Privacy Policy - Tandigm Health

Website Privacy Policy

Please read this Website Privacy Policy (“Privacy Policy”) in its entirety to understand how Tandigm Health, LLC (“Tandigm”) will handle the privacy of personal information that you provide through the Website. Unless otherwise specified, this Privacy Policy does not describe how Tandigm may handle your personal information in offline settings.

Tandigm may use and disclose the information that you provide through this Website only for purposes permitted or required by law, for purposes described in this Privacy Policy, or for purposes which you might authorize. If you do not wish for Tandigm to use or disclose information that you provide through this Website as described in this Privacy Policy, you should disconnect from this Website. Tandigm may need to change this Privacy Policy from time to time to address new functionality or changes to this Website, or to address new issues or changes in law that require changes to this Privacy Policy. Please refer back to the Privacy Policy regularly because your use of the Website signifies that you agree to be bound by this Privacy Policy.

Tandigm also has developed Terms and Conditions of Access describing your responsibilities when using this Website. Please read the Privacy Policy and the Terms and Conditions of Access carefully. Tandigm may revise and update the Privacy Policy and the Terms and Conditions at any time. Therefore, please periodically review the Privacy Policy and the Terms and Conditions of Access posted at this Website.

1. Tandigm Website Privacy Policy

Welcome to the Tandigm Health Website. Our publicly-accessible Website is designed to make it easier for visitors to learn about the services and programs provided by Tandigm. As with all online resources, we appreciate that visitors to our Website are concerned about the privacy of personal information. This Privacy Policy discloses Tandigm’s policy for collecting, using and disseminating information through its Website.

Please note that this Privacy Policy is distinct from Tandigm’s Notice of Privacy Practices (“the Tandigm Notice”), which is a special notice required by a federal privacy law known as “the HIPAA Privacy Rule.” The Tandigm Notice describes how Tandigm uses “individually identifiable health information” collected by Tandigm — both online and offline — to provide services to you and to administer the various programs that Tandigm administers. You can request a copy of the Tandigm Notice of Privacy Practices by calling 215-241-9453. Together, this Privacy Policy and the Tandigm Notice describe how Tandigm uses your individually identifiable health information and personal information collected through this Website. Information you provide to Tandigm in an offline setting is covered by the Tandigm Notice, but is not covered by this Privacy Policy unless otherwise specified in this Policy.

2. Collection of Personal Information from Site Visitors to Tandigm’s Website

When you visit http://www.tandigmhealth.com, Tandigm may collect and/or track: (1) your home server domain names, your email address, your type of computer, the files downloaded, the search engine used, operating system, and type of web browser; (2) the email address you use when you communicate with Tandigm via email; (3) information knowingly provided by you in online forms, surveys, email, contest entries, and other online submissions (including demographic and personal profile data), and (4) aggregate information on pages accessed by you.

To better serve you, we use “cookies” to customize your browsing experience. Cookies are simple text files stored by your browser, and they provide a method of distinguishing among visitors to our sites. We use “cookies” to store a randomly generated tag on your computer such that when you revisit our sites, we may recognize you by the Internet cookie and customize your experience accordingly. The cookies created on your computer by using our sites do not contain personally identifiable information. You may refuse a cookie, or delete the cookies file from your computer at any time by using any one of a number of widely available methods.

3. Use of Online Personal Data Collected Through Tandigm’s Website

When you access the Website, you may choose to give Tandigm online personal information about you. “Online personal information” is any information or data you provide through this Website that is individually identifiable, such as a name, address, postal address, email address, birth date, phone number, and other personal information, including health information that you voluntarily provide to Tandigm. It also may include other information that we collect about you that is associated with your name or address, such as your email address. You may provide that information to us on our Website, if you email us, or at some other point during your online interaction.

Tandigm may use the online personal information for a number of different reasons, including editorial and feedback purposes, healthcare marketing and promotions, performing a statistical analysis of visitor usage, product development, content improvement, to protect our rights or property, or to customize the content and layout of our site. Aggregate data that does not identify individual users may be used for internal purposes or provided to third parties.

