Effective Date: January 1, 2022
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND/OR DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
The terms of this Notice of Privacy Practices ("Notice") apply to Mission Med, LLC, and its employees (collectively "Mission Med," "we," "us"). Mission Med will use and disclose (share) certain health information of patients as necessary to carry out treatment, payment, and health care operations as permitted by law and for the purposes described below.
We are required by the Health Insurance Portability and Accountability Act ("HIPAA") to maintain the privacy of our patients' protected health information and to provide patients with notice of our legal duties and privacy practices with respect to protected health information (“PHI”). We are required by law to abide by the terms of this Notice for as long as it remains in effect. We reserve the right to change the terms of this Notice as necessary and to make a new Notice effective for all PHI collected by Mission Med. We are also required to inform you that there may be a provision of state law that relates to the privacy of your health information that may be stricter (or more protective of you) than a standard or requirement under HIPAA, and we will comply with the stricter (or more protective) standard. A copy of any revised Notice or information pertaining to a specific State law may be obtained by mailing a request to the HIPAA Privacy Officer, Mission Med, LLC, 7304 SW 45th St, Miami, Florida 33155.
The following categories describe different ways that we may use and disclose health information. For each category of uses or disclosures, we will explain what we mean and provide some examples. Not every use or disclosure in a category will be listed. However, all the ways we are permitted to use and disclose health information will fall within at least one of the categories.
For Treatment We may use your information to provide, coordinate, and manage your care and treatment. For example, Mission Med may share your health information with another health care provider for a consultation or a referral.
For Payment We may use and disclose medical information about your health to bill and collect payment directly, or through a billing service, from you, an insurance company, or another third party, for treatment and services provided to you by Mission Med. For example, we may need to give your health plan information about treatment you received by Mission Med so your health plan will pay us or reimburse you for the treatment. We may also tell your health plan about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment.
Health Care OperationsWe may use and disclose medical information about you for Mission Med health care operations. Health care operations include the use and disclosure of information that is necessary to run Mission Med and to make sure that all our patients receive quality care. For example, we may use medical information to:
o Review and improve the quality, efficiency and cost of our treatment and services,
Conduct business planning and business management,
Evaluate and improve the skills, qualifications and performance of our healthcare professionals providing care to you
Cooperate with outside organizations that assess the quality of care we provide and evaluate, certify, or license healthcare providers, and
Comply with this Notice and with applicable laws.
To Business AssociatesSome services are provided by or to Mission Med through contracts with business associates. Examples include Mission Med’s attorneys, management service company, consultants, collection agencies, and accreditation organizations. We may disclose information about you to our business associate so that they can perform the job we have contracted with them to do. To protect the information that is disclosed, each business associate is required to sign an agreement to appropriately safeguard the information and not to redisclose the information unless specifically permitted by law.
De-identified Health InformationWe may use your health information to create “de-identified” information that is not identifiable to any individual in accordance with HIPAA. We may also disclose your health information to a business associate for the purpose of creating de-identified information, regardless of whether we will use the de-identified information.
For certain circumstances, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
Individuals Involved in Your Care or Payment of Your CareMission Med may share health information with a family member, relative, friend, or individual identified by you, which is directly relevant to the involvement that person has in your care or for the payment of your care. We may, for example, provide limited medical information to allow a family member to pick up a prescription for you. Generally, we will get your written consent prior to making disclosures about you to family or friends. If you are able to make your own health care decisions, Mission Med will ask your permission before using your medical information for these purposes. If you are unable to make health care decisions, Mission Med will disclose relevant medical information to family members or other responsible people if we feel it is in your best interest to do so, including in an emergency. We will comply with additional state law confidentiality protections if you are a minor and receive treatment for pregnancy, drug and/or alcohol abuse, communicable disease, or mental health.
Disaster ReliefIn the event of a disaster, Mission Med may use or disclose Protected Health Information to a public or private entity authorized by law or by its charter to assist in disaster relief efforts for the purpose of notifying or assisting in the notification of (including identifying or locating) your family member, personal representative, or another person responsible for your care regarding your location, general condition, or death.
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 must meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
Please note that we do not create or manage a hospital directory.
There are a variety of circumstances in which your health information will be used and/or disclosed, without your prior consent or authorizations. These circumstances include the following:
• As Required by LawMission Med will disclose medical information about you when we are required to do so by federal, state, or local law
• To Avert a Serious Threat to Health or SafetyMission Med may use and disclose your health information when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent or reduce the threat.
• Health Oversight ActivitiesMission Med may disclose your health information to a federal or state health oversight agency for oversight activities authorized by law. These oversight activities include, for example, government audits, investigations, inspections, and licensure activities. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.
