OUTLIER ABA LLC
NOTICE OF PRIVACY PRACTICES
Notice of Privacy Practices
Effective: September 5, 2025
THIS NOTICE DESCRIBES HOW PATIENT
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 of Privacy
Practices, please contact our HIPAA Privacy and Security
Officer, Michelle Vinay at michell@outlieraba.com.
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. “Protected health information” is
information about you, including demographic information,
that may identify you and that relates to your past, present or
future medical, physical or mental health or conditions and
related medical and health care services.
We are required to abide by the terms of this Notice of
Privacy Practices. We may change the terms of this
Notice at any time. Any revised Notice of Privacy
Practices would 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 by calling the office and requesting
that a revised copy be sent to you in the mail. A copy of
the current Notice of Privacy Practices will be
prominently displayed in our office at all times and
posted on our website.
1. USES AND DISCLOSURES OF PROTECTED
HEALTH INFORMATION
Uses and Disclosures of Protected Health Information
We may use or disclose your protected health information to
third parties without your written authorization for
treatment, payment or operational purposes as further
described below, and as permitted under the law.
Treatment: We will use and disclose your protected health
information to provide, coordinate or manage your health
care and any related treatment. This includes the
coordination or management of your medical care and
related care with a third party that already has obtained your
permission to have access to your protected health
information. For example, we would disclose your protected
health information, as necessary, to your primary care
physician or other providers or specialists that provide
treatment to you.
Payment: Your protected health information will be used,
as needed, to obtain payment for your health care services
(as applicable). This may include certain activities that your
health insurance plan may undertake before it approves or
pays for the health care services we provide for you,
determining your eligibility or coverage for insurance
benefits, reviewing services provided to you for necessity
and undertaking utilization review activities.
Health Care Operations: We may use or disclose, as
needed, your protected health information in order to support
the business activities of our practice. These activities
include, but are not limited to, quality assessment activities,
employee review activities, licensing, and conducting or
arranging for other business activities. For example, we may
disclose your protected health information to an insurer or
accreditation agency which performs chart audits. In
addition, we may use a sign-in sheet at the registration desk
where you will be asked to sign your name. We may use or
disclose your protected health information, as necessary, to
contact you to remind you of your scheduled appointment.
We will share your protected health information with third
party “business associates” that perform various activities
for our practice (e.g., computer consulting company, law
firm or other consultants). Whenever an arrangement
between our office and a business associate involves the use
or disclosure of your protected health information, we will
have a written contract that contains terms that will protect
the privacy of your protected health information.
We may use or disclose your protected health information,
as necessary, to provide you with information about
treatment alternatives or other health-related benefits and
services that may be of interest to you. You may contact our
HIPAA Privacy and Security Officer to request that these
materials not be sent to you.
Uses and Disclosures of Protected Health Information
Based upon Your Written Authorization
Other uses and disclosures of your protected health
information will be made only with your written
authorization, unless otherwise permitted or required by law
as described below. You may revoke your authorization at
any time, in writing, except to the extent that we have taken
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an action in reliance on the use or disclosure indicated in the
authorization.
The following uses and disclosures will be made only with
your authorization:
Uses and disclosures for marketing purposes;
Uses and disclosures that constitute the sale of PHI;
Most uses and disclosures of psychotherapy notes
(if the practice maintains psychotherapy notes); and
Other uses and disclosures not described in the
notice.
Other Permitted and Required Uses and Disclosures
That May Be Made With Your Permission or
Opportunity to Object
Others Involved in Your Health Care: Unless you object,
we may disclose to a member of your family, a relative, a
close friend or any other person you identify, your protected
health information that directly relates to that person’s
involvement in your health care. If you are unable to agree
or object to such a disclosure, we may disclose such
information as necessary if we determine that it is in your
best interest based upon our professional judgment.
Information to your family members: Unless prior
preference is expressed to our practice, a deceased patient’s
health information may be disclosed to a family or other
persons who were involved in the individual’s care or
payment for care prior to the individual’s death if such
protected health information is relevant to person’s
involvement.
Immunization Disclosure to Schools: Upon your
agreement, which may be oral or in writing, the practice may
disclose proof of immunization to a school where a state or
other law requires the school to have such information prior
to admitting the student.
Other Permitted and Required Uses and Disclosures that
may be made without your Consent or Authorization
Required by Law: We may use or disclose your protected
health information to the extent that the use or disclosure is
required by law. The use or disclosure will be made in
compliance with the law.
Public Health: We may disclose your protected health
information for public health activities 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. We also may
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.
Communicable Diseases: 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: We may disclose your protected health
information to a governmental agency for activities
authorized by law, such as audits, investigations, and
inspections.
Abuse or Neglect: We may disclose your protected health
information to a public health authority that is authorized by
law to receive reports of abuse or neglect. In addition, we
may disclose your protected health information if we believe
that you have been a victim of abuse, neglect or domestic
violence to the governmental entity or agency authorized to
receive such information.
Product Monitoring and Recalls: We may disclose your
protected health information to a person or company
required by the Food and Drug Administration to report
adverse events, product defects or problems, and biologic
product deviations; to track products; to enable product
recalls; to make repairs or replacements, or in connection
with post-marketing surveillance, as required by law.
Legal Proceedings: We may disclose protected health
information in the course of any judicial or administrative
proceeding, in response to an order of a court or
administrative tribunal (to the extent such disclosure is
expressly authorized), in certain conditions in response to a
subpoena, discovery request or other lawful process.
