SUMMARY OF OUR NOTICE OF PRIVACY PRACTICES

Medicine & Nephrology Associates of Northwest Jersey, P.C.

Effective Date: September 1, 2007

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION

WHO WILL FOLLOW THIS NOTICE:

Medicine & Nephrology Associates of Northwest Jersey, P.C. This notice describes our privacy practices. All these entities, sites, and locations follow the terms of this notice. In addition, these entities, sites, and locations may share health information with each other for treatment, payment, or health care operations purpose described in this notices.

OUR PLEDGE REGARDING HEALTH INFORMATION:

We understand that health information about you and your health care is personal. We are committed to protecting health information about you. We create a record of the care and services you receive from us. We need to record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by this health care practice, whether made by your personal doctor or others working in this office. This notice will tell you about the ways in which we may use and disclose health information about you. We also describe your rights to the health information we keep about you, and describe certain obligations we have regarding the use and disclosure of your health information.

We are required by law to:

• Make sure that health information that identifies you is kept private;

• Give you this notice of our legal duties and privacy practices with respect to health information about you; and

• Follow the terms of the notice that is currently in effect.

 HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU.

The following categories describe different ways that we use and disclose health information. By coming for care, you give us the right to use your information for treatment, to get reimbursed for your care, and to operate our organization.

Workers compensation. We may release health information about you for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illness.

Public Health Risks. We may disclose health information about you for public health activities. These activities generally included the following:

• To prevent or control disease, injury or disability;

• To report births and deaths;

• To report child abuse or neglect;

• To report reactions to medication or problems with products;

• To notify people of recalls or products they may be using;

• To notify person or organization required to receive information on FDA-regulated products;

• To notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition;

• To notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect, or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.

Health oversight Activities. We may disclose health information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.

Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may disclose health information about you in response to a court of administrative order. We may also disclose health information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.

Law Enforcement. We may release health information if asked to do so by law enforcement official:

• In reporting certain injuries, as required by law, gunshot wounds, burns, injuries to perpetrators or crime;

• In response to a court order, subpoena, warrant, summons or similar process;

• To identify or locate a suspect, fugitive, material witness, or missing person;

• Name and address;

• Date or birth or birthplace;

• Social security number;

• Blood type or Rh factor;

• Type of injury;

• Date and time or treatment and/or death, if applicable; and

• A description of distinguishing physical characteristics

• About the victim of a crime, if the victim agrees to disclose or under certain limited circumstances, we are unable to obtain the person’s agreement;

• About a death we believe may be the result of criminal conduct;

• About a criminal conduct at our facility; and

• In emergency circumstances to report a crime; the location of the crime or victims; or the identity, description, or location of the person who committed the crime.

• Coroners, Health Examiners and Funeral Directors. We may release health information to a coroner or health examiner. This may be necessary, for example, to identity a deceased person or determine the cause of death. We may also release health information about patients to funeral directors as necessary to carry out their duties

• National Security and Intelligence Activities. We may release health information about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.

• Protective Services for the President and Others. We may disclose health information about you to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or conduct special investigation.

• Inmates. If you are an inmate of a correctional institution or under the custody of law enforcement officials, we may release health information about you 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.

• YOUR RIGHTS REGARDING HEALTH INFORMATION ABOUT YOU

• You have the following rights regarding health information we maintain about you:

• Right to Inspect and Copy: you have the right to inspect and copy health information that may be used to make decisions about your care. Usually, this included health and billing records.

• To inspect and copy health information that may be used to make decisions about you, you must submit your request in writing to Medicine & Nephrology Associates of Northwest Jersey, P.C.  If you request a copy of the information, we may charge a fee for the cost of copying, mailing, or other supplies and services associated with your request. State law permits us to charge $1.00 per page up to $100 maximum for paper copies. We assess this charge when providing copies to patients, other physicians, insurance companies, attorneys courts, other. Payments expected before copies are provided.

• We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to health information, you may request that the denial be reviewed. Another licensed health care professional chosen by our practice 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 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 we keep the information. To request an amendment, your request must be made in writing, submitted to Medicine & Nephrology Associates of Northwest Jersey, P.C. and must be contained on one page of paper legibly handwritten or typed in at least 10 point font size. In addition, you must provide a reason that supports your request for an amendment. 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:

• Was not created by us, unless the person or entity that created the information is no longer available to make the amendment;

• Is not part of the health information kept by or for our practice;

• Is not party of the information which you would be permitted to inspect and copy; or

• Is accurate and complete

Any amendment we make to your health information will be disclosed to those with whom we disclose information as previously specified.

Right to an Accounting of Disclosures. You have the right to request a list accounting for any disclosure or yours health information we have made, except for uses and disclosures for treatment, payment, and health care operations, as previously described.

Right to Request Restrictions. You have the right to request a restriction or limitation on the health information we use or disclose about you for treatment, payment, or health care operations. You also have the right to request a limit on the health information we disclose about you to someone who is involved in your care or the payment for your care, such as a family member or friend. For example, you could ask that we restrict a specified nurse from use of your information, or that we not disclose information to your spouse about a surgery you had.

We are not required to agree to your request for restrictions if it is not feasible for us to ensure our compliance or believe it will negatively impact the care we may provide you. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment. To request a restriction, you must make you request in writing to Medicine & Nephrology Associates of Northwest Jersey, P.C. In your request, you must tell us what information you want to limit and to whom you want the limits to apply; for example, use of any information by a specified nurse, or disclosure of specified surgery to your spouse.

Right to Request Confidential Communications. You have the right to request that we communicate with you about health matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by a post office box.

There are also various other ways in which we may use or disclose your information:

• Appointment Reminders

• To allow oversight of the quality of the healthcare we provide

• To allow workers’ compensation claims

• All required by Subpoena in lawsuits and disputes

• Various uses as required by law or to avert a serious threat to health or safety

The full details for all these uses are contained in the full NPP

YOUR RIGHTS REGARDING HEALTH INFORMATION ABOUT YOU.

You have the following rights regarding health information we maintain about you:

• Right to inspect and copy

• Right to Amend

• Right to an accounting of disclosure

• Right to request restrictions

• Right to request confidential communications

• Right to a paper copy of this notice

Information on how to exercise these rights can be seen in the Notice of Privacy Practices or can be obtained from Medicine & Nephrology Associates of Northwest Jersey, P.C. (908) 684-4244.

CHANGES TO THIS NOTICE

We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for health information we already have about you as well as any information we receive in the future. We will past a copy of the current notice in our facility. The notice will contain on the first page, in the top right-hand corner, the effective date. In addition, each tie your register for treatment or health care services, we will offer you a copy of the current notice in effect.