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MED-CARE PHARMACY INC.
NOTICE OF PRIVACY PRACTICES

As Required by the Privacy Regulations
Promulgated Pursuant to the Health Insurance
Portability and Accountability Act of 1996 (HIPAA)
A. OUR COMMITMENT TO YOUR PRIVACY
Our Organization is dedicated to maintaining
the privacy of your identifiable health
information. In conducting our business, we
will create records regarding you and the
treatment and services we provide to you. We
are required by law to maintain the
confidentiality of health information that
identifies you. We also are required by law
to provide you with this notice of our legal
duties and privacy practices concerning your
identifiable health information By law, we
must follow the terms of the notice of
privacy practices that we have in effect at
the time.
To summarize this notice provides you with
the following important information
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How we may use and disclose your
identifiable health information
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Your privacy rights in your identifiable
health information
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Our obligations concerning the use and
disclosure of your' identifiable health
information
The terms of this notice apply to all
records containing your identifiable health
information that are created or retained by
our practice. We reserve the right to revise
or amend our notice of privacy practices.
Any revision or amendment to this notice
will be effective for all of your records
our organization has created or maintained
in the past and for any of your records we
may create or maintain in the future. Our
organization will post a copy of our current
notice in our offices in a prominent
location and yon may request a copy of our
most current notice at any time,
B. IF YOU HAVE QUESTIONS OR CORRESPONDENCE
IN REFERENCE TO THIS NOTICE. PLEASE
CONTACT:
MED-CARE PHARMACY INC.
ATTENTION: DEPT. OF PATIENT PRIVACY
3300 SW 15th St.
Deerfield Beach, FL 33442
C. WE MAY USE AND DISCLOSE YOUR HEALTH
INFORMIATION IN THE FOLLOWING WAYS:
The following categories describe the
different ways in which we may use and
disclose your identifiable health
information
1. Assistance. Our organization may use your
identifiable health information to assist
you For example, we may ask you to perform a
home respiratory treatment, and we may use
the results to help us reach a solution to
any problems you may be encountering. Many
of the people who work for Our organization
may use or disclose your identifiable health
information in order to assist you in
solving any problems Additionally, we may
disclose your identifiable health
information to others who may assist in your
care, such as your physician, therapists,
affiliate companies of MED-CARE PHARMACY
INC., spouse, children or parents
2. Payment. Our organization may use and
disclose your identifiable health
information in order to bill and collect
payment for the services and items you may
receive from you, for example, we may
contact your health insurer to certify that
you are eligible for benefits (and for what
range of benefits), and we may provide your
insurer with details regarding your
treatment to determine if your insurer will
cover, or pay for, your treatment. We also
may use and disclose Your identifiable
health information to obtain payment from
third parties that may be responsible for
such costs, such as family members Also, we
may use your identifiable health information
to bill you directly for services and items
3. Health Care Operations. Our organization
may use and disclose your identifiable
health information to operate our business.
As examples of the ways in which we may use
and disclose your information for our
Operations, Our organization may use your
health information to evaluate the quality
of care you received from us, or to conduct
cost-management and business planning
activities for our practice
4.Order Reminders. Our organization may use
and disclose your identifiable health
information to contact you and remind you of
orders/deliveries
5. Health-Related Benefits and Services. Our
organization may use and disclose your
identifiable health information to inform
you of health-related benefits or services
that may be of interest to you
6. Release of Information to Family/Friends.
Our organization may release your
identifiable health information to a friend
or family member that is helping you pay for
your health care, or who assists in taking
care of you
7. Disclosures Required By Law. Our
organization will use and disclose your
identifiable health information when we are
required to do so by federal, state or local
law.