• Public Health RisksMission Med may disclose your health information to appropriate government authorities for public health activities. These activities generally include the following:
o Preventing or controlling disease, injury, or disability.
o Reporting births and deaths.
o Reporting child abuse or neglect, or abuse of a vulnerable adult.
o Reporting reactions to medications or problems with products.
o Notifying people of recalls of products they may be using.
o Notifying a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition.
o Reporting to the FDA as permitted or required by law, or
o Supporting public health surveillance and combat bioterrorism.
• Law EnforcementWe may release health information to a law enforcement official for certain law enforcement purposes. It may become necessary to disclose your Protected Health Information to a law enforcement official for law enforcement purposes, including:
o Compliance with a legal process (i.e., subpoena) or as required by law
o Information for identification and location purposes (e.g., suspect, or missing person)
o Information regarding a person who is or is a suspected crime victim
o In situations where the death of an individual may have resulted from criminal conduct
o In the event of a crime occurring on the premises of Mission Med
o An occurrence of a medical emergency not on Mission Med’s premises, where it appears that a crime has occurred.
However, if you request treatment and rehabilitation for drug dependence from us, your request will be treated as confidential, and we will not disclose your name to any law enforcement officer unless you consent.
• Lawsuits and DisputesIn the course of any judicial or administrative proceeding, we may disclose your health information in response to a court or administrative order, subpoena, discovery request, or other lawful process.
• Coroners, Medical Examiners and Funeral DirectorsWe may release health information to a coroner or medical examiner. This may be necessary to identify a deceased person or determine the cause of death. We may also release health information to funeral directors as necessary for them to carry out their duties.
• Organ and Tissue Donation: We may release health information to organizations that handle organ procurement or organ, eye, or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.
• Specialized Government FunctionsWe may disclose health information about you if it relates to military and veterans' activities, national security and intelligence activities, protective services for the President, and medical suitability determinations of the Department of State.
• Workers' Compensation: We may release your health information for workers' compensation or similar programs. These programs provide benefits for work-related injuries or illness.
• Inmates: If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release your health information to the correctional institution or law enforcement official. This release is required: (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; and (3) for the safety and security of the correctional institution.
• ResearchUnder certain circumstances permitted by Federal Law, Mission Med may use and disclose medical information about you for research purposes. This can be done either with your specific, written authorization or when the study has been reviewed for privacy protection by an Institutional Review Board or Privacy Board before the research begins. In some cases, researchers may be permitted to use information in a limited way to determine whether the study or the potential participants are appropriate. We will make a good faith effort to obtain your consent or refusal to participate in external research, as required by law, prior to releasing any identifiable information about you to external researchers.
We will not disclose or use your Protected Health Information in the situations listed below without first obtaining written authorization to do so. In addition to the uses and disclosures listed below, other uses not covered in this Notice will be made only with your written authorization. If you provide us with authorization, you may revoke it at any time by submitting a request in writing:
• Psychotherapy Notes Mission Med will not use or disclose psychotherapy notes without your written consent
• Marketing and Sale of Private Medical Information Mission Med will not use or disclose your private medical information for marketing purposes, nor will we sell your private medical information for marketing purposes without your written consent.
• As Required by Privacy Law The confidentiality the following types of information is specifically protected by state and/or federal law and regulations. Generally, Mission Med may not disclose such information unless you consent in writing, the disclosure is allowed by a court order, or in other limited, regulated circumstances:
o substance abuse treatment records
o certain psychotherapy notes
o HIV/AIDS testing or test results
o genetic information
o venereal disease information
o tuberculosis information
o confidential communication with a Licensed Social Worker
o certain information related to the treatment of a minor (e.g., when the minor seeks emancipated treatment for pregnancy or treatment related to the minor's child or a sexually transmitted disease)
• Contact With your prior written consent, Mission Med will contact you via call or text message, on the telephone number we have on file, to coordinate your care and provide appointment reminders. You can revoke this consent at any time by replying STOP to any text message, email support@missionmedus.com , or call (305) 748-2517 .
• Breach Notification : You will be notified in writing by Mission Med within sixty (60) days if we become aware of any violation of HIPAA privacy rules resulting in the acquisition, unauthorized access, or use or disclosure of your private medical information if that information is not protected by government approved security measures.
You have the following rights regarding the health information we maintain about you:
• Right to Inspect and Copy Protected Health InformationPursuant to your written request, you have the right to inspect and copy your Protected Health Information in paper or electronic format. Under federal law, you may not inspect or copy the following types of records: psychotherapy notes, information compiled as it relates to civil, criminal, or administrative action or proceeding; information restricted by law; information related to medical research in which you have agreed to participate; information obtained under a promise of confidentiality; and information whose disclosure may result in harm or injury to yourself or others. We have up to 30 days to provide the Protected Health Information and may charge a fee for the associated costs.
