Mandatory HIPAA Notice
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.
1. Our Commitment to Your Privacy
At Kidney Specialists, Inc., we understand that medical information about you and your health is personal and confidential. We are committed to protecting your medical information. We create a record of the care and services you receive at our Madera and Fresno clinics and affiliated hospital facilities to provide quality nephrology care and comply with state and federal legal requirements.
This Notice outlines your legal rights under the Health Insurance Portability and Accountability Act (HIPAA), the California Confidentiality of Medical Information Act (CMIA, Cal. Civ. Code § 56), and the California Patient Access to Health Records Act (PAHRA, Cal. Health & Safety Code § 123110).
2. Your Rights Regarding Your Health Information
Under federal and California law, you have specific rights regarding your health records:
Right to Inspect and Receive Copies of Your Records
You have the right to inspect or receive paper or electronic copies of your medical records.
- California Statutory Timelines (Cal. HSC § 123110): We will make your records available for inspection within 5 business days of receiving your written request, or provide copies within 15 calendar days.
- Electronic Records: If maintained electronically, you have the right to receive an electronic copy in the format requested if readily producible.
- California Public Benefit Fee Exemption (Cal. HSC § 123110(j)): We may assess a reasonable, cost-based fee for paper reproduction and postage. However, no fee will be charged for copies requested to support a claim or appeal regarding eligibility for a public benefit program (such as Medi-Cal, SSI, SSDI, CalWORKs, or Veterans Affairs benefits).
Right to Request Amendments & California 250-Word Addendum Right
If you believe that information in your record is incorrect or incomplete, you may submit a written request asking us to amend the record. We will act on your request within 60 days. If denied, we will provide a written explanation.
California 250-Word Statement of Addendum (Cal. HSC § 123111): Under California law, if your amendment request is denied or you dispute an entry, you have the statutory right to submit a written statement of up to 250 words per disputed item, which will be permanently appended to your medical record and transmitted whenever that portion of your record is disclosed.
Right to Confidential Communications (AB 1184)
You have the right to request communication via a specific telephone number or delivery to an alternative physical or mailing address. In accordance with California’s Confidential Communications Act (AB 1184), we accommodate all reasonable requests without requiring an explanation of reason.
Right to Request Restrictions & Out-of-Pocket Payment Protections
You may ask us to restrict how we use or disclose your health information for treatment, payment, or healthcare operations. While we are not legally required to agree to all general restriction requests, if we do agree, we will abide by that agreement.
Paid Out-of-Pocket in Full (Absolute Restriction): If you pay for a healthcare service or prescription entirely out-of-pocket in full, you have the absolute legal right to restrict disclosure of that service record to your health plan for payment or operations purposes (unless disclosure is required by law).
Additional Core Patient Rights
- Accounting of Disclosures: You may request an accounting of non-routine disclosures of your health information made during the six years prior to your request date. One accounting report per 12-month period is provided free of charge.
- Paper Copy: You retain the right to obtain a physical paper copy of this Notice at any time upon request.
- Personal Representative: If you have designated an individual with durable medical power of attorney or have a legal guardian, that person can exercise your privacy rights once legal authority is verified.
3. Your Choices and Written Authorizations
For certain health information, you can tell us your choices about what we share:
- Family and Friends: With your verbal agreement or lack of objection, we may share relevant health information with family members or designated individuals involved in your care or payment for care. In emergency or incapacitated situations, clinicians will exercise professional judgment in your best medical interest.
- Marketing and Sale Prohibition: Under California’s CMIA (Cal. Civ. Code § 56.10(d)), we will never sell your health information or use your information for third-party marketing purposes without your express written authorization.
- Revocation: You may revoke any written authorization in writing at any time, except to the extent we have already taken action relying on it.
4. Routine Permitted Uses and Disclosures (Treatment, Payment, and Operations)
We routinely process and disclose your protected health information across our core healthcare operations:
Clinical Treatment & Care Coordination
We share health records with physicians, nurses, outpatient dialysis centers (e.g., Madera Kidney Center, DaVita, Fresenius), diagnostic testing laboratories, imaging centers, and consulting specialists (such as cardiologists or vascular surgeons) involved in your care.
