HIPAA Notice of Privacy Practices

Effective date: September 27th, 2026

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 applies to Hawaii Island Stem Cell Therapy and Regenerative Medicine and to the physicians, other clinicians, and staff who work at our clinic at 15-3039 Pahoa Village Road in Pahoa, Hawaii. It explains how we handle your protected health information, meaning anything in your records that identifies you and relates to your health, your care, or payment for that care.

Our Legal Duties

Federal law requires us to keep your protected health information private, to give you this notice describing our legal duties and privacy practices, and to notify you if a breach of unsecured health information affects you. We must follow the version of this notice currently in effect.

Treatment, Payment, and Clinic Operations

We may use and share your health information for the following purposes without asking for your written permission each time.

• Treatment. Your physician may review the MRI report you sent before your consultation, discuss your case with another clinician on our team, or send your chart notes to an outside lab that runs your bloodwork.
• Payment. We use your information to prepare invoices, process card payments, and answer billing questions. If you ask us to submit a claim to an insurer or a health savings account administrator, we will send the information needed for that claim.
• Health care operations. We may review charts to evaluate the quality and safety of our procedures, train new staff, work with attorneys or accountants, and prepare for licensing reviews. Vendors who help with these tasks must sign business associate agreements that obligate them to protect your information.

We may also contact you with appointment reminders or information about treatment options we offer.

Family Members and Others Involved in Your Care

With your agreement, or when you are present and do not object, we may share relevant information with a relative, friend, or caregiver who helps with your care or pays for it. If you are unable to respond, we will use professional judgment about what is in your best interest.

Other Uses and Disclosures Allowed Without Your Authorization

Federal law permits or requires us to release health information in these additional situations:

• When a law requires it, including disclosures to the U.S. Department of Health and Human Services when it reviews our HIPAA compliance
• Public health activities, such as reporting certain diseases to the Hawaii State Department of Health or reporting adverse reactions to products to the FDA
• Suspected abuse, neglect, or domestic violence, reported to the agency authorized to receive the report
• Health oversight, including audits and investigations by the Hawaii Medical Board and other licensing agencies
• Court and administrative proceedings, in response to a court order, or a subpoena that meets legal requirements
• Law enforcement, for limited purposes such as identifying a suspect or responding to a warrant
• Coroners, medical examiners, and funeral directors, as needed for their duties
• Organ and tissue donation, to organizations that coordinate donation
• Research, when an institutional review board or privacy board has approved the use under federal rules
• A serious threat to health or safety, to someone able to prevent or reduce the threat
• Specialized government functions, including military command authorities and national security activities
• Workers’ compensation, as state law allows for work-related injuries

Information shared under these rules may be shared again by the recipient and may no longer be protected by federal privacy law.

• Substance use disorder records. Outside records we receive for a patient sometimes include notes from an addiction treatment program. Records that come from a program regulated under 42 CFR Part 2 get added protection. Neither the records nor testimony describing them can be used against you in a civil, criminal, administrative, or legislative proceeding without your written consent. The only other route is a court order issued after you, or whoever holds the records, had notice and a chance to respond, and that order must come with a subpoena or similar legal mandate before anything is released.

Uses That Require Your Written Authorization

We will ask for your signed authorization before we:

• Use or disclose psychotherapy notes, with narrow exceptions set by federal law
• Use your information for marketing communications, or accept payment from a third party to send them
• Sell your health information
• Post your name, story, or before-and-after photos as a testimonial on our website, in advertising, or on social media

Any use or disclosure not described in this notice will also require your written authorization. If you change your mind, a written revocation stops any future sharing under that authorization, although it cannot reverse disclosures made before we received it. We do not contact patients for fundraising.

Your Rights

1. Get a copy of your records. You can view or receive a paper or electronic copy of your billing and medical records. We will act on your request within 30 days; if we need more time, we will tell you in writing and may take up to 30 additional days. Our clinic may charge you a reasonable, cost-based fee for copies. You may ask us to send records by regular email; if you choose that option, we will explain the risk of unencrypted email before sending.
2. Ask for a correction. If you believe information in your record is wrong or incomplete, you may ask us in writing to amend it. We will answer within 60 days, or within 90 if we notify you in writing that we need more time. If we say no, the written reply will explain why.
3. Request our clinic to limit what we share. A request can cover any part of your information we would otherwise use for care, clinic operations, or billing. In most cases, we are not required to agree. If you complete, in full, a payment for a service out of pocket and ask our clinic not to share information about it with your health plan, we must honor that request unless the law requires the disclosure.
4. Choose how we contact you. Tell us if you would rather be reached at another phone number, email, or mailing address. We will accommodate reasonable requests.
5. Get a list of disclosures. On request, we will provide an accounting of when we shared your information during the six years before you asked. The list will not include disclosures for treatment, payment, or operations, or disclosures you authorized. The first list in any 12-month period is free.
6. Get a paper copy of this notice. The front desk will print one whenever you ask, including for patients who first read it online.
7. Name a personal representative. If you have given someone medical power of attorney, or someone is your legal guardian, that person may exercise your rights on your behalf.

Hawaii Law

Hawaii’s Health Care Privacy Harmonization Act (HRS Chapter 323B) aligns state health privacy law with the federal HIPAA standards described in this notice. State law also requires us to retain medical records for at least seven years after the last entry and to preserve basic information from each record for 25 years (HRS §622-58).

Changes to This Notice

We reserve the right to change this notice and to apply the revised version to all health information we already hold as well as information we receive in the future. The current notice will be posted in our Pahoa office and on this page, and you may request a copy at any visit.

Complaints

If you believe that your privacy rights may have been violated, you may file a complaint(s) with our Privacy Officer using the address below. You may also submit a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, online at www.hhs.gov/ocr/complaints or by calling 1-800-368-1019 (TDD 1-800-537-7697).

Complaints to the Office for Civil Rights generally must be filed within 180 days of when you learned of the problem. The clinic will not penalize you or take any action against you because you filed a complaint, and it will not change the care you receive here.

Contact

Privacy Officer Hawaii Island Stem Cell Therapy and Regenerative Medicine
Office Address: 15-3039 Pahoa Village Road Pahoa, HI 96778
Phone: (808) 936-1156