefully.

“Protected health information” is information about you, including information that may identify you and that relates to your past, present, or future physical or mental health or condition and related to health care services.

We understand that medical information about you and your health is personal. We are committed to protecting medical information about you.

This notice applies to all of the records of your care generated by Inland Vascular Institute, whether made by Inland Vascular Institute personnel or by your doctor.

Other doctors may have different policies or notices regarding their use and disclosure of your medical information.

1. CHANGES TO THIS NOTICE

We are required by law to abide by the terms of this Notice of Privacy Practices. We are required by law to keep your protected health information private and to provide you with a notice of our legal duties and our privacy practices. We may change the terms of our notice, at any time. The new notice will be effective for all protected health information that we maintain at that time. Upon your request, we will provide you with any revised Notice of Privacy Practices. The Notice is available by accessing our website at www.inlandvascular.com; calling the phone number at the top of this page and requesting that a revised copy be sent to you in the mail, or by asking for a copy at the time of your next visit or admission.

2. HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU

The following categories describe different ways that we use and disclose medical information. For each category of uses or disclosures we will explain what we mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.

► For Treatment: We may use medical information about you to provide you with medical treatment or services. We may disclose medical information about you to doctors, nurses, technicians, or other healthcare personnel who are involved in taking care of you.

For example, a doctor treating you may request a copy of your medical record. Your protected health information may be provided from time-to-time to another doctor or health care provider who, at the request of your doctor, becomes involved in your care. This is done to ensure that the doctor has the necessary information to diagnose or treat you. In addition, if you are hospitalized, medical information may be shared with different departments of the hospital in order to coordinate the different services that you need. We may also make your protected health information available to other health care organizations that are involved in your care via our computer network. We may also disclose medical information about you to people who may be involved in your medical care after you leave the hospital, such as family members, clergy, or others that are part of your care. We may also contact you regarding treatment alternatives.

► For Payment: We may use and disclose medical information about you so that the treatment and services you receive at Inland Vascular Institute can be billed and payment can be collected from you, an insurance company or a third party. For example, we may need to give your health plan information about services you received so your health plan will pay us or reimburse you for the services. We may also tell your health plan or the sponsor of the health plan about services or treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the services. For example, your health plan may require prior authorization before services are covered.

► For Health Care Operations: We may use and disclose medical information about you in order to support the business activities of our organization. These uses and disclosures are necessary to provide services and make sure that all of our patients receive quality care. For example, we may use medical information to review our treatment and services and to evaluate the performance of our staff in caring for you. We may also combine medical information about many of our patients to decide what additional services we should offer, what services are not needed, and whether certain new procedures are effective. We may also disclose information to your doctor, nurse, technician, or other personnel for review and educational purposes. We may also combine the medical information we have with medical information from other health care organizations to compare how we are doing and see where we can make improvements in the care and services we offer. We may remove information identifying you from such combined sets of medical information so that others may use the information for clinical studies without learning the identity of specific patients.

· For Appointments: We may call you by name in the waiting room when we are ready to see you. We may use or disclose your protected health information, as necessary, to remind you of your appointment.

· For Billing and Transcription Services: We will share your protected health information with business associates that perform various activities (for example, billing, or transcription services) for us.

· For Health-Related Benefits and Services: We may also use and disclose your protected health information, as necessary, to provide you with information about health-related benefits and services that may be of interest to you.

· Individuals Involved in Your Care or Payment for Your Care: We may release medical information about you to a friend or family member who is involved in your medical care. We may also give information to someone who helps pay for your care. In addition, we may disclose medical information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location.

► As Required By Law. We will disclose medical information about you when required to do so by federal, state or local law.

► For Fundraising: We may disclose protected health information about you for fundraising. For example, we may provide your name and phone number to an organization to enable them to solicit a donation from you.

► For Marketing: We may provide you with general marketing information about our services or give you small promotional gifts when we see you in person without your written authorization.

