Notice of Privacy Practices at Sameem
Effective date: June 15 2026
THIS NOTICE DESCRIBES:
HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED
YOUR RIGHTS WITH RESPECT TO YOUR HEALTH INFORMATION
HOW TO FILE A COMPLAINT CONCERNING A VIOLATION OF THE PRIVACY OR SECURITY OF YOUR HEALTH INFORMATION, OR OF YOUR RIGHTS CONCERNING YOUR INFORMATION
YOU HAVE A RIGHT TO A COPY OF THIS NOTICE (IN PAPER OR ELECTRONIC FORM) AND TO DISCUSS IT WITH OUR PRIVACY OFFICER AT 617-213-6887 OR care@sameemcare.com IF YOU HAVE ANY QUESTIONS.
Please read this notice carefully. It explains how we may use information about you and when we may share it with others, describes your rights, and describes our responsibilities regarding your health information.
Who this notice covers
This notice applies to Sameem Behavioral Health, LLC and Sameem Associates, Inc., which work together to provide your care and which we refer to together as "Sameem." Where Massachusetts law protects your information more strictly than federal law, we follow the stricter rule.
Special protection for substance use disorder records
NOTE: If you do not receive substance use disorder treatment from us, these additional federal protections may not apply to your records, but every other protection described in this notice applies to you.
Federal law (42 CFR Part 2) gives extra protection to records that identify you as someone who has, or has had, a substance use disorder, or who has received substance use disorder treatment. In general, we may not tell anyone outside Sameem that you attend or have attended our program, or share other protected information about you, unless you consent in writing, a court orders it, or another narrow exception described in this notice applies.
How we may use and disclose your health information
For most of your care, we use and share your information for three purposes. For your substance use disorder records, we do so based on your written consent:
Treatment. We use your information to provide and coordinate your care. For example, the clinicians and staff involved in your care may share information with one another, and we may share information with other providers you ask us to coordinate with.
Payment. We use your information to bill and obtain payment for your care — for example, to submit claims to your insurer when you ask us to, or to charge the credit card you keep on file.
Health care operations. We use your information to run our practice — for example, scheduling, quality review, staff training, and improving our services.
A single consent for treatment, payment, and health care operations. For your substance use disorder records, you may sign a single written consent that allows us to use and share those records for all future treatment, payment, and health care operations. You do not have to sign a new consent each time.
Uses and disclosures that require your written consent. Except as described in this notice, we will use or share your information only with your written consent. For example, we will share your records with a family member, a school, an employer, or a provider not involved in your care only if you give us written consent. You may revoke your written consent at any time, in writing (as provided in 42 CFR §§ 2.31 and 2.35), except to the extent we have already acted in reliance on it.
Uses and disclosures we may make without your consent.
In limited situations, the law permits or requires us to use or share information without your consent. Where this involves your substance use disorder records, the narrower rules of 42 CFR Part 2 apply. These situations include:
When required by law — when a federal or state law requires the use or disclosure.
Medical emergencies — to medical personnel when there is an immediate threat to your health and you are unable to consent.
Reports of abuse or neglect — Massachusetts law requires us to report suspected abuse or neglect of a child, an elder, or a person with a disability to the appropriate state agency. Federal substance use disorder rules do not protect this reporting.
To prevent serious harm — if we believe you are threatening serious bodily harm to yourself or to another person, we are required to take protective action, which may include notifying the potential victim, notifying the police, seeking hospitalization, or contacting family members who can help protect you. We would make every effort to discuss this with you first.
Court proceedings and law enforcement — as described in the next section, your substance use disorder records may be used in legal proceedings only with your written consent or a qualifying court order. Information about a crime committed at our program or against our staff, or a threat to commit such a crime, is not protected.
Research, audit, or program evaluation — to qualified personnel for these purposes, under the protections required by law.
Health oversight and public health — for oversight, public health, or similar activities permitted by law.
Federal protection for substance use disorder records (42 CFR Part 2)
The confidentiality of your substance use disorder treatment records is protected by federal law. In addition to the points above:
Legal proceedings. Your records — and any testimony repeating what is in them — may not be used or disclosed in any civil, criminal, administrative, or legislative proceeding against you unless you give specific written consent or a court orders it. A court may order use or disclosure only after you (or the holder of the record) have been given notice and an opportunity to be heard, where required by law, and any such court order must be accompanied by a subpoena or similar legal mandate before the record is disclosed.
Re-disclosure after a treatment, payment, or operations consent. If you consent in writing to share your records for treatment, payment, or health care operations, the program, health plan, or business associate that receives them may re-share them as the HIPAA rules allow — except they may not be used against you in the legal proceedings described above without your consent or a court order.
Crimes and child abuse. Federal law does not protect information about a crime you commit at the program or against program staff, or a threat to commit such a crime. It also does not protect the reporting of suspected child abuse or neglect under state law.
Reporting violations. Violation of these federal laws and regulations by a program is a crime. Suspected violations may be reported to the United States Attorney for the district in which the violation occurs.
For more information, see 42 U.S.C. § 290dd-2 and 42 CFR Part 2.
Your rights
You have the following rights regarding your health information. To exercise any of them, contact our Privacy Officer using the information at the end of this notice.
Get a copy of your records. You may inspect and obtain a copy of your records, in paper or electronic form, with limited exceptions.
Request a correction. You may ask us to amend information you believe is incorrect or incomplete.
Request restrictions. You may ask us to limit how we use or share your information for treatment, payment, or health care operations. If you pay in full, out of pocket, for a service, you may ask us not to share the records of that service with your health plan, and we will agree as required by law.
Request confidential communications. You may ask us to contact you in a specific way or at a specific location.
Get an accounting of disclosures. You may request a list of certain disclosures we have made of your records, and a list of disclosures made by an intermediary, as provided by law.
Get a paper or electronic copy of this notice. You may request a copy at any time, even if you agreed to receive it electronically.
Be notified of a breach. You have the right to be notified if there is a breach of your unsecured health information.
Ask questions about this notice. You may discuss this notice with our Privacy Officer.
Our duties
We are required by law to protect the privacy of your records, to give you this notice of our legal duties and privacy practices, and to notify affected patients following a breach of unsecured records.
We are required to follow the terms of the notice currently in effect.
We reserve the right to change this notice and to make the revised notice apply to records we already maintain. If we make a material change, we will post the revised notice in our office and on our website, and make it available to you on request.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with us and with the U.S. Department of Health and Human Services, Office for Civil Rights.
To complain to us, contact our Privacy Officer (below). You may also use our Patient Grievance Policy at www.sameembh.com/patient-grievance-policy.
To complain to the federal government, contact the Office for Civil Rights at www.hhs.gov/ocr.
We will not retaliate against you for filing a complaint.
Contact
Privacy Officer, Sameem
34 Lincoln Street, Newton Highlands, MA 02461
Phone: 617-213-6887 · Email: care@sameemcare.com