Health Information Exchange Notice

Eden Health Medical, PC ("Eden Health") and its affiliated Eden Health, Inc. entity (collectively, the "Companies," "we" or "us") may utilize a Health Information Exchanges (“HIE”) to improve the quality of care services for Users. Please read the following HIE notice (this “Notice”) to understand your rights and the Companies policies regarding the use of HIEs.

HIEs share information about people’s health electronically and securely to improve the quality of health care services. This kind of sharing is called ehealth or health information technology (“Health IT”). To learn more about Health IT in New York State, read the brochure, “Better Information Means Better Care” at www.ehealth4ny.org.

In agreeing to the Terms of Service, you authorize the Companies’ health care providers (“Healthix Participants”) to obtain access to your medical records through Healthix, which is a Health Information Exchange, or Regional Health Information Organization (RHIO), a not-for-profit organization recognized by the State of New York. This can also help collect the medical records you have in different places where you get healthcare, and make them available electronically to the providers treating you. A complete list of current Healthix Information Sources is available from Healthix and can be obtained at any time by checking the Healthix website at http://www.healthix.org or by calling Healthix at 877-695-4749.

This can help collect the medical records you have in different places where you get health care, and make them available electronically to the providers treating you. You have the right to opt-out of this consent if you provide the Companies with written notice of your desire to do so by email or regular mail at support@edenhealth.com or Eden Health, One Liberty Plaza, Worksuite 301, New York, NY 10006 within thirty (30) days following the date you first accept these Terms (such notice, an "HIE Opt-out Notice"). If you don’t provide the Companies with an HIE Opt-out Notice within the thirty (30) day period, you will be deemed to have knowingly and intentionally waived your right to opt-out of the HIE consent as expressly set forth above.

With your consent, consistent with New York State and Federal law, your electronic health information may be used by Healthix Participants to:

• Provide you with medical treatment and related services.
• Check whether you have health insurance and what it covers.
• Improve Payers and Insurers ability to meet quality and performance program requirements by having a more complete view of a patient’s clinical information.
• Provide Care Management Activities including, but not limited to, assisting you in obtaining appropriate medical care, improving the quality of healthcare services provided to you, coordinating the provision of multiple health care services provided to you, or supporting you in following a plan of medical care.
• Provide Quality Improvement Activities including, but not limited to, evaluating and improving the quality of medical care (and related services) provided to you and all Users and Healthix members and participating organizations.

What Types of Information About You Are Included

By agreeing to the Terms of Service, all employees, agents and members of the medical staff of Mount Sinai may access ALL of your electronic health information available through Healthix. This includes information created before and after the date of this Consent. Your health records may include a history of illnesses or injuries you have had (like diabetes or a broken bone), test results (like X-rays or blood tests), and lists of medicines you have taken. This information may relate to sensitive health conditions, including but not limited to:

• Alcohol or drug use problems
• Mental health conditions
• Birth control and abortion (family planning)
• HIV/AIDS
• Genetic (inherited) diseases or tests
• Sexually transmitted diseases

Where Health Information About You Comes From

Information about you comes from places that have provided you with medical care or health insurance (“Information Sources”). These may include hospitals, physicians, pharmacies, clinical laboratories, health insurers, the Medicaid program, and other ehealth organizations that exchange health information electronically. A complete list of current Healthix Information Sources is available from Healthix and can be obtained at any time by checking the Healthix website at http://www.healthix.org or by calling Healthix at 877-695-4749.

Who May Access Information About You

Only these people may access information about you: doctors and other health care providers who serve on the medical staff of an approved Healthix Participant and who are involved in your medical care; health care providers who are covering or on call for an approved Healthix Participant; designated staff involved in quality improvement or care management activities; and staff members of an approved Healthix Participant who carry out activities permitted by this Consent Form as described above in paragraph one.

Public Health and Organ Procurement Organization Access

Federal, state or local public health agencies and certain organ procurement organizations are authorized by law to access health information without a patient’s consent for certain public health and organ transplant purposes. These entities may access your information through Healthix for these purposes without regard to whether you give consent, deny consent or do not fill out a consent form.

Penalties for Improper Access to or Use of Your Information

There are penalties for inappropriate access to or use of your electronic health information. If at any time you are concerned that someone who should not have seen or gotten access to information about you has done so via Healthix, visit Healthix’s website: www.healthix.org; or call the NYS Department of Health at 518-474-4987; or follow the complaint process of the federal Office for Civil Rights at the following link: http://www.hhs.gov/ocr/privacy/hipaa/complaints/.

Re-disclosure of Information

Any electronic health information about you may be re-disclosed by a Healthix Participant to others only to the extent permitted by state and federal laws and regulations. This is also true for health information about you that exists in a paper form. As stated above, if you give consent, ALL of your electronic health information, including sensitive health information will be available through Healthix. Some state and federal laws provide special protections for some kinds of sensitive health information, including related to:

• your assessment, treatment or examination of a health condition by certain providers;
• HIV/AIDS;
• mental illness;
• mental retardation and developmental disabilities;
• substance abuse; and
• genetic testing.

Their special requirements must be followed whenever people receive these kinds of sensitive health information. Eden Health, Healthix and persons, who access this information through these health information exchanges must comply with these requirements.

Effective Period

This Consent Form will remain in effect until the day you change your consent choice or until such time as Healthix ceases operation. If Healthix merges with another Qualified Entity your consent choices will remain effective with the newly merged entity.

If you want to deny consent for all Provider Organizations and Health Plans participating in Healthix to access your electronic health information through Healthix, you may do so by visiting Healthix’s website at www.healthix.org or calling Healthix at 877-695-4749.