Notice of Privacy Practices
Last modified: June 22, 2026
Notice of Privacy Practices – Clarity Pediatrics Medical Group
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 of Privacy Practices (the “Notice”) describes how Alesandro Larrazabal Martinez, M.D., P.C., a California professional corporation, Clarity Pediatrics Medical Group, PLLC, a Texas professional limited liability company and Clarity Pediatrics Medical, PLLC, a New York professional limited liability company, collectively, “Clarity Pediatrics Medical Group” (“we” or “our”) may use and disclose your Protected Health Information to carry out treatment, payment or business operations and for other purposes that are permitted or required by law. “Protected Health Information” or “PHI” is information about you, including demographic information, that may identify you and that relates to your past, present or future physical health or condition, treatment or payment for health care services. This Notice also describes your rights to access and control your Protected Health Information.
Our Privacy Obligations
We understand that your health information is personal and we are committed to protecting your privacy. In addition, we are required by law to maintain the privacy of your Protected Health Information, to provide you with this Notice of our legal duties and privacy practices with respect to your Protected Health Information, and to notify you in the event of a breach of your unsecured Protected Health Information as required by law. When we use or disclose your Protected Health Information, we are required to abide by the terms of this Notice (or other notice in effect at the time of the use or disclosure).
USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION:
Your Protected Health Information may be used and disclosed by our health care providers, our staff, and others outside of our office that are involved in your care and treatment for the purpose of providing health care services to you, to support our business operations, to obtain payment for your care, and any other use and disclosure permitted by or required by law.
TREATMENT:
We will use and disclose your Protected Health Information to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with a third party. For example, your Protected Health Information may be provided to a health care provider to whom you have been referred to ensure the necessary information is accessible to diagnose or treat you.
PAYMENT:
Your Protected Health Information may be used to bill and obtain payment for your health care services. This may include certain activities that your health insurance plan may undertake before it approves or pays for your services, such as making a determination of eligibility or coverage for insurance benefits and reviewing services provided to you for medical necessity.
HEALTH CARE OPERATIONS:
We may use or disclose, as needed, your Protected Health Information in order to support the business activities of the practices. These activities include, but are not limited to, improving quality of care, providing information about treatment alternatives or other health-related benefits and services, development or maintaining and supporting computer systems, legal services, and conducting audits and compliance programs, including fraud, waste and abuse investigations.
Each of the entities listed at the beginning of this Notice may share Protected Health Information with the others as necessary to carry out treatment, payment, or health care operations.
We also may disclose your Protected Health Information with certain of our “business associates” or other third parties that perform various activities (e.g., billing, coordinating care, transcribing records) for us. We contractually require our business associates to implement safeguards to protect the privacy of your Protected Health Information.
USES AND DISCLOSURES THAT DO NOT REQUIRE YOUR AUTHORIZATION:
We may use or disclose your Protected Health Information in the following situations without your authorization.
Disclosure to Relatives, Close Friends and Other Caregivers. We may use or disclose your Protected Health Information to a family member, other relative, a close personal friend or any other person identified by you when you are present for, or otherwise available prior to, the disclosure, if: (1) we obtain your agreement or provide you with the opportunity to object to the disclosure and you do not object; or (2) we reasonably infer that you do not object to the disclosure.
If you are not present for or unavailable prior to a disclosure (e.g., when we receive a telephone call from a family member or other caregiver), we may exercise our professional judgment to determine whether a disclosure is in your best interests. If we disclose information under such circumstances, we would disclose only information that is directly relevant to the person’s involvement with your care.
As Required by Law. We may use and disclose your Protected Health Information when required to do so by any applicable federal, state or local law.
Public Health and Reporting Activities. We may disclose your Protected Health Information: (1) to report health information to public health authorities for the purpose of preventing or controlling disease, injury or disability; (2) to report abuse, domestic violence and neglect to a government authority authorized by law to receive such reports; (3) to report information about products under the jurisdiction of the U.S. Food and Drug Administration; (4) to alert a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading a disease or condition; and (5) to report information to your employer as required under laws addressing work-related illnesses and injuries or workplace medical surveillance.
Health Oversight Activities. We may disclose your Protected Health Information to an agency that oversees the health care system and is charged with responsibility for ensuring compliance with the rules of government health programs including for example Medicaid.
Judicial and Administrative Proceedings. We may disclose your Protected Health Information in the course of a judicial or administrative proceeding in response to a legal order or other lawful process.
Law Enforcement Officials. We may disclose your Protected Health Information to the police or other law enforcement officials as required by law or in compliance with a court order.
Decedents. We may disclose your Protected Health Information to a coroner or medical examiner as authorized by law.
Organ and Tissue Procurement. We may disclose your Protected Health Information to organizations that facilitate organ, eye or tissue procurement, banking or transplantation.
Clinical Trials and Other Research Activities. We may use and disclose your Protected Health Information for research purposes pursuant to a valid authorization from you or when an institutional review board or privacy board has waived the authorization requirement. Under certain circumstances, your Protected Health Information may be disclosed without your authorization to researchers preparing to conduct a research project, for research or decedents or as part of a data set that omits your name and other information that can directly identify you.