D. USE AND DISCLOSURE OF YOUR IDENTIFIABLE
HEALTH INFORMATION IN CERTAIN SPECIAL
CIRCUMSTANCES:
The following categories describe unique
scenarios in which we may use or disclose
you identifiable health information:
1. Public Health Risks. Our organization may
disclose your identifiable health
information to public health authorities
that are authorized by law to collect
information for the purpose of:
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Maintaining vital records, such as
births and deaths
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Reporting child abuse or neglect
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Preventing or controlling disease,
injury or disability
-
Notifying a person regarding potential
exposure to a communicable disease
-
Notifying a person regarding a potential
risk for spreading or contracting a
disease or condition
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Reporting reactions to drugs or problems
with products or devices
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Notifying individuals if a product or
device they may be using has been
recalled
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Notify appropriate government
agency(ies) and authority(ies) regarding
the potential abuse or neglect of an
adult patient (including domestic
violence); however, we will only
disclose this information if the patient
agrees or we are required or authorized
by law to disclose this information
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Notifying your employer under limited
circumstances related primarily to
workplace injury or illness or medical
surveillance
2. Health Oversight Activities. Our
organization may disclose your identifiable
health information to a health oversight
agency for activities authorized by law
oversight activities can include, for
example, investigations inspection, audits
surveys, Licensure and disciplinary actions
civil, administrative and criminal
procedure, or actions or other activities
necessary for the government to monitor
government programs compliance with civil
rights law, and the health care system in
general.
3. Lawsuits and Similar Proceedings. Our
organization may use and disclose your
identifiable health information in response
to a court or administrative order. If you
are involved in a lawsuit or similar
proceeding we also may disclose you
identifiable health information in response
to a discovery request subpoena or other
lawful process by another party involved in
the dispute but only if we have made an
effort to inform you of the request or to
obtain an order protecting the information
the party has requested.
4. Law Enforcement. We may release
identifiable health information if asked to
do so by a law enforcement official
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Regarding a crime ,victim in certain
situations if we are unable to obtain
the person, agreement
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Concerning a death we believe might have
resulted from criminal conduct
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Regarding criminal conduct at our
offices
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In response to a warrant summons, court
order ,subpoena or similar legal process
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To identify/locate a suspect material
witness fugitive or missing person
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In an emergency to report a crime
(including the location of victim(s) of
the crime or the description identity or
location of the perpetrator)
5. Serious Threats to Health or Safety. Our
organization may use and disclose your
identifiable health information when
necessary to reduce or prevent a serious
threat to your health and safety, or the
health and safety of another individual or
the public. Under those circumstances, we
will only make disclosures to a person or
organization able to help prevent the
threat.
6. Military. Our organization may disclose
your identifiable health information if you
are a member of US or foreign military
forces (including, veterans) and if required
by an appropriate military command
authorities.
7. National Security. Our organization may
disclose your identifiab1e health
information to federal officials for
intelligence and national security
activities authorized by law. We also may
disclose, our identifiable health
information to federal officials in order to
protect the President other officials or
foreign heads of state or to conduct
investigations
8. Inmates. Our organization may disclose
your identifiable health information to
correctional institutions or law enforcement
officials if you are an inmate or under the
custody of a Law enforcement official
Disclosure for these purposes would be
necessary (a) for the institution to provide
heath care services to you (b) for the
satiety and Security of the institution
and/or (c) to protect your health and safety
or the health and safety of other
individuals
9. Workers' Compensation. Our organization
may release your identifiable health
information for workers compensation and
similar program
E. YOUR RIGHTS REGARDING YOUR IDENTIFIABLE
HEALTH INFORMATION:
You have the following rights regarding the
identifiable health information that we
maintain about you:
1. Confidential Communications. You have the
right to request that our organization
communicate with you about your health and
related issues ill a particular manner or
for a certain location, for instance you may
ask that we contact you at home rather than
work In order to request a type of
confidential communication y\,u must make a
written request, to MED-CARE PHARMACY INC.