• Right to Amend : You have the right to request that Mission Med makes amendments to the Protected Health Information we have on file for you, if you believe that it is inaccurate or incomplete. Your request for an amendment must be submitted in writing and detail what information is inaccurate and why. Please note that a request for an amendment does not necessarily indicate the information will be amended. If we deny your request, we will provide you with a written denial within sixty (60) days stating the basis of the denial, your right to submit a written statement disagreeing with the denial, and a description of how you may file a complaint with us or the Secretary of the U.S. Department of Health and Human Services (“DHHS”). This denial will also include a notice that if you do not submit a statement of disagreement, you may request that we include your request for amendment and the denial with any future disclosures of your personal health information that is the subject of the requested amendment. Copies of all requests, denials, and statements of disagreement will be included in your designated record set. If we accept your request for amendment, we will make reasonable efforts to inform and provide the amendment within a reasonable time to persons identified by you as having received personal health information of yours prior to amendment and persons that we know have the personal health information that is the subject of the amendment and that may have relied, or could foreseeably rely, on such information to your detriment.
• Right to an Accounting of Disclosures You have the right to receive a list (accounting) of the times we have shared your health information for six (6) years prior to the date you ask, who we shared it with, and why. The request can be made for paper and/or electronic disclosures and will not include disclosures made for the purposes of (a) treatment, payment, and healthcare operations, (b) disclosures pursuant to your authorization, (C) disclosures to you, (d) for a facility directory or to persons involved in your care, (e) for national security or intelligence purposes, (f) to correctional institutions, and (g) with respect to disclosures occurring prior to 4/14/03. We will provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within twelve (12) months. We will inform you of the amount of the fee in advance and you can decide not to receive the additional accounting.
• Right to Request Restrictions You have a right to request that Mission Med restricts and/or limits the information we disclose to others, such as family members, friends, and individuals involved in your care or payment for your care. You also have the right to limit or restrict the information we use or disclose for treatment, payment, and/or health care operations. Your request must be submitted in writing and include the specific restriction requested, whom you want the restriction to apply, and why you would like to impose the restriction. Please note that Mission Med is not required to agree to your request for restriction, apart from a restriction requested to not disclose information to your health plan for care and services in which you have paid in full out-of-pocket.
• Right to Request Confidential Communications You have a right to request confidential communications from us by alternative means or at an alternative location. For example, you may designate we send mail only to an address specified by you which may or may not be your home address. You may indicate we should only call you on your work phone or specify which telephone numbers we are allowed or not allowed to leave messages on. You do not have to disclose the reason for your request; however, you must submit a request with specific instructions in writing. We will say “yes” to all reasonable requests.
• Right to Obtain an Electronic Copy of Medical Records You have the right to request an electronic copy of your medical record for yourself or to be sent to another individual or organization when your Protected Health Information is maintained in an electronic format. We will make all reasonable efforts to provide the records in the format you request; however, in the case that the information is not readily accessible or producible in the format you request, we will provide the record in a standard electronic format or a legible hard copy form. Record requests may be subject to a reasonable, cost-based fee for the work required in transmitting the electronic medical records.
• Right to a Summary of your Protected Health InformationYou have the right to request only a summary of your Protected Health Information if you do not desire to obtain a copy of your entire record. You also have the option to request an explanation of the information when you request your entire record.
• Right to Receive Notice of a Breach In the event of a breach of your unsecured Protected Health Information, you have the right to be notified of such breach.
• Right to a Paper Copy of This Notice: Even if you have agreed to receive an electronic copy of this Privacy Notice, you have the right to request we provide it in paper form. You may make such a request at any time. We will provide you with a paper copy promptly.
• Right to Choose Someone to Act for You : 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.
• Right to File a ComplaintIf you believe we have violated your rights, you can contact us using the contact information in this Notice. 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.
• 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. However, previously released information is not covered by this request.
• We will maintain your paper or electronic medical record for as long as required by applicable law.
For more information visit: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html
The effective date of this notice is January 1, 2022, and it has been updated effective June 1, 2023. We reserve the right to change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our website
If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Department of Health and Human Services. To file a complaint with Mission Med, or to ask a question about this Notice, contact:
Mission Med LLC
E-mail:support@missionmedus.com
Phone:(305) 748-2517
All complaints must be submitted in writing. You will not be penalized for filing a complaint.