Hospital Inpatient Consultations
When our nephrologists provide bedside consultations or inpatient care at affiliated medical centers (including Saint Agnes Medical Center, Community Regional Medical Center, Clovis Community Medical Center, or Madera Community Hospital), we coordinate clinical data with hospital staff.
Billing and Claims Processing
We transmit diagnostic codes, clinical documentation, and insurance information to health plans, Medicare, Medi-Cal, or billing intermediaries to secure reimbursement for services rendered.
Healthcare Operations Management
We use health data internally to evaluate clinical quality, perform protocol audits, train clinical staff, and maintain our electronic health record infrastructure.
5. Special Public Interest & Statutory Disclosures
We are permitted or legally required to disclose health information under specific conditions:
- Public Health & Safety: To report communicable diseases, adverse drug reactions, product recalls, or suspected abuse or neglect of children, elders, or dependent adults.
- Renal Registries & Health Oversight: To report mandatory clinical data to state and federal oversight agencies and renal health registries (such as CMS ESRD programs and the United States Renal Data System - USRDS).
- Organ and Tissue Procurement: To organ procurement organizations (OPOs) or tissue banks to facilitate kidney and organ donation and transplantation.
- Coroners & Medical Examiners: To coroners, medical examiners, or funeral directors to perform statutory duties.
- Workers’ Compensation & Judicial Orders: In compliance with California Workers’ Compensation programs or in response to a lawful court order or valid subpoena.
6. Special California & Federal Protections
Reproductive Health Care Privacy (California AB 352 & Shield Laws)
Under California Civil Code § 56.108 and state shield legislation, Kidney Specialists, Inc. will not disclose medical information to cooperate with out-of-state investigations or legal proceedings targeting lawful reproductive health care or gender-affirming care provided under California law.
Substance Use Disorder Records (42 CFR Part 2)
If we receive medical records originating from specialized substance use disorder programs subject to federal 42 CFR Part 2, those records are maintained under heightened confidentiality and will not be disclosed in legal proceedings without specific written consent or a qualifying court order.
Sensitive Health Information (HIV & Genetic Data)
California law (Health & Safety Code § 120980 / § 1374.7) mandates separate, explicit written authorization before disclosing HIV/AIDS testing results or genetic information, except as specifically required by law.
7. Our Responsibilities
- We are required by law to maintain the privacy and security of your protected health information.
- We will notify you promptly if a breach occurs that compromises the privacy or security of your unsecured health information.
- We will strictly follow the duties and privacy practices described in this Notice.
- Changes to this Notice: We reserve the right to change the terms of this Notice. Any revised Notice will apply to all information we maintain, will be published on our website (www.kidneyspecialistinc.com), and will be available in our clinic offices.
8. Questions, Records Requests, and Filing Complaints
If you have questions about this Notice, wish to submit a written records request or amendment, or believe your privacy rights have been violated, you may contact our Privacy Official. We will not retaliate against you in any way for filing a complaint.
Practice Privacy Official
Adam Youssef, Privacy Official
Kidney Specialists, Inc.
451 E Almond Ave, Suite 101, Madera, CA 93637
Phone: (559) 661-1965
Secure Fax: (559) 661-1952
Privacy Inquiries Email: privacy@kidneyspecialistinc.com
Security Advisory: Standard internet email is not encrypted end-to-end. To safeguard your health information, please do not send detailed clinical records or urgent medical requests via unencrypted email. We encourage utilizing telephone or secure fax.
External Regulatory Agencies
U.S. Department of Health and Human Services (OCR)
Office for Civil Rights
Phone: 1-877-696-6775
Medical Board of California (State Licensing & Complaints)
Medical doctors are licensed and regulated by the Medical Board of California.
To check a license or file a complaint regarding healthcare practice standards:
Phone: (800) 633-2322 | Email: licensecheck@mbc.ca.gov