HIPAA

The following describes MicroPath Laboratories, Inc.’s policy for obtaining prior, written patient authorization for uses and disclosures of Protected Health Information (“PHI”) for purposes other than treatment, payment and/or health care operations.

MicroPath Laboratories, Inc. is committed to protecting the privacy of information about patients. As a result, MicroPath Laboratories, Inc. will seek to use and disclose patient PHI for purposes other than treatment, payment and/or health care operations, only as specifically authorized by the patient in writing (an “Authorization”).

MicroPath Laboratories Inc.’s employees may not use or disclose PHI pursuant to an Authorization Form, without ensuring the validity of the Authorization Form. To be valid, an Authorization Form must be complete, not be expired or revoked, and the information must not be known to be false.

A. An Authorization Form cannot be combined with any other document to create a combined authorization unless the Authorization Form is combined with an:

1. Authorization for the use of disclosure of PHI for a research study may be combined with any other type of written permission for the same research study, including another authorization for the use or disclosure of PHI for such research or a consent to participate in such research study; or
2. An Authorization for a use or disclosure of psychotherapy notes may only be combined with another authorization for a use or disclosure of psychotherapy notes.

B. MicroPath Laboratories, Inc. will not condition treatment of an individual on the provision of an Authorization Form except in the following circumstances:

1. For research-related treatment; or
2. When the provision of health care is solely for the purpose of creating PHI for disclosure to a third party.

A patient may revoke an Authorization at any time. To revoke an Authorization, the patient must submit the revocation in writing, which will become effective immediately. The revocation will be invalid if the Corporation has already acted in reliance upon the Authorization.