Personally identifiable information that visitors voluntarily provide to Tandigm, online or offline, may be added to our databases and used for future communications, which may include Website updates, new products and services, the confirmation of transactions through the website, upcoming events, or health reminders, and for other purposes in accordance with applicable state and federal law.

Online personal information may or may not be individually identifiable health information that is also protected by the federal HIPAA privacy law (“the HIPAA Privacy Rule”). Where online personal information also constitutes individually identifiable health information under the HIPAA Privacy Rule, the provisions of this Privacy Rule and the Tandigm Notice also will govern Tandigm’s permitted uses and disclosures of the online personal information.

4. Disclosure of Online Personal Data Collected Through the Tandigm Website to Third Parties

Unless otherwise authorized by a visitor or required or permitted by law [e.g., disclosure to healthcare oversight agencies, etc. would be permitted and that isn’t stated herein], Tandigm will not sell, rent, license, or disclose personally identifiable information collected through the Tandigm Website to unaffiliated third parties. Under the HIPAA Privacy Rule, however, Tandigm is permitted to disclose individually identifiable health information to business associates who perform various functions or provide services on their behalf. To perform these functions or to provide services, business associates will receive, create, maintain, use, or disclose individually identifiable health information that has been provided to or made available to the business associate by Tandigm, but only after we require the business associates to agree in writing to contract terms designed to safeguard your information.

Except as set forth above, Tandigm will not release personally identifiable information to any party unless required to do so by government authorities or legal process in accordance with applicable law, to protect our rights or property, or in conjunction with an acquisition of all or part of our company. Laws that permit disclosure of your personally identifiable information as part of healthcare operations might include activities such as Wellness Programs.

5. Links from Tandigm Websites to Other Websites

Tandigm Website may include links to other organizations’ websites for your convenience in locating health-related information, services, and products. Please be advised that when you link to these other sites, you are leaving Tandigm’s Website and that these other sites are maintained by organizations over which Tandigm may have no control.

Accordingly, a link on any of these sites does not constitute an endorsement of the content, viewpoint, policies, products, or services provided or advertised on that site. These other third-party sites may have their own terms and conditions and privacy policies or no policy at all. Once you link to a website not maintained by Tandigm, you are subject to any terms and conditions of that site, including, but not limited to any privacy policy. The Tandigm Privacy Policy and the Terms and Conditions of Access do not apply to the sites of such other third parties. Tandigm does not guarantee that you will receive an alert that you are leaving a Tandigm Website and linking to other third-party websites. It is your responsibility to determine when you have left the Tandigm Website.

6. Security Measures

Tandigm has implemented numerous security features to prevent the unauthorized release of, or access to, personal information. For example, all Tandigm employees are required to certify their understanding that personal information is considered confidential, that it is important to safeguard personal information, and that Tandigm will take appropriate action against any employee who fails to acknowledge these facts or adhere to the requisite security standards of conduct.

You should be aware that the confidentiality of any communication or material transmitted to/from Tandigm via this site or email cannot be guaranteed. Tandigm is not responsible for the security of information transmitted via the Internet. Visitors who prefer to communicate with Tandigm in another manner other than through our site can email us at Compliance@Tandigm.com.

7. Opt-out Right

Visitors may opt out of having certain personally identifiable information, i.e. PHI, used by Tandigm or its affiliates for health-related promotional communications by contacting Tandigm via regular mail or email at the addresses above. This opt-out right does not apply to Tandigm’s collection of the type of web browser of the visitor to Tandigm’s site or the sharing of PHI permitted under the HIPAA Privacy Rule for treatment, payment, or healthcare operations as described above.

8. Access to and Ability to Correct Online Personal Data.

Upon request via regular mail or email, Tandigm provides visitors a summary of any personally identifiable information retained by Tandigm regarding the visitor. Visitors may seek to modify, correct, change, or update information that Tandigm has collected by contacting us via regular mail or email at the addresses above. Although you may provide individually identifiable health information on this Website, the information is not a medical record, and is not, under the HIPAA Privacy Rule, considered information we maintain in a designated record set. Such information, however, will be treated as PHI, as discussed in this Privacy Policy and in Tandigm’s Notice.

