We may use or disclose your PHI without your written authorization when permitted or required by law. These situations may include:

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• Required by law. We may use or disclose PHI when a law requires us to do so.

• Public health activities. We may disclose PHI for public health purposes, such as reporting certain diseases, injuries, vital events, adverse events, or other information required by public health authorities.

• Health oversight activities. We may disclose PHI to government agencies or oversight bodies for audits, investigations, inspections, licensing, certification, or compliance activities.

• Abuse, neglect, or domestic violence. We may disclose PHI to appropriate authorities when required or permitted by law to report suspected abuse, neglect, exploitation, or domestic violence.

• Serious threat to health or safety. We may disclose PHI when necessary to prevent or lessen a serious and imminent threat to the health or safety of you, another person, or the public.

• Judicial and administrative proceedings. We may disclose PHI in response to a court order, subpoena, discovery request, or other lawful process when applicable legal requirements are met.

• Law enforcement. We may disclose PHI to law enforcement officials when permitted or required by law.

• Medical emergencies. We may disclose information as necessary to respond to a medical emergency.

• Workers’ compensation. We may disclose PHI as authorized by and to the extent necessary to comply with workers’ compensation or similar laws.

• Coroners, medical examiners, and funeral directors. We may disclose PHI to these persons when needed for them to perform their duties.

• Organ and tissue donation. We may disclose PHI to organizations involved in organ, eye, or tissue donation and transplantation.

• Research. We may use or disclose PHI for research when applicable legal requirements are met.

• Business associates and qualified service organizations. We may disclose PHI to vendors, contractors, business associates, or qualified service organizations that perform services for us if they agree to protect the information as required by law.

• Correctional institutions and custodial situations. If you are in custody, we may disclose PHI to correctional institutions or law enforcement officials when permitted or required by law.

• Specialized government functions. We may disclose PHI for certain government functions, such as military, veterans, national security, protective services, or correctional purposes, as permitted by law.

For records protected by 42 CFR Part 2, Square Medical Group will not disclose information identifying you as having or having had a substance use disorder, or as receiving substance use disorder diagnosis, treatment, or referral services, except as permitted by Part 2, with your written consent, with a valid court order, or as otherwise allowed by law. Part 2 records may not be used or disclosed in civil, criminal, administrative, or legislative proceedings against you unless you provide written consent or a court order or other legal mandate specifically authorizes the use or disclosure.

We must obtain your written authorization before using or disclosing your PHI for purposes not described in this Notice, unless another law permits or requires the use or disclosure.

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Your written authorization is generally required for:

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• Most uses and disclosures of psychotherapy notes;

• Uses and disclosures for marketing, except in limited circumstances permitted by law;

• Sale of PHI;

• Certain disclosures of substance use disorder treatment records protected by 42 CFR Part 2;

• Certain disclosures of HIV/AIDS, sexually transmitted infection, genetic, mental health, or other specially protected information when required by state or federal law; 

• Any other use or disclosure not otherwise permitted or required by law.

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Psychotherapy notes are separate notes recorded by a mental health professional documenting or analyzing the contents of a counseling session. Psychotherapy notes do not include medication management records, treatment plans, progress notes, diagnosis summaries, symptoms, prognosis, functional status, treatment modalities or frequencies, counseling session start and stop times, clinical test results, or other information maintained as part of the medical record.

You may revoke your authorization in writing at any time, except to the extent we have already relied on it.

Square Medical Group’s substance use disorder diagnosis, treatment, and referral services meet the definition of a federally assisted substance use disorder program under 42 CFR Part 2. Part 2 protections apply to records that identify you as having or having had a substance use disorder, or as receiving substance use disorder diagnosis, treatment, or referral services from Square Medical Group. Records that do not identify you as having or having had a substance use disorder, or as receiving substance use disorder diagnosis, treatment, or referral services from Square Medical Group, are not Part 2 records solely because they are maintained by Square Medical Group. Those records remain protected by HIPAA and other applicable privacy laws.

Federal law generally prohibits us from disclosing Part 2 records without your written consent, except in limited circumstances permitted by Part 2. These may include certain medical emergencies, audits and evaluations, research, qualified service organization arrangements, reporting of suspected child abuse or neglect, crimes on program premises or against program personnel, and disclosures required by the Secretary of the U.S. Department of Health and Human Services to investigate or determine compliance.

You may provide one written consent for future uses and disclosures of Part 2 records for treatment, payment, and health care operations. Once Part 2 records are disclosed to a HIPAA covered entity or business associate for treatment, payment, or health care operations pursuant to your written consent, the recipient may redisclose the information as permitted by HIPAA. However, the information may not be used or disclosed in legal proceedings against you unless permitted by Part 2.
Violations of 42 CFR Part 2 may be reported to the U.S. Department of Health and Human Services and may result in penalties under applicable federal law.