Practice Privacy Policy

Notice of Privacy Practices 

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.

This
Notice describes the privacy practices of Molina Healthcare’s affiliated health
plans (referred to herein as “Molina”, “we” or “our”). We use and share
protected health information (“PHI”) about you to provide your health benefits
as a Molina member. We use and share your PHI to carry out treatment, payment
and health care operations. We also use and share your PHI for other reasons as
allowed and required by law. We have the duty to keep your health information
private and to follow the terms of this Notice. The effective date of this
Notice is January 1, 2026.

PHI
is health information that includes your name, member number or other
identifiers, and is used or shared by us. PHI includes health information about
substance use disorders and biometric information (like a voiceprint).

·       Why do we use or share your PHI? We use or share your
PHI to provide you with health care benefits. Your PHI is also used or shared
for treatment, payment, and health care operations.

·       For Treatment: We may use or share
your PHI to give you, or arrange for, your medical care. This treatment also
includes referrals between your doctors or other health care providers. For
example, we may share information about your health with a specialist. This
helps the specialist talk about your treatment with your doctor.

·        For Payment: We may use or share
PHI to make decisions on payment. This may include claims, approvals for
treatment, and decisions about medical need. Your name, your condition, your
treatment, and supplies given may be written on the bill. For example, we may
let a doctor know that you have our benefits. We would also tell the doctor
about the amount of the bill that we would pay.

·       For Health Care Operations: We may use or share
PHI about you to run our health plan(s). For example, we may use information
from your claim to let you know about a health program that could help you. We
may also use or share your PHI to solve your concerns. Your PHI may also be used
to see that claims are paid right.

Health
care operations involve many daily business needs. It includes but is not
limited to, the following:

 • Improving quality.

 • Actions in health programs to help members
with certain conditions (such as asthma).

 • Conducting or arranging for medical review.

 • Legal services, including fraud and abuse
detection and prosecution programs.

 • Actions to help us obey laws.

 • Addressing member needs, including solving
complaints and grievances.

We
will share your PHI with other companies (“business associates”) that perform
different kinds of activities for our health plan(s). We may also use your PHI
to give you reminders about your appointments. We may use your PHI to give you
information about other treatment(s), or other health-related benefits and
services.

When
can we use or share your PHI without getting written authorization (approval)
from you?
In addition to treatment, payment and health care operations, the law allows or
requires Molina to use and share your PHI for several other purposes including
the following:

·       Required by law: We will use or share information about you as
required by law. We will share your PHI when required by the Secretary of the
Department of Health and Human Services (HHS). This may be for a court case,
other legal review, or when required for law enforcement purposes.

·       Public Health: Your PHI may be used or shared for public
health activities. This may include helping public health agencies to prevent
or control disease.

·       Health Care: Oversight Your PHI may be used or shared with
government agencies. They may need your PHI for audits.

·       Research: Your PHI may be used or shared for research in
certain cases, such as when approved by a privacy or institutional review
board.

·       Legal or Administrative Proceedings: Your PHI may be used
or shared for legal proceedings, such as in response to a court order.

·       Law Enforcement: Your PHI may be used or shared with police for
law enforcement purposes, such as to help find a suspect, witness or missing
person.

·       Health and Safety: Your PHI may be shared to prevent a serious
and imminent threat to the health or safety of a person or the public.

·       Government Functions: Your PHI may be shared with the
government for special functions. An example would be to protect the President.

·       Victims of Abuse, Neglect or Domestic Violence: Your PHI may be shared
with legal authorities if we believe that a person is a victim of abuse or
neglect.

·       Workers’ Compensation: Your PHI may be used or shared to obey
Workers’ Compensation laws.

·       Other Disclosures: Your PHI may be shared with funeral directors
or coroners to help them do their jobs.

·       Additional Restrictions on Use and Disclosure: Some federal and state
laws may require special privacy protections that restrict the use and
disclosure of certain types of health information. Such laws may protect the
following types of information: alcohol and substance use disorders, biometric
information, child or adult abuse or neglect including sexual assault,
communicable diseases, genetic information, HIV/AIDS, mental health, minors'
information, prescriptions, reproductive health, and sexually transmitted
diseases. We will follow the more stringent law, where it applies

·       Substance Use Disorder (SUD) Information: Although we are not a
substance use disorder treatment program under federal law (a “SUD Program”),
we may receive information from a SUD Program about you. We may not disclose
SUD information for use in a civil, criminal, administrative, or legislative
proceeding against you unless we have (i) your written consent, or (ii) a court
order accompanied by a subpoena or other legal requirement compelling
disclosure issued after we and you were given notice and an opportunity to be
heard.

·       When do we need your written authorization (approval) to
use or share your PHI? We need your written approval to use or share your PHI for
a purpose other than those listed in this Notice. We need your authorization
before we disclose your PHI for the following: (1) most uses and disclosures of
psychotherapy notes; (2) uses and disclosures for marketing purposes; and (3)
uses and disclosures that involve the sale of PHI. You may cancel a written
approval that you have given us. Your cancellation will not apply to actions
already taken by us because of the approval you already gave to us. 

What are your health information rights?

You have the right to:

·        Request Restrictions on PHI Uses or Disclosures (Sharing of
Your PHI):
You may ask us not to share your PHI to carry out treatment, payment or health
care operations. You may also ask us not to share your PHI with family, friends
or other people you name who are involved in your health care. However, we are
not required to agree to your request. You will need to make your request in
writing. You may use our form to make your request. 

·        Request Confidential Communications of PHI: You may ask Molina to
give you your PHI in a certain way or at a certain place to help keep your PHI
private. We will follow reasonable requests, if you tell us how sharing all or
a part of that PHI could put your life at risk. You will need to make your
request in writing. You may use our form to make your request.

·        Review and Copy Your PHI: You have a right to
review and get a copy of your PHI held by us. This may include records used in
making coverage, claims and other decisions about you as our member. You will
need to make your request in writing. You may use our form to make your request.
We may charge you a reasonable fee for copying and mailing the records. In
certain cases, we may deny the request. Important Note: We do not have complete
copies of your medical records. If you want to look at, get a copy of, or
change your medical records, please contact your doctor or clinic.

·        Amend Your PHI: You may ask that we amend (change) your PHI.
This involves only those records kept by us about you as a member. You will
need to make your request in writing. You may use our form to make your
request. You may file a letter disagreeing with us if we deny the request. 

·        Receive an Accounting of PHI Disclosures (Sharing of Your
PHI):
You may ask that we give you a list of certain parties that we shared your PHI
with during the six years prior to the date of your request. The list will not
include PHI shared as follows:

o   
for
treatment, payment or health care operations.

o   
to
people about their own PHI.

o   
sharing
done with your authorization.

o   
incident
to a use or disclosure otherwise permitted or required under applicable law.

o   
PHI
released in the interest of national security or for intelligence purposes; or

o   
as
part of a limited data set in accordance with applicable law.

If
you have questions about our privacy policy, please contact our Privacy Officer
at the number below.

You
have the right to file a complaint with us or with the Office for Civil Rights.
We will not discriminate against or retaliate in any way for this action. To
file a complaint, please contact the applicable party:

Privacy Officer

Phone Number:
405-399-2900

Fax Number:
405-212-4405

Office for Civil Right

https://www.hhs.gov/ocr/privacy/hipaa/complaints/index.html

We are required to
abide by the policies stated in the Notice of Privacy Practices, which became
effective on (date): 03/03/2026