9. Collection of Online Personal Data From Children.

Tandigm does not attempt to knowingly collect personal information from children under 18. Adults should not assist minors in accessing the Site. When visitors enter personal information on our Website, the visitor is representing to us that he/she is an adult over 18 years old.

To the extent that Tandigm is able to determine the age of visitors by their submissions to or communications with Tandigm’s site, Tandigm will not knowingly (1) collect or post information from individuals under age 18 without their parent’s or guardian’s consent, or (2) provide any personally identifying information collected from children, regardless of its source, to any third party for any purpose whatsoever unless otherwise permitted by law.

No information collected through Tandigm’s Website from visitors who identify themselves as children will knowingly be used for any promotional purposes. If there are no age restrictions on a contest that requires registration, and if a child wins, notification and prizes will be sent to the parents or guardians identified in the initial registration process.

10. Tandigm’s Right to Contact Visitor.

Tandigm reserves the right to contact Website visitors regarding account status and changes to the Privacy Policy or any other policies or agreements relevant to those who visit the Website.

11. Tandigm’s Right to Change Privacy Policy.

Tandigm reserves the right to change this Privacy Policy at any time. Consequently, you should refer back to this Privacy Policy regularly as it might be amended from time to time.

12. Terms and Conditions of Access

Tandigm Health (“Tandigm”) provides you with access to its Website subject to the following Terms and Conditions of Access (“Terms and Conditions”).

We may update these Terms and Conditions at any time and without notice. Unless stated otherwise, changes will be effective when they are posted on our website at http://www.tandigmhealth.com.

By logging on to the Website, you agree to be bound by these Terms and Conditions as well as under our Website Privacy Policy and our HIPAA Notice of Privacy Practices. If you do not wish to be bound by these Terms and Conditions, policies and procedures posted on our Website under the Legal Information section, Tandigm’s Website Privacy Policy and Tandigm’s HIPAA Notice of Privacy Practices, you should disconnect from this Website immediately.

THE CONTENT OF THE WEBSITE IS NOT INTENDED IN ANY WAY TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTH PROVIDER WITH ANY QUESTIONS YOU MAY HAVE REGARDING A MEDICAL CONDITION. NEITHER THE CONTENT NOR ANY OTHER SERVICE OFFERED BY OR THROUGH THE WEBSITE IS INTENDED TO BE RELIED ON FOR MEDICAL DIAGNOSIS OR TREATMENT. NEVER DISREGARD MEDICAL ADVICE OR DELAY IN SEEKING IT BECAUSE OF SOMETHING YOU HAVE READ ON THE WEBSITE! IN AN EMERGENCY, CALL 911 OR YOUR LOCAL EMERGENCY ASSISTANCE NUMBER.
Tandigm has created certain security procedures to assist in keeping your information confidential. You agree to provide us with accurate, current and complete information about yourself as requested and to maintain and promptly update your information to keep it accurate, current and complete.
You understand that you may access the websites of third parties through the Website. You understand and agree that the websites of third parties will have their own policies and procedures (including a privacy policy) to which you will be subject. These websites are maintained by the third parties that Tandigm does not control. Tandigm recommends that you read the policies and procedures (including the privacy policy) of the websites of third parties that you access.
In some instances, you will be notified when you leave Tandigm’s Website and access the websites of third parties. However, Tandigm does not guarantee that you will receive such a notice before accessing the websites of third parties. You understand and agree that it is your responsibility to determine when you have accessed the websites of third parties and to be aware when the policies and procedures (including the privacy policy) of third parties are applicable.
The Portal may include or provide links to other websites on the Internet including, but not limited to, links to our business associates’ web pages. These other websites may provide opinions, recommendations, or other information from various individuals, organizations or companies. IN PROVIDING LINKS TO THE WEBSITES OF THIRD PARTIES, TANDIGM DOES NOT INVESTIGATE THE CONTENT OF SUCH INFORMATION AND DOES NOT ENDORSE, GUARANTEE OR WARRANT THE ACCURACY OF SUCH INFORMATION OR NECESSARILY SUBSCRIBE TO ANY SUCH OPINIONS OR RECOMMENDATIONS. TO THE EXTENT THAT YOU MAKE USE OF ANY LINK TO ANY OTHER WEBSITE ON THE INTERNET, YOU UNDERSTAND AND AGREE YOUR USE OF THE WEBSITES OF THIRD PARTIES IS AT YOUR SOLE RISK. THE WEBSITES OF THIRD PARTIES ARE PROVIDED ON AN “AS IS” AND “AS AVAILABLE” BASIS. TANDIGM EXPRESSLY DISCLAIMS ALL WARRANTIES OF ANY KIND, WHETHER EXPRESS OR IMPLIED, INCLUDING, BUT NOT LIMITED TO THE IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE AND NON–INFRINGEMENT. YOU EXPRESSLY UNDERSTAND AND AGREE THAT TANDIGM WILL NOT BE LIABLE FOR ANY DIRECT, INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL OR EXEMPLARY DAMAGES FOR ANY REASON RESULTING FROM YOUR USE OF THE WEBSITES OF THIRD PARTIES.”