· For example, we may send you a newsletter or a list of our health classes or we may give you a pen with our organization’s name on it. We must obtain your written authorization before we can send you marketing information about specific products or services that we provide. You may contact our Privacy Officer to request that these materials not be sent to you.

► To Avert a Serious Threat to Health or Safety. We may use and disclose medical information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat.

3. Other Permitted and Required Uses and Disclosures of Protected Health Information That May be Made Without Your Authorization or Opportunity to Object

► Military Activity and National Security: When the appropriate conditions apply, we may use or disclose protected health information of individuals who are Armed Forces personnel (1) for activities deemed necessary by appropriate military command authorities; (2) for the purpose of a determination by the Department of Veterans Affairs of your eligibility for benefits; or (3) to foreign military authority if you are a member of that foreign military services. We may also disclose your protected health information to authorized federal officials for conducting national security and intelligence activities, including for the provision of protective services to the President or others legally authorized.

► Workers' Compensation. Your protected health information may be disclosed by us as authorized to comply with workers’ compensation laws and other similar legally-established programs. For example, we are required by Washington state law to disclose health information to the Department of Labor and Industries or a self-insured employer for workers’ compensation or crime victims’ claims. We can disclose health information to an employer about light duty work without any authorization from you. We can disclose health information to an employer without an authorization from you if the information is about a workplace injury or illness, a workplace medical surveillance or a return-to-work examination.

► Public Health Risks. We may disclose your protected health information for public health activities and purposes to a public health authority that is permitted by law to collect or receive the information. The disclosure will be made for the purpose of controlling disease, injury or disability; to report the abuse or neglect of children, elders or dependent adults; to notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect, or domestic violence. We may also disclose your protected health information, if directed by the public health authority, to a foreign government agency that is collaborating with the public health authority. We may disclose your protected health information, if authorized by law, to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading the disease or condition.

► Health Oversight Activities. We may disclose your protected health information to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections. Oversight agencies seeking such information would include: government agencies that oversee the health care system, government benefit programs and government agencies that oversee compliance with civil rights laws.

► Legal Proceedings, Lawsuits and Disputes. We may disclose your protected health information in response to a court or administrative order or in response to a subpoena, discovery request, or other lawful process to the extent such disclosure is expressly authorized.

► Law Enforcement. We may disclose your protected health information for law enforcement purposes when applicable legal requirements are met. These law enforcement purposes include: (1) legal processes, or as otherwise required by law, (2) identification or location of a suspect, fugitive, material witness, or missing person; (3) investigations pertaining to victims of a crime; (4) suspicion that death has occurred as a result of criminal conduct; (5) investigations of a crime that occurred on our premises; and (6) in a medical emergency (not on our premises) in which it is likely that a crime may have been committed.

► Coroners, Medical Examiners, Funeral Directors, and Organ Donation: We may disclose your protected health information to a coroner or medical examiner for identification purposes, for determining cause of death, or for the coroner or medical examiner to perform other duties authorized by law. We may also disclose protected health information to a funeral director, as authorized by law, in order to permit the funeral director to carry out their duties. Protected health information may be used and disclosed for cadaveric organ, eye, or tissue donation purposes.

► Research: Under certain circumstances, we may use and disclose protected health information about you for research purposes. For example, a research project may involve comparing the health and recovery of all patients who receive one medication to those who received another, for the same condition. All research projects, however, are subject to a special approval process. This process evaluates a proposed research project and its use of protected health information, trying to balance the research needs with patients' need for privacy of their protected health information. Before we use or disclose protected health information for research, the project will have been approved through this research approval process, but we may, however, disclose protected health information about you to people preparing to conduct a research project, for example, to help them look for patients with specific medical needs, so long as the information they review does not leave Inland Vascular Institute. We will ask for your specific permission if the researcher will have access to your name, address or other information that reveals who you are, or will be involved in your care at Inland Vascular Institute.

► Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may disclose your protected health information to the correctional institution or law enforcement official. This release would be necessary (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) for the safety and security of the correctional institution.

► Other uses and disclosures will be made only with your written authorization. You may revoke such authorization at any time.

4. YOUR RIGHTS REGARDING YOUR MEDICAL INFORMATION

You have the following rights regarding your protected health information:

► Right to Inspect and Copy: You have the right to inspect and copy protected health information that may be used to make decisions about your care. Usually, this includes medical and billing records. Under Federal law, however, you may not inspect or copy the following records: psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding; and protected health information that is subject to law that prohibits access to protected health information.

· To inspect and copy protected health information that may be used to make decisions about your care, you must submit your request in writing to Inland Vascular Institute Medical Records. If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies associated with your request.

· We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to protected health information, you may request that the denial be reviewed. Another licensed health care professional chosen by Inland Vascular Institute will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.

► Right to Amend. If you feel that protected health information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by Inland Vascular Institute.

· To request an amendment, your request must be made in writing and submitted to Inland Vascular Institute Medical Records. In addition, you must provide a reason that supports your request.

· We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that: (1) was not created by us, unless the person or entity that created the information is no longer available to make the amendment; (2) is not part of the protected health information kept by or for Inland Vascular Institute; (3) is not part of the information which you would be permitted to inspect and copy; or (4) is accurate and complete.

► Right to an Accounting of Certain Disclosures. You have the right to request an "accounting of disclosures.” An accounting of disclosures is a listing of the disclosures we have made of your health information, except as it was used for treatment, payment, or health care operations. It also excludes disclosures we may have made to you, to family members or friends involved in your care, or for notification purposes. You have the right to receive specific information regarding these disclosures that occurred after April 14, 2003.

· To request this list or accounting of disclosures, you must submit your request in writing to the Privacy Officer identified at the beginning of this Notice of Privacy Practices. Your request must state a time period which may not be longer than six years and may not include dates before April 14, 2003. The first list you request within a 12 month period will be free. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request before any costs are incurred.

► Right to Request Restrictions. You have the right to request a restriction or limitation on the protected health information we use or disclose about you for treatment, payment or health care operations. This means you may ask us not to use or disclose any part of your protected health information for the purposes of treatment, payment, or healthcare operations. You may also request that any part of your protected health information not be disclosed to family members or friends who may be involved in your care or for notification purposes as described in the Notice of Privacy Practices.

· We are not required to agree to a restriction that you may request. If we believe it is in your best interest to permit use and disclosure of your protected health information, use and disclosure of your protected health information will not be restricted. If we do agree to the requested restriction, we agree to comply with your request, unless the information is needed to provide you with emergency treatment. With this in mind, please discuss any restriction you wish to request with your physician.

· To request restrictions, you must make your request in writing to the Privacy Officer identified at the beginning of this Notice of Privacy Practices. In your request, you must tell us: (1) what information you want to limit; (2) whether you want to limit our use, our disclosure or both; and (3) specifically, to whom you want the restriction to apply.

► Right to Request Confidential Communications: You have the right to request that we communicate with you about medical matters in a certain way or at a certain location or alternative address. For example, you can ask that we only contact you by mail at a different address. We will accommodate reasonable requests. We will not ask the reason for your request. We may, however, ask you for information as to how payment will be handled.

· To request confidential communications, you must make your request in writing to the Privacy Officer identified at the beginning of this Notice of Privacy Practices. Your request must specify how or where you wish to be contacted.

► Right to a Paper Copy of This Notice. You have the right to obtain a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice. Or, you can obtain a copy of this notice from our website at www.inlandvascular.com.

5. PRIVACY COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint with Inland Vascular Institute or with the Secretary of the Department of Health and Human Services. To file a complaint with Inland Vascular Institute, contact the Privacy Officer identified at the beginning of this Notice of Privacy Practices. All complaints must be submitted in writing. You will not be penalized for filing a concern.

This notice was published and effective on April 1, 2003.