Law Enforcement: We may also disclose protected health
information, so long as applicable legal requirements are
met, for law enforcement purposes. These law enforcement
purposes included (1) legal processes, (2) limited
information requests for identification and location purposes,
(3) pertaining to victims of a crime, (4) suspicion that death
has occurred as a result of criminal conduct, (5) in the event
that a crime occurs on the premises of the practice, and
(6) medical emergency (not on practice’s premises) and it is
likely that a crime has occurred.
Decedents: Health information may be disclosed to funeral
directors or coroners to enable them to carry out their lawful
duties. Protected health information does not include health
information of a person who has been deceased for more
than 50 years.
Organ/Tissue Donation: Your health information may be
used or disclosed for cadaver organ, eye or tissue donation
purposes.
Criminal Activity: We may disclose your protected health
information if we believe that the use or disclosure is
necessary to prevent or lessen a serious and imminent threat
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to the health or safety or a person or the public. We also
may disclose protected health information if it is necessary
for law enforcement authorities to identify or apprehend an
individual.
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 for authorized military purposes, as
required by law.
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.
Inmates: We may use or disclose your protected health
information if you are an inmate of a correctional facility
and your provider created or received your protected health
information in the course of providing care to you.
Required Uses and Disclosures: Under the law, we must
make disclosures to you and when required by the Secretary
of the Department of Health and Human Services to
investigate or determine our compliance with the
requirements of the federal privacy regulations.
2. YOUR RIGHTS
You have the right to inspect and copy your protected
health information. This means you may inspect and
obtain a copy of protected health information about you that
is contained in a patient record maintained by the practice
for as long as we maintain the protected health information.
We may charge you our standard fee for the costs of
copying, mailing or other supplies we use to fulfill your
request.
You have the right to request a restriction of your
protected health information. 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 health
care operations. You also may 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 this Notice of Privacy
Practices. Your request must state the specific restriction
requested and to whom you want the restriction to apply.
In most circumstances, your provider is not required to agree
to a restriction that you may request. If your provider
believes it is in your best interest to permit use and
disclosure of your protected health information, your
protected health information will not be restricted.
However, if you request us to restrict disclosures to health
plans that we would normally make as part of payment or
health care operations, we must agree to that restriction if
the protected health information relates to health care which
you have paid out of pocket in full.
If your provider does agree to the requested restriction, we
may not use or disclose your protected health information in
violation of that restriction unless it is needed to provide
emergency treatment. With this in mind, please discuss any
restriction you wish to request with your provider. You may
request a restriction using the form for requests for
restrictions on protected health information from the HIPAA
Privacy and Security Officer, or you may provide us your
request, in writing. Your request must include (a) the
information you wish restricted; (b) whether you are
requesting to limit the practice’s use, disclosure, or both; and
(c) to whom you want the limits to apply.
You have the right to electronic copies of your protected
health information when requested. Where information
is not readily producible in the form and format requested,
the information must be provided in an alternative readable
electronic format as agreed to by you and the practice may
charge a reasonable cost based fee for labor in copying
protected health information and postage where you request
that information be transmitted via mail or courier.
You have the right to request to receive confidential
communications from us by alternative means or at an
alternative location. For example, you may ask us to
contact you by mail, rather than by phone at home. You do
not have to provide us a reason for this request. We will
accommodate reasonable requests. We also may condition
this accommodation by asking you for information as to how
payment will be handled or specification of an alternative
address or other method of contact. Please make this request
in writing to our HIPAA Privacy and Security Officer.
You may have the right to have your provider amend
your protected health information. This means you may
request an amendment of protected health information about
you that we maintain. In certain cases, we may deny your
request for an amendment. If we deny your request for
amendment, you have the right to file a statement of
disagreement with us and we may prepare a rebuttal to your
statement and will provide you with a copy of any such
rebuttal. Please contact our HIPAA Privacy and Security
Officer if you have questions about amending your patient
record.
You have the right to receive an accounting of certain
disclosures we have made, if any, of your protected
health information. This right applies generally to
disclosures for purposes other than treatment, payment or
health care operations as described in this Notice of Privacy
Practices. However, you do have the right to an accounting
of disclosures for treatment, payment or health care
operations if the disclosures were made from an electronic
health record.
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Your right to an accounting of disclosures excludes
disclosures we may have made to you, or to family members
or friends involved in your care, or for notification purposes.
You have the right to receive specific information regarding
other disclosures that occurred up to six years from the date
of your request (three years in the case of disclosures from
an electronic health record made for treatment, payment or
health care operations). You may request a shorter
timeframe. The first list you request within a 12-month
period is free of charge, but there is a charge involved with
any additional lists within the same 12-month period. We
will inform you of any costs involved with additional
requests, and you may withdraw your request before you
incur any costs.
You have the right to obtain a paper copy of this Notice
from us.
You have the right to opt out of fundraising
communications (to the extent the practice conducts
fundraising).
You have the right to receive notice in the event of a
breach of unsecured protected health information. This
means that you will receive notice if a breach of your
protected health information is discovered within 60 days of
discovery.
3. COMPLAINTS
You may complain to us or to the Secretary of Health and
Human Services if you believe your privacy rights have been
violated by us. You may file a complaint with us by
notifying our HIPAA Privacy and Security Officer of your
complaint. We will not retaliate against you for filing a
complaint.
You may contact our HIPAA Privacy and Security Officer,
Michelle Vinay at michelle@outlieraba.com for further information.