DEPARTMENT OF PATIENT PRIVACY specifying the
requested method of contact or the location
where you wish to be contacted Our
organization will accommodate reasonable
requests You do not need to give a reason
for your request
2. Requesting Restrictions. You have the
right to request a restriction in our use or
disclosure of your identifiable health
information for treatment payment or health
care operations Additionally You have the
right to request that we limit our
disclosure of your identifiable health
information to individuals involved in your
care or the payment for your care, such as
family members and friends We are not
required to agree to your request however,
if we do agree we are bound by our agreement
except when otherwise required by law in
emergencies or when the information is
unnecessary to treat you. In order to
request a restriction in our use or
disclosure of your identifiable health
information you must make your request in
writing to MED-CARE PHARMACY INC. DEPARTMENT
OF PATIENT PRIVACY. Your request must
describe in a clear and concise fashion (a)
the information you wish restricted (b)
whether you are requesting to limit our
organizations use disclosure or both and (c)
to whom you want the limits to apply).
3. Inspection and Copies. You have the right
to inspect and obtain a copy of tile
identifiable health information that may be
used to make decisions about you including
patient medical records and billing records
but not including psychotherapy notes you
must submit your request in writing to
MED-CARE PHARMACY INC. DEPARTMENT OF PATIENT
PRIVACY in order to inspect and/or obtain a
copy of your identifiable health
information. Our organization may charge a
fee for the costs of coping mailing labor
and supplies associated with your request.
Our practice may deny your request to
inspect and/or copy. In certain limited
circumstances however you may request a
review of our denial review will be
conducted by another licensed health care
professional chosen by us.
4. Amendment You may ask us to amend your
health information if you believe it is
incorrect or incomplete and you may request
an amendment for a, long as the information
is kept by or for our organization To
request an amendment your request must be
made in writing and submitted to MED-CARE
PHARMACY INC. DEPARTMENT OF PATIENT PRIVACY.
You must provide us with a reason that
support, your request for amendment. Our
organization will deny your request if you
fail to submit your request (and the reason
supporting your request) in writing. Also,
we may deny your request if you ask us to
amend information that is (a) accurate and
complete (b) not part of the identifiable
health information kept by or for tile
organization (c) not part of the
identifiable health information which you
would be permitted to inspect and copy or
(d) not created by our organization unless
the individual or entity that created the
information is not available to amend the
information.
5. Accounting of Disclosures. All of our
patients have the right to request an
'accounting of disclosures'. An 'accounting
of disclosures' is a list of certain
disclosure, our organization has made of
your identifiable health information In
order to obtain an accounting of disclosures
you must submit your request in Writing to
MED-CARE PHARMACY INC. DEPARTMIENT OF
PATIENT PRIVACY. All requests for an
accounting of disclosures must state a time'
period which nay not be longer than six
years and nay not include dates before April
14, 2003 The first list you request within a
12 month period is free of charge, but our
organization may charge you for additional
lists within the same 12 month period. Our
organization will notify you of the costs
involved with additional requests, and you
may withdraw your request before you incur
any costs.
6. Right to a Paper Copy of This Notice. You
are entitled to receive a paper copy of our
notice of privacy practices. You may ask us
to give you a copy of this notice at any
time. To obtain a paper copy of this notice,
contact MED-CARE PHARMACY INC. DEPARTMENT OF
PATIENT PRIVACY: (800) 899-4852.
7. Right to File a Compliant. If you believe
your privacy rights have been violated. You
may file a complaint with our organization
or with the Secretary of the Department of
Health and Human Services To review a
complaint with our organization, contact
MED-CARE PHARMACY INC. DEPARTMENT OF PATIENT
PRIVACY. All complaints must be submitted in
writing. You will not be penalized for
filing a complaint.
8. Right to Provide an Authorization for
Other Uses and Disclosures. Our organization
will obtain your written authorization for
uses and disclosures that are not identified
by this notice or permitted by applicable
law. Any authorization you provide to us
regarding the use and disclosure of your
identifiable health information may be
revoked at any time in writing. After you
revoke your authorization, we will no longer
use or disclose your identifiable health
information for the reasons described in the
authorization Please note we are required to
retain records of your care. |