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.
Nivano Physicians, Inc.
Effective Date: August 7, 2025
Last Reviewed: March 11, 2026
Our Commitment to Your Privacy
Nivano Physicians is committed to protecting the privacy of your health information. We are required by law to:
- Maintain the privacy of your protected health information (PHI)
- Provide you with this notice of our legal duties and privacy practices
- Follow the terms of the notice currently in effect
- Notify you if a breach of your unsecured PHI occurs
This notice applies to all health information created, received, maintained, or transmitted by Nivano Physicians and all of the following individuals working within our organization:
- Physicians, nurses, and other healthcare providers
- Staff members, employees, and volunteers
- Students and trainees
- Business associates acting on our behalf
How We May Use and Disclose Your Health Information
Treatment
We may use and disclose your health information to provide you with medical treatment and coordinate your care across our network. This includes sharing information with doctors, nurses, specialists, urgent care providers, imaging centers, and other personnel involved in your care.
Example: Your primary care physician may share your health history with a specialist to whom you have been referred, so the specialist can provide appropriate care.
Payment
We may use and disclose your health information so that the treatment and services you receive may be billed and payment may be collected from you, an insurance company, Medicare, Medi-Cal, or another third party.
Example: We may need to provide your health plan with information about a procedure you received so your plan will pay for the service.
Health Care Operations
We may use and disclose your health information for health care operations necessary to run our organization and ensure quality care across our network. This includes quality assessment and improvement, care coordination, provider credentialing and evaluation, compliance activities, fraud prevention, and business planning.
Example: We may use your health information to evaluate the quality of care provided by physicians in our network.
Health Plan Administration
As an Independent Physician Association (IPA) that administers Medicare Advantage, Medi-Cal managed care, and ACO REACH programs, we may use and disclose your health information to coordinate benefits, process claims, conduct utilization review, and fulfill our obligations to contracted health plans.
Other Permitted Uses and Disclosures (Without Your Authorization)
We may use or disclose your health information without your written authorization for the following purposes:
Public Health Activities
To authorized public health authorities for the purpose of controlling disease, injury, or disability, including reporting communicable diseases, product defects, and workplace injuries.
Reporting Abuse, Neglect, or Domestic Violence
To government authorities authorized to receive reports of abuse, neglect, or domestic violence, as required or permitted by law.
Health Oversight Activities
To government agencies for activities authorized by law, such as audits, investigations, inspections, and licensing activities related to the oversight of the health care system.
Judicial and Administrative Proceedings
In response to a court order, subpoena, discovery request, or other lawful process in judicial or administrative proceedings.
Law Enforcement
To law enforcement officials for limited law enforcement purposes, as required or permitted by law, including to identify or locate a suspect, witness, or missing person.
Decedents
To a coroner, medical examiner, or funeral director as authorized or required by law.
Organ and Tissue Donation
To organizations involved in the procurement, banking, or transplantation of organs, eyes, or tissue.
Research
To researchers when approved by an Institutional Review Board or Privacy Board, or when a waiver of authorization has been granted under appropriate protections.
Serious Threats to Health or Safety
To prevent or lessen a serious and imminent threat to the health or safety of a person or the public, when consistent with applicable law and ethical standards.
Specialized Government Functions
For military and veterans’ activities, national security and intelligence activities, protective services for the President, and correctional institution functions, as authorized and required by law.
Workers’ Compensation
To comply with workers’ compensation laws and programs.
Required by Law
When disclosure is required by federal, state, or local law.
Uses and Disclosures That Require Your Written Authorization
For the following purposes, we will obtain your written authorization before using or disclosing your health information:
- Most uses and disclosures of psychotherapy notes
- Uses and disclosures of your PHI for marketing purposes
- Disclosures that constitute a sale of your PHI
- Any other use or disclosure not described in this notice
You have the right to revoke an authorization at any time by submitting a written request to our Privacy Officer. Revocation will not apply to uses or disclosures already made in reliance on your prior authorization.