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.

Tandigm Care Solutions, an affiliate of Tandigm Health, provides care management and other clinical services to patients with a focus on providing the right care, at the right place, and at the right time.

We understand that your health information is personal, and we are committed to protecting your privacy. We use and disclose health information about you for treatment, to obtain payment for treatment, for administrative purposes, to evaluate the quality of care that you receive, and for other purposes permitted by the Health Insurance Portability and Accountability Act or 1996 (HIPAA).

For purposes of this Notice, Tandigm Care Solutions and the pronouns “we,” “us” and “our” refer to all of the facilities operated, managed or affiliated with Tandigm Care Solutions in the state of Pennsylvania. This Notice applies to all records about your care that are created, and/or maintained by us. This Notice also applies to the physicians, licensed professionals, and employees of Tandigm Care Solutions. We reserve the right to change our privacy practices, as reflected in this Notice, to revise this Notice, and to make the new provisions effective for all protected health information we maintain. Revised Notices will be available on our website, or upon your request.

How Tandigm Care Solutions May Use or Disclose Your Protected Health Information (PHI): Uses and Disclosures of Your Protected Health Information that Do Not Require an Authorization

We may use or disclose your health information, in certain situations, without an authorization. Such uses or disclosures may be in oral, paper, or electronic format.

For Treatment. We may use and disclose your health information to provide you with medical treatment or services or to assist in the coordination, continuation, or management of your health care and any related services. This includes the coordination or management of your health care with a third party. For example, a health care provider, such as a physician, nurse, or other person providing health services to you, will record information in your record that is related to your treatment. This may include interdisciplinary conferences with team members from Tandigm Care Solutions and support care teams from other facilities involved in your care and treatment or other providers who may be able to provide information or insight in developing and coordinating your plan of care. This information is necessary for other health care providers to determine what treatment you should receive.

For Payment. We may use and disclose your health information to others for purposes of obtaining payment for treatment and services that you receive. For example, a bill may be sent to you or to a third-party payer, such as an insurance company or health plan, for care, items, or services provided to you.

For Health Care Operations. We may use and disclose your protected health information (PHI) for our health care operations. These include internal administration and planning, various activities that improve the quality and cost effectiveness of health care services, health care delivery review, regulatory compliance, staff performance evaluation, education and training of physicians and other health care providers, business planning and development, business management and general administrative activities. We use this information to continuously improve the quality of care for all patients we serve. For example, we may use your PHI to evaluate the performance of our physicians, nurses and other health care workers. We may also use PHI to resolve patient problems and complaints. Additionally, we may share your PHI with other health care providers and payors for certain business operations if the information is related to a relationship the provider or payor currently has or previously had with you, and if the provider or payor is required by federal law to protect the privacy of your protected health information.

Communicating with You. We will use your protected health information (PHI) to communicate with you about appointment information and reminders, your care, treatment options, and/or other health-related services, payment for your care. We may leave a brief message on your answering machine/voicemail or leave a message with an individual who answers the phone at your residence. We may, from time to time, contact you to provide information about other health-related benefits and services that may be of interest to you, refill reminders, and/or informational materials about a particular product or service that may be helpful for your treatment. Materials may also come from a third party.

