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.
During your treatment at Kavira Health, LLC and its affiliates (collectively referred to herein as “Kavira” or “we” or “us”), doctors, nurses, and other caregivers may gather information about your medical history and your current health. This notice explains how that information may be used and shared with others. It also explains your privacy rights regarding this kind of information. The terms of this notice apply to health information created or received by Kavira. We are required by law to: make sure that medical information that identifies you is kept private; give you this notice of our legal duties and privacy practices with respect to medical information about you; and follow the terms of the notice that is currently in effect.
Your medical information may be used and disclosed for the following purposes:
Treatment: We may use your information to provide, coordinate, and manage your care and treatment. For example, your provider may share your medical information with another provider for a consultation or a referral.
Payment: We may use and disclose medical information about you so that the treatment and services you receive may be billed to, and payment may be collected from, you, an insurance company, or another third party. For example, we may need to give your health plan information about treatment you received at Kavira so your health plan will pay us or reimburse you for the treatment.
Health Care Operations: We may use and disclose medical information about you for Kavira’s health care operations. Health care operations are the uses and disclosures of information that are necessary to run Kavira and to make sure that all of our patients receive quality care. For example, we may use medical information to review our treatment and services, business planning and business management, and to evaluate and improve the performance of our staff and providers in caring for you.
To People Assisting in Your Care. We may disclose medical information about you to persons taking care of you or helping you to pay your bills, or your other close family members or friends if they need to know this information to help you, and then only to the extent permitted by law. We may, for example, provide limited medical information to allow a family member to pick up a prescription for you. Generally, we will get your written consent prior to making disclosures about you to family or friends. If you are able to make your own health care decisions, we will ask your permission before using your medical information for these purposes. If you are unable to make health care decisions, we will disclose relevant medical information to your family members or other responsible people if we feel it is in your best interest to do so, including in an emergency.
Research: We may use and disclose medical information about you for research purposes, either with your specific, written authorization or when the study has been reviewed for privacy protection by an Institutional Review Board or Privacy Board before the research begins. In some cases, researchers may be permitted to use information in a limited way to determine whether the study or the potential participants are appropriate. When required by law, we will make a good faith effort to obtain your consent or refusal to participate in external research before releasing any identifiable information about you to external researchers.
As Required by Law: We will disclose medical information about you when we are required to do so by federal, state or local law.
To Avert a Serious Threat to Health or Safety: We may use and disclose medical information about you when necessary to prevent or lessen a serious and imminent threat to your health and safety, or the health and safety of the public or another person. Any disclosure must be only to someone who is able to help prevent the threat, and shall be made in accordance with applicable state and federal law (for example, laws that impose a “duty to warn” on certain types of health care providers).
To Business Associates: Some services are provided by or to Kavira through contracts with business associates. Examples of business associates include Kavira’s attorneys, management service company, consultants, collection agencies, and accreditation organizations. We may disclose information about you to our business associate so that they can perform the job we have contracted with them to do. To protect the information that is disclosed, each business associate is required to sign an agreement to appropriately safeguard the information and not to redisclose the information unless specifically permitted by law.
Your medical information may be released in the following special situations:
Organ and Tissue Donation: We may release your medical information to organizations that handle organ procurement or organ, eye or tissue transplantation, or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation. The information that we may disclose is limited to the information necessary to make a transplant possible.
Military and Veterans: If you are a member of the armed forces, we will release medical information about you as requested by military command authorities if we are required to do so by law, or when we have your written consent. We may also release medical information about foreign military personnel to the appropriate foreign military authority as required by law or with written consent.
Workers’ Compensation: We may release medical information about you for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illness. We are permitted to disclose information regarding your work-related injury to your employer or your employer’s workers’ compensation insurer without your specific consent, so long as the information is related to a workers’ compensation claim.
Public Health: We may disclose medical information to public health authorities about you for public health activities. These disclosures generally include the following:Preventing or controlling disease, injury or disability;
Reporting births and deaths;
Reporting child abuse or neglect, or abuse of a vulnerable adult;
Reporting reactions to medications or problems with products;
Notifying people of recalls of products they may be using;
Notifying a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; or
Reporting to the FDA as permitted or required by law.
