THIS NOTICE DESCRIBES HOW INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Commitment to Privacy:

Cala Health is dedicated to maintaining the privacy or your healthcare information and we are required by law to maintain the confidentiality of information that identifies you, including but not limited to information that we receive from your Cala Health Trio stimulator, such as the number of sessions you complete, the average number of sessions per day, your average stimulation level, and your patient satisfaction score. Any use of healthcare information beyond the uses described below requires your individual written authorization. The Health Insurance Portability and Accountability Act (HIPAA) obligates Cala Health to provide you with a copy of our Notice of Privacy Practices, outlining our privacy practices and how we safeguard your health information. Cala Health abides by the terms of this Notice of Privacy Practices currently in effect and reserves the right to revise or amend this Notice of Privacy Practices, as needed. We also maintain a Privacy Policy regarding use of personal information obtained from your use of our website.

In this notice, when we use “your information” or “health information” we’re referring to information that identifies you and relates to your health or condition, your health care services, or payment for those services. It includes health information, like diagnosis and treatment plans. It also includes demographic information like your name, address, phone number and date of birth.

Your Health Information Rights and Cala Health’s Responsibilities:

When it comes to your information and privacy, you have important rights under state and federal law. This section explains those rights. Ask us about them and we’ll explain the process:

• Request a restriction on certain uses and disclosures of your information
  • 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.
• Obtain a paper copy of the notice of privacy practices
  • 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.
• Ask to inspect and/or receive a paper or electronic copy of health information we may have about you
  • We will provide a copy or summary of your health information, usually within 30 days of your request.
• Obtain an accounting of disclosures of your health 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.
• Request confidential communication
  • 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 amend health information about you that you think is incorrect or incomplete
  • We may say “no” to your request, but we’ll tell you why in writing within 60 days.
• Choose someone to act for you by submitting a written request
  • 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 have been violated
  • You can complain if you feel we have violated your rights by contacting us using the information provided in this Notice of Privacy Practices.
  • 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.

All rights requests must be submitted in writing to the contact information provided in this Notice of Privacy Practices.

Your Choices Regarding Your Health Information and Cala’s Responsibilities:

If you have a clear preference for how we share your information in the situations described below, let us know. Tell us what you want us to do, and we will follow your instructions. *

• In the following cases, you have the right and choice to tell us not 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 the following cases, we never share your information unless you give us written authorization:
  • Marketing purposes
  • Sale of your information

You have the right to revoke your authorization to use or disclose health information except to the extent that action has already been taken.

*Cala Health does not: create or manage a hospital directory, conduct fundraising activities, and does not manage or create psychotherapy notes.

How We Use or Share Your Health Information:

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

• We will use your health information for treatment – Information obtained by our company will be documented in your healthcare record and will be used to provide you with durable medical equipment and supplies, including the Cala Health Trio stimulator. The prescription that your physician has ordered will be part of the record and will determine the equipment and supplies that you receive.
• We will use your health information for payment – Cala Health will use or share your health information to bill and get payment from you, health plans, or other entities. The health information that identifies you, your diagnosis, equipment, and supplies may be included on any bill or other communications regarding payment for services provided by Cala Health.
• We will use your health information for healthcare operations – Cala Health may use your health information to monitor your usage of the Cala Health Trio stimulator, to evaluate the performance of the Cala Health Trio device and share this information with your physician if requested, to evaluate the quality of care you receive from us, to conduct cost management assessments, to make product improvements, and to plan business activities. This information is used to continually improve the quality and effectiveness of the healthcare services we provide.

Other Uses and Disclosures:

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 have to meet many conditions in the law before we can share your information for these purposes. These purposes include, but are not limited to:

• Public Health – We may use or share your health information to public health or legal authorities charged with preventing disease, helping with product recalls, reporting adverse reactions or events to medications or medical devices, reported suspected abuse, neglect or domestic violence, preventing or reducing a serious threat to anyone’s health or safety.
• For Research – We may use or share your information for research purposes.
• Comply with the law – We will share information about you if state or federal laws require it, including to the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
• Worker’s Compensation – We may release your health information to the extent necessary to comply with laws relating to worker’s compensation or other similar programs established by law.
• Government requests – We may share health information about you for certain law enforcement purposes or with a law enforcement official or for special government functions such as military, national security, and presidential protective services.
• Lawsuits and legal actions – We can share health information about you in response to a court or administrative order or in response to some subpoenas.
• Organ and tissue donation requests – We can share health information about you with organ procurement organizations.
• Medical examiners and funeral directors – We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

For more information see: https://www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/index.html

Cala Health is required to:

• Maintain the privacy and security of your protected health information;
• Let you know promptly if a breach occurs that may have compromised the privacy or security of your information;
• Provide you with a copy of our Notice of Privacy Practices, which describes our legal duties and privacy practices with respect to health information we collect and maintain about you;
• Not use or share your information other than as described herein 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.

Cala Health reserves the right to change our practices and to make the new provisions effective for all protected health information we maintain. Should our information practices change, we will notify you and make available a revised Notice of Privacy Practices. We will not use or disclose your health information without your authorization, except for the purposes described in this document. Cala Health also reserves the right to create a collection of information that is de-identified so that it does not contain unique personal identifiers and no longer can be linked to you.

For More Information or to Contact Cala Health:

Please contact Cala Health’s Privacy Officer if you require additional information or want to pursue your rights:

Privacy Officer
(888)699-1009
875 Mahler Rd Ste 168, Burlingame, CA 94010

Effective Date: February 2, 2021