We may contact you at the email address, telephone number, or address that you provide. If your contact information changes, it is important for you to let us know. We may contact you via text message for these communications. Regarding text messages, please note that message and data rates may apply, and you will have an opportunity to opt out. Texting and email communications are not 100% secure.

Disclosures to Relatives, Friends, or Other Caregivers . We may disclose your protected health information (PHI) to a family member, other relative, friend, or any other person if we: (1) obtain your agreement; (2) provide you with the opportunity to object to the disclosure and you do not object; or (3) we reasonable assume that you do not object.

If we provide information to any individual(s) identified above, we will release only information that we believe is directly relevant to that person’s involvement with your health care or payment related to your health care. We may also disclosure your PHI in the event of an emergency or notify (or assist in notifying) such persons of your location, general condition, or death.

We will ask you to complete a form to help clarify for us which of your family members and/or friends are likely to be involved with your health care and/or payment for your health care. If we disclose information to a family member, relative or close personal friend, we will disclose only information that we believe is relevant to that person’s involvement with your health care or payment related to your health care.

Health Information Exchanges (HIEs). We participate in initiatives to facilitate electronic sharing of patient information, including but not limited to, Health Information Exchanges. HIEs involve coordinated information sharing among HIE members for purposes of treatment, payment, and health care operations. HIEs bring together health professionals for secure, electronic sharing of your health information to help to provide improved care for you. You may opt out of Tandigm Care Solutions’ information sharing through its HIE activities. If you wish to opt out, please speak with your care team or contact the Tandigm Care Solutions Privacy Officer as described below.

Business Associates. We may contract with one or more third parties (our business associates) in the course of treatment, payment/billing activities, and our health care operations. We may disclose your health information to our business associates so that they can perform the job we have asked them to do. We require that our business associates sign a business associate agreement and agree to safeguard the privacy and security of your protected health information.

Certain Research Activities. When conducting research, in most cases, we will ask for your written authorization before PHI is used. However, we may use and disclose your health information for research purposes permitted by applicable law without an authorization. For example, when an institutional review board has waived the authorization requirement.

Other Uses and Disclosures of Your Protected Health Information. We may be permitted by law to make certain other uses and disclosures of your PHI without your authorization. If a use or disclosure is required by law, the use or disclosure will be made in compliance with the law and will be limited to the relevant requirements of the law.

Subject to conditions specified by law, we may release your PHI without an authorization:

For any purposes required by law;
For public health activities, including but not limited to, preventing or controlling disease, injury or disability, alerts for exposure to an infectious disease and/or risk of contracting or spreading a disease or condition, reporting birth and death, required public health investigations, reporting adverse events, reporting information to your employer as required by laws addressing work-related illness and injuries or workplace medical surveillance, reporting information about products and services under the jurisdiction of the U.S. Food and Drug Administration, such as reactions to medications and problems with products, or enabling product recalls;
To government agencies if we suspect child/elder adult abuse, neglect, or domestic violence;
To your employer when we have provided screenings and health care at their request for occupational health and safety;
For purposes related to your workers’ compensation benefits;
To a government oversight agency conducting audits, investigations, inspections and related oversight functions;
In emergencies, such as to prevent a serious and imminent threat to a person or the public;
If required by a court or administrative order, subpoena or discovery request;
For law enforcement purposes, including to law enforcement officials to identify or locate suspects, fugitives, witnesses, or victims of crime;
To coroners, medical examiners, and funeral directors;
If necessary, to arrange organ or tissue donation or transplant;
For specialized government functions, to units of the government with special functions such as U.S. military or U.S. Department of State under certain circumstances, such as for national security, intelligence, or protective services activities;
To disaster relief authorities so that your family can be notified of your location and condition;
For public safety to prevent or lessen a serious and imminent threat to the safety of a person or to the public;
If you are or become an inmate of a correctional institution or you are in the custody of a law enforcement official.
How Tandigm Care Solutions May Use or Disclose Your Protected Health Information (PHI): Uses and Disclosures of Your Protected Health Information that Require an Authorization

While we may use or disclose your health information without your written authorization as explained above, there are other instances where we will obtain your written authorization before using or disclosing your health information. Except as otherwise provided in this Notice, we will not use or disclose your health information without your prior written authorization. You have the right to revoke an authorization at any time, except to the extent we have already relied on the authorization and taken action.