Health Oversight Activities: We may disclose medical information to a health oversight agency for health oversight activities that are authorized by law. These oversight activities include, for example, government audits, investigations, inspections, and licensure activities. 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, dispute, or other judicial proceeding, we will disclose medical information about you only in response to a valid court order, or with your written consent.
Law Enforcement: We may release your medical information if asked to do so by a law enforcement official in response to a valid court order or with your written consent. In addition, we are required to report certain types of wounds, such as gunshot wounds and some burns. In most cases, reports will include only the fact of injury, and any additional disclosures would require your consent or a court order.
We may also release information to law enforcement that is not a part of the health record (in other words, non-medical information) for the following reasons:
To identify or locate a suspect, fugitive, material witness, or missing person;
If you are the victim of a crime, if, under certain limited circumstances, we are unable to obtain your agreement;
About a death we believe may be the result of criminal conduct;
About 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 believed to have committed the crime.
Coroners, Medical Examiners, and Funeral Directors: We will release medical information to a coroner or medical examiner in the case of certain types of death, and we must disclose health records upon the request of the coroner or medical examiner. This may be necessary, for example, to identify you or determine the cause of death. We may also release the fact of death and certain demographic information about you to funeral directors as necessary to carry out their duties.
National Security and Intelligence Activities: We will release medical information about you to authorized federal officials for intelligence, counterintelligence, and other national security activities only as required by law or with your written consent.
Protective Services for the President and Others: We will disclose medical information about you to authorized federal officials so they may protect the President, other authorized persons, or foreign heads of state, or conduct special investigations only as required by law or with your written consent.
Inmates: If you are an inmate of a correctional institution or under the custody of a law enforcement official, we will release medical information about you to the correctional institution or law enforcement official only as required by law or with your written consent.
Psychotherapy Notes: We will not disclose psychotherapy notes about you without your written consent.
Marketing and Sale of Private Medical Information: We will not use or disclose your private medical information for marketing purposes, nor will we sell your private medical information for marketing purposes without your written consent.
Limitations on the Release of Reproductive Health Information. We will not release your reproductive health information for health oversight activities, judicial or administrative proceedings, law enforcement matters, or coroner/medical examiner tasks for a prohibited purpose. Such prohibited purposes include (i) to investigate a person for seeking, obtaining, providing, or facilitating lawful reproductive health care, or to identify a person for such an investigation; or (ii) to impose liability on a person for seeking, obtaining, providing, or facilitating lawful reproductive health care, or to identify a person for such an imposition of liability. For example, we will not release your reproductive health information to a law enforcement agency investigating your decision to obtain birth control prescriptions, devices, or services that were lawfully available to you.
Breach Notification: You will be notified in writing by Kavira within 60 days if we become aware of any violation of HIPAA privacy rules resulting in the acquisition, unauthorized access, or use or disclosure of your private medical information if that information is not protected by government approved security measures.
You have the following rights regarding medical information we maintain about you:
Right to Access, Inspect and Copy: You have the right to access, inspect and receive a copy of your medical information that is used to make decisions about your care. Usually, this includes medical and billing records maintained by Kavira.
If you wish to inspect and copy medical information, you must submit your request in writing to hello@kavira.health. If you request a copy of the information, we may charge a fee for the costs of copying, mailing, or other supplies associated with your request, to the extent permitted by state and federal law. If we maintain your health information in an electronic health record, you have the right to receive a copy of your health information in electronic form. You may also direct us to provide your health information directly to an entity or person clearly and specifically designated by you in writing.
We may deny your request to inspect and copy your information in certain very limited circumstances. For example, we may deny access if your provider believes it will be harmful to your health, or could cause a threat to others. In these cases, we may supply the information to a third party who may release the information to you. If you are denied access to medical information, you may request that the denial be reviewed. Another licensed health care professional chosen by Kavira 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 Request Amendment: If you believe that medical information we have about you is inaccurate or incomplete, you have the right to ask us to correct the inaccuracy or add the information needed to make your records complete. You have the right to request such amendments for as long as the information is kept by or for Kavira.
To request a change (amendment) to your information, you must submit your request and the reason(s) supporting your request, in writing, to hello@kavira.health.
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 Kavira, unless the person or entity that created the information is no longer available to make the amendment;
Is not part of the medical information kept by or for Kavira;
Is not part of the information which you would be permitted to inspect and copy; or
Is accurate and complete.
