Healthy MD, Inc. Privacy Practices

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. 

I. WHO WE ARE

This Notice of Privacy Practices (“Notice”) describes the privacy practices of Healthy MD, Inc. and its affiliates, including certain affiliated professional entities, their physicians, pharmacists,  other health care practitioners, and other personnel (“we” or “us”). 

II. OUR PRIVACY OBLIGATIONS

We are required by law to maintain the privacy of your health information (“Protected Health  Information” or “PHI”) and to provide you with this Notice of our legal duties and privacy  practices with respect to your PHI. We are also obligated to notify you following a Breach of  unsecured PHI. When we use or disclose your PHI, we are required to abide by the terms of this  Notice (or other notice in effect at the time of the use or disclosure). 

III. PERMISSIBLE USES AND DISCLOSURES WITHOUT YOUR WRITTEN AUTHORIZATION

In certain situations, which we describe in Section IV below, we must obtain your written  authorization in order to use and/or disclose your PHI. However, we do not need any type of  authorization from you for the following uses and disclosures: 

  1. Uses and Disclosures For Treatment, Payment and Health Care Operations. We may use and  disclose PHI, but not your “Highly Confidential Information” (defined in Section IV.B below),  in order to treat you, obtain payment for services provided to you and conduct our “Health Care  

Operations” as detailed below: Treatment. We may use and disclose your PHI to provide  treatment, for example, to diagnose and treat your injury or illness. We may also disclose PHI to  other health care providers involved in your treatment. 

Payment. In most cases, we may use and disclose your PHI to obtain payment for services that  we provide to you. For example, we may disclosure your PHI to claim and obtain payment from  your insurance plan, or other company that arranges or pays the cost of some or all of your health  care (“Your Payor”). 

Health Care Operations. We may use and disclose your PHI for our health care operations, which  include internal administration and planning and various activities that improve the quality and  cost effectiveness of the care that we deliver to you. For example, we may use PHI to evaluate 

the quality and competence of our physicians and other health care practitioners. We may  disclose PHI in order to resolve any complaints you may have. 

We may also disclose PHI to your other health care providers when such PHI is required for  them to treat you, receive payment for services they render to you, or conduct certain health care  operations, such as quality assessment and improvement activities, reviewing the quality and  competence of health care professionals, or for health care fraud and abuse detection or  compliance. 

  1. Disclosure to Relatives, Close Friends and Other Caregivers. We may use or disclose your  PHI to a family member, other relative, a close personal friend or any other person identified by  you when you are present for, or otherwise available prior to, the disclosure, if we
    (1) obtain  your agreement;
    (2) provide you with the opportunity to object to the disclosure and you do not  object; or
    (3) reasonably infer that you do not object to the disclosure. 

If you are not present, or the opportunity to agree or object to a use or disclosure cannot  practicably be provided because of your incapacity or an emergency circumstance, we may  exercise our professional judgment to determine whether a disclosure is in your best interests. If  we disclose information to a family member, other relative or a close personal friend, we would  disclose only information that we believe is directly relevant to the person’s involvement with  your health care or payment related to your health care. We may also disclose your PHI in order  to notify (or assist in notifying) such persons of your location, general condition, or death. 

  1. Public Health Activities. We may disclose your PHI for the following public health activities:
    (1) to report health information to public health authorities for the purpose of preventing or  controlling disease, injury or disability;
    (2) to report child abuse and neglect to public health  authorities or other government authorities authorized by law to receive such reports;
    (3) to  report information about products and services under the jurisdiction of the U.S. Food and Drug  Administration;
    (4) to alert a person who may have been exposed to a communicable disease or  may otherwise be at risk of contracting or spreading a disease or condition; and
    (5) to report  information to your employer as required under laws addressing work-related illnesses and  injuries or workplace medical surveillance.

     

  2. Victims of Abuse, Neglect or Domestic Violence. If we reasonably believe you are a victim  of abuse, neglect or domestic violence, we may disclose your PHI to a governmental authority,  including a social service or protective services agency, authorized by law to receive reports of  such abuse, neglect, or domestic violence.

     

  3. Health Oversight Activities. We may disclose your PHI to a health oversight agency that  oversees the health care system and is charged with responsibility for ensuring compliance with  the rules of government health programs, such as Medicare or Medicaid.

     

  4. Judicial and Administrative Proceedings. We may disclose your PHI in the course of a judicial  or administrative proceeding in response to a legal order or other lawful process.

     

  5. Law Enforcement Officers. We may disclose your PHI to the police or other law enforcement officials as required or permitted by law or in compliance with a court order or a grand jury or  administrative subpoena.
  6. Decedents. We may disclose your PHI to a coroner, medical examiner, or funeral director as  authorized by law.

     

  7. Research. We may use or disclose your PHI without your consent or authorization if an  Institutional Review Board or Privacy Board approves a waiver of authorization for disclosure.

     

  8. Health or Safety. We may use or disclose your PHI to prevent or lessen a serious and imminent  threat to a person’s or the public’s health or safety.

     

  9. Specialized Government Functions. We may use and disclose your PHI to units of the  government with special functions, such as the U.S. military or the U.S. Department of State  under certain circumstances.

     

  10. Workers’ Compensation. We may disclose your PHI as authorized by and to the extent  necessary to comply with state law relating to workers’ compensation or other similar programs.

     

  11. M. As Required By Law. We may use and disclose your PHI when required to do so by any  other law not already referred to in the preceding categories.

