HIPAA 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.

Effective Date: April 2026

Lumae Functional Health LLC. (“we,” “us,” or “our”) is required by law to maintain the privacy of your protected health information (“PHI”), to provide you with this Notice of our legal duties and privacy practices, and to follow the terms of the Notice currently in effect. PHI is information that identifies you and relates to your health, your care, or payment for your care.

How We May Use and Disclose Your Health Information

We may use and disclose your PHI for the following purposes without your written authorization:

  • Treatment. We may use your PHI to provide, coordinate, or manage your care, and we may share it with other providers involved in your care. Example: we may share relevant history and test results with a specialist to whom we refer you.
  • Payment. We may use and disclose your PHI to obtain payment for services. Example: we may provide information to a payment processor or to you to bill for services rendered.
  • Health Care Operations. We may use and disclose your PHI for operational activities such as quality review, training, and administration of the practice. Example: we may review records to evaluate and improve the care we provide.

We may also use or disclose your PHI without your authorization in the following circumstances, subject to the limits and conditions set by law:

  • When required by law.
  • For public health activities, such as reporting disease, injury, or vital events.
  • To report suspected abuse, neglect, or domestic violence as permitted or required by law.
  • For health oversight activities, such as audits and investigations by oversight agencies.
  • In response to a court order, subpoena, or other lawful process in judicial or administrative proceedings.
  • For specified law enforcement purposes as permitted by law.
  • To avert a serious and imminent threat to health or safety.
  • To coroners, medical examiners, and funeral directors as permitted by law.
  • For organ and tissue donation, where applicable.
  • For workers’ compensation purposes as authorized by law.
  • For specialized government functions, such as military and veterans’ activities and national security, where applicable.
  • To business associates who perform services on our behalf, under written agreements that require them to safeguard your PHI.
  • To family members or others involved in your care, or to notify them of your location or condition, when you agree or when, under the circumstances, we reasonably infer you do not object.

Uses and Disclosures That Require Your Written Authorization

The following uses and disclosures will be made only with your written authorization:

  • Most uses and disclosures of psychotherapy notes, where applicable.
  • Uses and disclosures for marketing purposes.
  • Any sale of your PHI.

Any other use or disclosure not described in this Notice will be made only with your written authorization. You may revoke an authorization in writing at any time, except to the extent we have already acted in reliance on it.

Special Protections for Certain Information

Some information may have additional protection under state or federal law. In particular, substance use disorder treatment records that originate from a federally assisted program may be protected under 42 CFR Part 2 and may require your specific consent before they are used or disclosed, beyond what HIPAA alone requires. Where state or other federal law provides greater privacy protection than HIPAA, we follow the more protective law.

Your Rights Regarding Your Health Information

You have the right to:

  • Inspect and copy your PHI in our designated record set, and to receive a copy in an electronic format where readily producible. We may charge a reasonable, cost-based fee.
  • Request an amendment to your PHI if you believe it is incorrect or incomplete. We may deny the request in certain circumstances and will explain any denial in writing.
  • Receive an accounting of disclosures of your PHI for certain purposes, as required by law.
  • Request restrictions on certain uses and disclosures. We are not required to agree to most requested restrictions, except that we must agree to a request to restrict disclosure to a health plan for a service you paid for in full out of pocket, where the disclosure is for payment or health care operations and is not otherwise required by law.
  • Request confidential communications by alternative means or at an alternative location, and we will accommodate reasonable requests.
  • Receive a paper copy of this Notice on request, even if you agreed to receive it electronically.
  • Be notified following a breach of your unsecured PHI, as required by law.

To exercise any of these rights, contact our Privacy Officer using the information below.

Our Responsibilities

We are required by law to:

  • Maintain the privacy and security of your PHI.
  • Provide you with this Notice describing our legal duties and privacy practices.
  • Follow the terms of the Notice currently in effect.
  • Notify you following a breach of your unsecured PHI when required by law.
  • Obtain your written authorization for uses and disclosures not described in this Notice, and honor a valid revocation of authorization.

Changes to This Notice

We reserve the right to change this Notice and to make the revised Notice effective for PHI we already have, as well as for PHI we receive in the future. The current Notice will be posted at the clinic and on our website, will show its effective date, and will be available on request.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us using the contact information below. You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint.

U.S. Department of Health and Human Services Office for Civil Rights 200 Independence Avenue, S.W. Washington, D.C. 20201 Phone: 1-877-696-6775 Website: www.hhs.gov/ocr/privacy/hipaa/complaints/

 

Contact

Lumae Functional Health LLC.

Attn: Privacy

15725 37th Ave N, Unit 1

Plymouth MN 55446

 

Phone: 612-305-8825

Email: hello@LumaeHealthMN.com