MICHELLE MASTER, M.D. FAMILY MEDICINE, PLLC 

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.

Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you. 


Get an electronic or paper copy of your medical record

  • You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
  • We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost‐based fee.


Ask us to correct your medical record

  • You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
  • We may say “no” to your request, but we’ll tell you why in writing within 60 days.


Request confidential communications

  • You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
  • We will say “yes” to all reasonable requests.

Ask us to limit what we use or share

  • You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.
  • If you pay for a service or health care item out‐of‐pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.


Get a list of those with whom we’ve shared information

  • You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
  • We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost‐based fee if you ask for another one within 12 months.


Get a copy of this Notice

You can ask for a paper copy of this Notice at any time, even if you have agreed to receive the Notice electronically. We will provide you with a paper copy promptly.


Choose someone to act for you

  • If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
  • We will make sure the person has this authority and can act for you before we take any action.
  • File a complaint if you feel your rights are violated
  • You can complain if you feel we have violated your rights by contacting us in writing:

Michelle Master, M.D. Family Medicine, PLLC 

1400 Centre St, Suite 206

Newton Center, MA, 02459

admin@doctormaster.com

  • You can file a complaint with the U.S. 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.


Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, email us at admin@doctormaster.com and let us know what you want us to do, and we will follow your instructions.


You have both the right and choice to tell us whether to share information with your family, close friends, or others involved in your care.


If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety. 


In these cases, we never share your information unless you give us written permission:

  • Marketing purposes
  • Sale of your information
  • Psychotherapy notes, unless otherwise required by law


In the case of fundraising:

  • We may contact you for fundraising efforts, but you can “opt out” or “unsubscribe” and we will not contact you again with this type of communication.


Our Uses and Disclosures

How do we typically use or share your health information?

We typically use or share your health information in the following ways.


To treat you

We can use your health information and share it with other professionals who are treating you. Example: A doctor treating you for a health condition asks us about your behavioral health conditions that may affect treatment. 


To run our organization

We can use and share your health information to run our practice, improve your care, and contact you when necessary. Example: We use health information about you to manage your treatment and services. 


To bill for our services

We can use and share your health information to bill and get payment from health plans or other entities.

Example: We give information about you to your health insurance plan, so it will pay for the services we provided to you. 


How else can we use or share your health information?

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We must meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.


Help with public health and safety issues

We can share health information, limited to the minimum necessary amount of information that is reasonably necessary, about you without authorization (except where indicated) for certain situations such as:

  • Medical emergencies 
  • Care of a minor 
  • Incompetent and deceased patients 
  • Preventing disease 
  • Helping with product recalls 
  • Reporting adverse reactions to medications 
  • Reporting suspected child abuse or neglect, and under certain circumstances, abuse, neglect or domestic violence involving adults 
  • Preventing or reducing a serious threat to anyone’s health or safety 


Do research

We can use your information, for health research, in aggregate (your personal information will not be separately identifiable).


Comply with the law

We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.


Work with a medical examiner or funeral director

We can share health information with a coroner, medical examiner, or funeral director when an individual dies.


Address workers’ compensation, law enforcement, and other government requests 

We can use or share health information about you:

  • For workers’ compensation claims
  • For law enforcement purposes or with a law enforcement official
  • For example: We may share your health information or SUD information with the police or other law enforcement officials if you commit a crime on the premises or against program personnel or threaten to commit such a crime. We cannot share information regarding illegal activities (e.g., selling drugs, prostitution, etc. unless it poses an imminent danger to someone). 
  • With health oversight agencies for activities authorized by law
  • For special government functions such as military, national security, and presidential protective services


Respond to lawsuits and legal actions

We can generally share health information about you in response to a court or administrative order, or in response to a subpoena. 

 

Appointment Reminders

We may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.


Special Restrictions On Our Uses and Disclosures

  • Conflict of Laws
  • If more than one law applies to the use or disclosure of information that is the subject of this Notice, we will comply with the requirements of the law that affords you greater privacy protections, including more stringent state laws in the state where you reside.
  • For example, some states have strict requirements regarding disclosure of information related to substance use disorder treatment, HIV status, and genetic information. Depending upon where you reside, we will adhere to your state’s requirements.


Our Responsibilities

  • We are required by law to maintain the privacy and security of your protected health information.
  • We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
  • We must follow the duties and privacy practices described in this Notice and give you a copy of it.
  • We will not use or share your protected health information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.


For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.


Changes to the Terms of this Notice

We can change the terms of this Notice, and the changes will apply to all information we have about you. 


For questions about this Notice, please contact: 


Michelle Master, M.D. Family Medicine, PLLC 

1400 Centre St, Suite 206

Newton Center, MA, 02459

admin@doctormaster.com


Last updated December 4, 2025.