In some situations, a signed authorization is required for uses and disclosures of you protected health information (PHI), including:

Most uses and disclosures of psychotherapy notes;
Most uses and disclosures for marketing purposes;
Disclosures that constitute the sale of PHI;
Uses and disclosures for certain research protocols;
Media or patient recognition activities;
As required by privacy law. Federal and state laws require special privacy protections for certain highly confidential information about you. The confidentiality of substance use disorder and mental health treatment records as well as HIV-related information maintained by us is specifically protected by state and/or federal law and regulations. Generally, we may not disclose such information unless you consent in writing, the disclosure is allowed by court order, or in other limited, regulated circumstances.
Your Health Information Rights

You have the following rights regarding your protected health information. To exercise any of the rights below, please contact the Tandigm Care Solutions Privacy Officer, 300 Four Falls Corporate Center, Suite 260, Conshohocken, Pennsylvania, 19428 or Privacy@Tandigm.com or 1-844-826-3446.

You have the right to:

Access to your Protected Health Information (PHI). Generally, you can access and inspect paper or electronic copies of certain PHI that we maintain about you. Requests to inspect or copy your health information must be in writing. A Tandigm Care Solutions representative can provide a form for you to use.

Amendments to your Protected Health Information (PHI). You can request amendments, or changes, to certain PHI that we maintain about you. Requests for changes must be made in writing. We may deny your request if we reasonably believe that the information is accurate and complete, if the information was not created by us, or if other special circumstances apply. If we decide to make an amendment, we may also notify others who have copies of the information about the change.

Accounting of Disclosures of Your Protected Health Information (PHI). In accordance with applicable law, you can ask for an accounting of certain disclosures made by us of your PHI. Requests for an accounting must be made in writing. This accounting specifically does not include disclosures made for purposes of treatment, payment, or health care operations or for certain other limited exceptions. An accounting will include disclosures made in the six (6) years prior to the date of a request.

Restrictions on Use and Disclosure of Your Protected Health Information (PHI). You can request restrictions on certain of our uses and disclosures of your PHI for treatment, payment, or health care operations. Requests for restrictions must be made in writing. We are not required to agree but will attempt to accommodate reasonable requests when appropriate.

Restrictions on Disclosures to Health Plans. You can request restrictions on certain of our uses and disclosures of your PHI to your health plan. 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 (not treatment) with your health insurer and we will agree to your request unless a law requires us to share that information. Requests for restrictions must be made in writing.

Confidential Communications. You can request that we communicate with you through alternative means or at alternative locations. We will accommodate reasonable requests. Requests for confidential communications must be made in writing.

Breach Notification. We are required to notify you in writing of any breach of your unsecured PHI without unreasonable delay and no later than sixty (60) days after we discover the breach.

Obtain Copy of Notice. You can ask for a paper copy of this Notice at any time, even if you have agreed to receive the notice electronically. This Notice is also available on at www.tandigmhealth.com.

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 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

Additional Information

Complaints. If you believe your privacy rights regarding your health information have been violated, you can file a complaint in writing with the Tandigm Care Solutions Privacy Officer, 300 Four Falls Corporate Center, Suite 260, Conshohocken, Pennsylvania, 19428 or Privacy@Tandigm.com or 1-844-826-3446.

You can also file a complaint with the Secretary of the U.S. Department of Health and Human Services in Washington, D.C.

You will not be retaliated against for filing a complaint. Filing a complaint will not affect the care that you receive or how you are treated by Tandigm Care Solutions.

Further Information. If you have any questions about this Notice, requests regarding privacy, or if you would like to request this notice in another language, please contact the Tandigm Care Solutions Privacy Officer, 300 Four Falls Corporate Center, Suite 260, Conshohocken, Pennsylvania, 19428 or Privacy@Tandigm.com or 1-844-826-3446.

This Notice of Privacy Practices is effective August 1, 2023.