Health or Safety. We may use or disclose your Protected Health Information to prevent or lessen a serious and imminent threat to a person’s or the public’s health or safety.
Specialized Government Functions. We may use and disclose your Protected Health Information to units of the government with special functions, such as the U.S. military or the U.S. Department of State under certain circumstances.
Workers’ Compensation. We may disclose your Protected Health Information as authorized by and to the extent necessary to comply with state law relating to workers’ compensation or other similar programs.
USES AND DISCLOSURES THAT REQUIRE YOUR AUTHORIZATION:
For any purpose other than the ones described above, we only use or disclose your Protected Health Information when you give us your written authorization. You may revoke your authorization, except to the extent that we have taken action in reliance upon it, by submitting a written statement to us using the contact information at the end of this Notice.
Marketing. “Marketing” means to make a communication to you that encourages you to purchase or use a product or service. We will not use or disclose your health information for marketing communications without your prior written authorization, except
- when permitted by HIPAA.
- to provide you with information regarding products or services that we offer related to your health care needs if We are not paid or otherwise receive compensation for such communications.
For example, we will not accept any payments from other organizations or individuals in exchange for making communications to you about treatments, therapies, health care providers, settings of care, case management, care coordination, products or services unless you have given us your authorization to do so or the communication is permitted by law.
Sale of Protected Health Information. We will not make any disclosure of Protected Health Information that is a sale of Protected Health Information without your written authorization.
Psychotherapy Notes. To the extent our providers maintain psychotherapy notes about you, we will not use or disclose those psychotherapy notes without your authorization except as permitted by law.
Uses and Disclosures of Your Highly Confidential Information. Federal and state law requires special privacy protections for certain health information about you (“Highly Confidential Information”), including mental health records, substance use disorder treatment records protected under 42 CFR Part 2, and other health information that is given special privacy protection under state or federal laws other than HIPAA. We may use and disclose Highly Confidential Information as permitted by these laws. However, in order for us to disclose any Highly Confidential Information for a purpose other than those permitted by law, we must obtain your authorization.
YOUR RIGHTS WITH RESPECT TO YOUR PROTECTED HEALTH INFORMATION:
Right to Request Additional Restrictions. You may request restrictions on our use and disclosure of your Protected Health Information (1) for treatment, payment and health care operations, (2) to individuals (such as a family member, other relative, close personal friend or any other person identified by you) involved with your care or with payment related to your care, or (3) to notify or assist in the notification of such individuals regarding your location and general condition. While we will consider all requests for additional restrictions carefully, we are not required to agree to a requested restriction unless the request is to restrict our disclosure to a health plan for purposes of carrying out payment or health care operations, the disclosure is not required by law and the information pertains solely to a health care item or service for which you (or someone on your behalf other than the health plan) have paid us out of pocket in full. If you wish to request additional restrictions, please contact us using the contact information at the end of this Notice.
Right to Receive Communications by Alternative Means or at Alternative Locations. You may request, and we will accommodate, any reasonable written request for you to receive your Protected Health Information by alternative means of communication or at alternative locations.
Right to Inspect and Copy Your Health Information. You may request access to your medical record file and billing records maintained by us in order to inspect and request copies of the records. Under limited circumstances, we may deny you access to a portion of your records. If you desire access to your records, you may submit a request through the patient portal if you are a patient or the patient’s personal representative, or you may contact us using the contact information at the end of this Notice. If you request copies, we may charge you a reasonable copy fee.
Right to Amend Your Records. You have the right to request that we amend your Protected Health Information maintained in your medical record file or billing records. If you desire to amend your records, please contact us using the contact information at the end of this Notice. We will comply with your request unless we believe that the information that would be amended is accurate and complete or other special circumstances apply.
Right to Receive an Accounting of Disclosures. Upon request, you may obtain an accounting of certain disclosures of your Protected Health Information made by us during any period of time prior to the date of your request provided such period does not exceed six (6) years. If you request an accounting more than once during a twelve (12) month period, we may charge you a reasonable fee for the accounting statement.
Right to Receive Paper Copy of this Notice. Upon request, you may obtain a paper copy of this Notice, even if you agreed to receive such notice electronically.
REVISIONS TO THIS NOTICE:
We reserve the right to revise this Notice and to make the revised Notice effective for Protected Health Information we already have about you as well as any information we receive in the future. You are entitled to a copy of the Notice currently in effect. Any significant changes to this Notice will be posted on our web site. You then have the right to object or withdraw as provided in this Notice. You also may obtain any new notice by contacting us using the contact information at the end of this Notice.
BREACH OF HEALTH INFORMATION:
We will notify you if a reportable breach of your unsecured Protected Health Information is discovered. Notification will be made to you no later than sixty (60) days from the breach discovery and will include a brief description of how the breach occurred, the Protected Health Information involved and contact information for you to ask questions.
COMPLAINTS:
Complaints about this Notice or how we handle your Protected Health Information should be directed to our HIPAA Privacy Officer. If you are not satisfied with the manner in which a complaint is handled you may submit a formal complaint to the Department of Health and Human Services, Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/. We will not retaliate against you for filing a complaint.
If you have any questions about this Notice, please contact us at info@claritypediatrics.com or call 415-599-0988 and ask to speak with our HIPAA Privacy Officer.