IV. Uses and Disclosures Requiring Your Written Authorization

  1. Use or Disclosure with Your Authorization. We must obtain your written authorization for most uses and disclosures of psychotherapy notes, uses and disclosures of PHI for marketing  purposes, and disclosures that constitute the sale of PHI. Additionally, other uses and disclosures  of PHI not described in this Notice will be made only when you give us your written permission  on an authorization form (“Your Authorization”). For instance, you will need to complete and  sign an authorization form before we can send your PHI to your life insurance company or to the  attorney representing the other party in a lawsuit in which you are involved.

     

  2. Uses and Disclosures of Your Highly Confidential Information. Federal and state law requires  special privacy protections for certain highly confidential information about you (“Highly  Confidential Information”). This Highly Confidential Information may include the subset of your  PHI that:
    (1) is maintained in psychotherapy notes;
    (2) is about mental health and developmental  disabilities services;
    (3) is about alcohol and drug abuse prevention, treatment and referral;
    (4) is  about HIV/AIDS testing, diagnosis or treatment;
    (5) is about sexually-transmitted disease(s);
    (6)  is about genetic testing;
    (7) is about child abuse and neglect;
    (7) is about domestic abuse of an  adult with a disability; or
    (8) is about sexual assault. In order for us to disclose your Highly  Confidential Information for a purpose other than those permitted by law, we must have Your  Authorization.

     

  3. Revocation of Your Authorization. You may withdraw (revoke) your Authorization, or any written authorization regarding your Highly Confidential Information (except to the extent that  we have taken action in reliance upon it) by delivering a written statement to the Privacy Officer  identified below. A form of written revocation is available upon request from the Privacy  Officer.

V. Your Rights Regarding Your Protected Health Information

    1. For Further Information; Complaints. If you would like more information about your privacy  rights, if you are concerned that we have violated your privacy rights, or if you disagree with a  decision that we made about access to your PHI, you may contact our Privacy Officer. Also, you  may make a complaint by calling our hotline at 1-844-584-3258. You may also file written  complaints with the Director, Office for Civil Rights of the U.S. Department of Health and  Human Services. Upon request, the Privacy Officer will provide you with the correct address for  the Director. We will not retaliate against you if you file a complaint with us or the Director.

    2. Right to Request Additional Restrictions. You have the right to request a restriction on the  uses and disclosures of your PHI (1) for treatment, payment and health care operations purposes,  and (2) to individuals (such as a family member, other relative, close personal friend or any other  person identified by you) involved in your care or with payment related to your care. For  example, you have the right to request that we not disclose your PHI to a health plan for payment  or health care operations purposes, if that PHI pertains solely to a health care item or service for  which we have been involved and which has been paid out of pocket in full. Unless otherwise  required by law, we are required to comply with your request for this type of restriction. For all  other requests for restrictions on use and disclosures of your PHI, we are not required to agree to  your request, but will attempt to accommodate reasonable requests when appropriate. If you wish  to request additional restrictions, please obtain a request form from our Privacy Officer and  submit the completed form to the Privacy Officer. We will send you a written response.

    3. Right to Receive Confidential Communications. You may request, and we will accommodate,  any reasonable written request for you to receive your PHI by alternative means of  communication or at alternative locations.

    4. Right to Inspect and Copy Your Health Information. You may request access to your medical  record file and billing records maintained by us in order to inspect and request copies of the  records. Under limited circumstances, we may deny you access to a portion of your records. If  you would like to access your records, please obtain a Record Request Form from the Privacy  Officer and submit the completed form to the Privacy Officer. If you request copies, we will  charge you a cost-based fee, consistent with California law, that includes
      (1) labor for copying  the PHI;
      (2) supplies for creating the paper copy or electronic media if you request an electronic  copy on portable media;
      (3) our postage costs, if you request that we mail the copies to you; and
      (4) if you agree in advance, the cost of preparing an explanation or summary of the PHI.

    5. Right to Request to Amend Your Records. You have the right to request that we amend PHI  maintained in your medical record file or billing records. If you desire to amend your records, please obtain an Amendment Request Form from the Privacy Officer and submit the completed  form to the Privacy Officer. We will comply with your request unless we believe that the  information that would be amended is accurate and complete or other special circumstances  apply.
    6. Right to Receive An Accounting of Disclosures. Upon request, you may obtain an accounting  of certain disclosures of your PHI made by us during any period of time prior to the date of your  request provided such period does not exceed six years. If you request an accounting more than  once during a twelve (12) month period, we will charge you a reasonable fee for additional  accountings of disclosure, and will inform you in advance of any fee to provide you with an  opportunity to withdraw or modify the request.

    7. Right to Receive A Copy of this Notice. Upon request, you may obtain a copy of this Notice,  either by email or in paper format. Please submit your request to: 

Privacy Officer
3800 Inverrary Blvd, Suite 109
Fort Lauderdale, FL 33319

VI. Effective Date and Duration of This

Notice

  1. Effective Date. This Notice is effective on June 9, 2022. 

  2. Right to Change Terms of this Notice. We may change the terms of this Notice at any time. If  we change this Notice, we may make the new notice terms effective for all Protected Health  Information that we maintain, including any information created or received prior to issuing the  new notice. If we change this Notice, we will post the new notice on our website at  www.nurx.com/privacy-practices. You also may obtain any new notice by contacting the Privacy  Officer. 

VII. Privacy Officer

You may contact the Privacy Officer at: 

Privacy Officer 
3800 Inverrary Blvd, Suite 109
Fort Lauderdale, FL 33319