Right to an Accounting of Disclosures: You have the right to request an “accounting of disclosures.” This is a list of the disclosures we made of medical information about you. This list will not include disclosures for treatment, payment, and health care operations; disclosures that you have authorized or that have been made to you; disclosures for facility directories; disclosures for national security or intelligence purposes; disclosures to correctional institutions or law enforcement with custody of you; disclosures that took place before April 14, 2003; and certain other disclosures.
To request this list of disclosures, you must submit your request in writing to hello@kavira.health. Your request must state a time period for which you would like the accounting. The accounting period may not go back further than six years from the date of the request. You may receive one free accounting in any 12-month period. We may charge you for additional requests made within the same 12-month period.
Right to Request Restrictions: You have the right to request a restriction or limitation on the medical information we use or disclose about you. If you pay out-of-pocket in full for an item or service, then you may request that we not disclose information pertaining solely to such item or service to your health plan for purposes of payment or health care operations. We are required to agree with such a request. However, we are not required to agree to any other request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment.
To request restrictions, you must make your request in writing to hello@kavira.health. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure, or both; and (3) to whom you want the limits to apply, for example, if you want to prohibit disclosures to your spouse.
Right to Request Confidential Communications: You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we contact you only at work or only by mail.
To request confidential communications, you must make your request in writing to hello@kavira.health. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted, and we may require you to provide information about how payment will be handled.
Right to a Paper Copy of This Notice: You have the right to receive a paper copy of this notice. You may ask us to give you a copy of this notice any time. This notice is also posted on our website (www.kavirahealth.com).
Changes to This Notice
The effective date of this notice is November 1, 2020, and it was most recently updated on January 6, 2025. We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for medical information we already have about you, as well as any information we receive in the future. If the terms of this notice are changed, we will provide you with a revised notice upon request and post the revised notice on our website (www.kavirahealth.com) and in designated locations at Kavira practice locations.
Compliance with State Law
Kavira provides services to patients in North Dakota, Minnesota and Wisconsin. When applicable, Kavira will comply with the privacy laws of these states in addition to applicable federal privacy laws. For example:
Treatment, Payment and Health Care Operations. If you live in Minnesota, we will obtain your written consent before releasing your health information for treatment, payment or health care operations purposes to anyone outside of Kavira unless (i) the disclosure is to a related provider for current treatment, (2) we cannot obtain your consent due to a medical emergency, or (iii) the release is specifically authorized by Minnesota law. If you live in Wisconsin, we will obtain your written consent before releasing your health information for payment purposes to anyone outside of Kavira.
External Research. If you live in Minnesota, you may object to the release of your health information for research purposes, and we will use reasonable efforts to obtain your general authorization (consent) to such releases in accordance with applicable law.
Health Oversight Activities. If you live in Minnesota or Wisconsin, we must typically remove certain identifying information (for example, your name, social security number, etc.) before making a disclosure for a health oversight activity. Examples of health oversight activities are provided above.
Compliance with Most Stringent Applicable Law; Potential for Redisclosure.
As discussed above, the privacy of your health information and your health information rights are governed by both state and federal laws. When multiple laws govern the privacy of your health information, we will comply with the law that most stringently protects this privacy. When multiple laws govern your health information rights, we will comply with the law that gives you the greatest right to access, amend, understand, and control your health information. For example, we will comply with the federal regulations governing the confidentiality of substance use disorder patient records (42 CFR Part 2) when these regulations prohibit uses and disclosures of these records that would be permitted under other applicable laws. However, these same laws may no longer protect your health information after it is disclosed by us. Therefore, there is a possibility that your health information may be redisclosed and no longer subject to legal protections after it is disclosed by us.
Complaints or Questions
If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Department of Health and Human Services. To file a complaint with Kavira, or to ask a question about this Notice, contact:
All complaints must be submitted in writing. You will not be retaliated against or penalized for filing a complaint.
Other Uses of Medical Information
Except as described above, we will not use or disclose your protected health information without a specific written authorization from you. If you provide us with this written authorization to use or disclose medical information about you, you may revoke that authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose medical information about you for the reasons covered by your written authorization, except to the extent we have already relied on your authorization. We are unable to take back any disclosures we have already made with your permission, and we are required to retain our records of the care that we provided to you.