Your Individual Rights
Right to Inspect and Copy
You have the right to inspect and obtain a copy of the health information we maintain about you in our designated record sets (which includes your medical records and billing records used to make decisions about your care).
To request access, submit a written request to our Privacy Officer. We may charge a reasonable cost-based fee. We will respond within 30 days (or 60 days if the records are off-site).
We may deny your request in limited circumstances. If denied, you may request a review of the denial.
Right to Request Amendment
If you believe that health information we have about you is incorrect or incomplete, you may request that we amend it. Your request must be in writing and must explain the reason for the requested amendment.
We may deny your request if the information: was not created by us; is not part of your designated record set; is not available for your inspection; or is accurate and complete.
Right to an Accounting of Disclosures
You have the right to receive a list of certain disclosures we have made of your PHI during the six years prior to the date of your request.
This accounting does not include disclosures made for treatment, payment, health care operations, or disclosures made with your authorization.
Right to Request Restrictions
You have the right to request restrictions on how we use or disclose your PHI for treatment, payment, or health care operations, or to individuals involved in your care.
We are required to agree to your request if:
- The disclosure is to a health plan for payment or health care operations (not treatment)
- You have paid for the service in full, out of pocket
- The restriction does not otherwise conflict with law
For other restriction requests, we will consider but are not required to agree.
Right to Request Confidential Communications
You have the right to request that we communicate with you about health matters in a specific way or at a specific location (for example, by sending mail to a different address, or contacting you only at work).
We will accommodate reasonable requests. Your request must specify how or where you want to be contacted.
Right to a Paper Copy of This Notice
You have the right to a paper copy of this Notice of Privacy Practices at any time, even if you have previously agreed to receive it electronically. To request a paper copy, contact our Privacy Officer.
Right to Be Notified of a Breach
You have the right to receive notification in the event that your unsecured PHI is involved in a breach. We will notify you in writing within 60 days of discovery of the breach. The notification will describe: the nature of the breach, the types of information involved, steps you can take to protect yourself, what we are doing to investigate and mitigate the breach, and our contact information.
Changes to This Notice
We reserve the right to change the terms of this notice and make the revised terms effective for all PHI we maintain, including information created or received before the change.
If we make a material change to this notice, we will:
- Post the revised notice on our website at nivanophysicians.com
- Make paper copies available at our offices upon request
- Notify you by mail or email where required by law
The effective date of the most current notice will always appear at the top of this document.
How to File a Complaint
If you believe that your privacy rights have been violated, you may file a complaint with Nivano Physicians or with the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.
File a Complaint with Nivano Physicians
Privacy Officer
Nivano Physicians, Inc.
2554 Millcreek Dr., Suite 100
Sacramento, CA 95833
Phone: (916) 407-2000
Fax: (916) 471-0332
Email: compliance@nivanophysicians.com
File a Complaint with HHS Office for Civil Rights
U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
Phone: 1-800-368-1019
TTY: 1-800-537-7697
Online: www.hhs.gov/civil-rights/filing-a-complaint
Regional Office — Region IX (California):
Office for Civil Rights, Region IX
90 7th Street, Suite 4-100
San Francisco, CA 94103
Phone: (415) 437-8310 | TDD: (415) 437-8311
Contact Our Privacy Officer
For questions about this notice or your privacy rights, contact:
Title: Chief Privacy Officer
Organization: Nivano Physicians, Inc.
Address: 2554 Millcreek Dr., Suite 100, Sacramento, CA 95833
Phone: (916) 407-2000
Email: compliance@nivanophysicians.com
This Notice of Privacy Practices was adopted in compliance with the HIPAA Privacy Rule (45 C.F.R. Part 164, Subparts A and E), the HITECH Act (42 U.S.C. § 17921 et seq.), and the California Confidentiality of Medical Information Act (CMIA). By receiving services from Nivano Physicians, you acknowledge that you have been provided with this Notice of Privacy Practices.
Effective Date: August 7, 2025
Document Version: 2.0
Next Review Date: August 7, 2026