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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.

 

MAIL-MEDS CLINICAL PHARMACY

 

 

NOTICE OF PRIVACY PRACTICES

JTJ MEDICAL SUPPLY, INC  Doing Business As MAIL-MEDS CLINICAL PHARMACY AND BLISS RX

NOTICE OF PRIVACY PRACTICES

 

 

 

As part of the federal Health Insurance Portability and Accountability Act of 1996, known as HIPAA, JTJ Medical Supply, Inc. has created this Notice of Privacy Practices (Notice). This Notice describes JTJ Medical Supply, Inc.’s privacy practices and the rights you, the individual, have as they relate to the privacy of your Protected Health Information (PHI). Your PHI is information about you, or that could be used to identify you, as it relates to your past and present physical and mental health care services. The HIPAA regulations require that JTJ Medical Supply, Inc. protect the privacy of your PHI that JTJ Medical Supply, Inc. has received or created.

 

JTJ Medical Supply, Inc. will abide by the terms presented within this Notice. For any uses or disclosures that are not listed below, JTJ Medical Supply, Inc. will obtain a written authorization from you for that use or disclosure, which you will have the right to revoke at any time, as explained in more detail below. Individually identifiable health information is used only for the purposes necessary for conducting the business of JTJ Medical Supply, Inc., including evaluation activities. JTJ Medical Supply, Inc. reserves the right to change JTJ Medical Supply, Inc.’s privacy practices and this Notice.

 

 

 

 

 

 

HOW MAIL-MEDS CLINICAL PHARMACY MAY USE AND DISCLOSE YOUR PHI

 

The following is an accounting of the ways that JTJ Medical Supply, Inc. is permitted, by law, to use and disclose your PHI.

 

  • Uses and disclosures of PHI for Treatment: We will use the PHI that we receive from you to fill your prescription and coordinate or manage your health care.
  • Uses and disclosures of PHI for Payment: JTJ Medical Supply, Inc. will disclose your PHI to obtain payment or reimbursement from insurers for your health care services.
  • Uses and disclosures of PHI for Health Care Operations: JTJ Medical Supply, Inc. may use the minimum necessary amount of your PHI to conduct quality assessments, improvement activities, and evaluate JTJ Medical Supply, Inc. workforce.

 

The following is an accounting of additional ways in which JTJ Medical Supply, Inc. is permitted or required to use or disclose PHI about you without your written authorization.

 

  • Uses and disclosures as required by law: JTJ Medical Supply, Inc. is required to use or disclose PHI about you as required and as limited by law.
  • Uses and disclosure for Public Health Activities: JTJ Medical Supply, Inc. may use or disclose PHI about you to a public health authority that is authorized by law to collect for the purpose of preventing or controlling disease, injury, or disability. This includes the FDA so that it may monitor any adverse effects of drugs, foods, nutritional supplements and other products as required by law.
  • Uses and disclosure about victims of abuse, neglect or domestic violence: JTJ Medical Supply, Inc. may use or disclose PHI about you to a government authority if it is reasonably believed you are a victim of abuse, neglect or domestic violence.
  • Uses and disclosures for health oversight activities: JTJ Medical Supply, Inc. may use or disclose PHI about you to a health oversight agency for oversight activities which may include audits, investigations, inspections as necessary for licensure, compliance with civil laws, or other activities the health oversight agency is authorized by law to conduct.
  • Disclosures for judicial and administrative proceedings: JTJ Medical Supply, Inc. may disclose PHI about you in the course of any judicial or administrative proceedings, provided that proper documentation is presented to JTJ Medical Supply, Inc.
  • Disclosures for law enforcement purposes: JTJ Medical Supply, Inc. may disclose PHI about you to law enforcement officials for authorized purposes as required by law or in response to a court order or subpoena.
  • Uses and disclosures about the deceased: JTJ Medical Supply, Inc. may disclose PHI about a deceased, or prior to, and in reasonable anticipation of an individual’s death, to coroners, medical examiners, and funeral directors.
  • Uses and disclosures for cadaveric organ, eye or tissue donation purposes: JTJ Medical Supply, Inc. may use and disclose PHI for the purpose of procurement, banking, or transplantation of cadaveric organs, eyes, or tissues for donation purposes.
  • Uses and disclosures for research purposes: JTJ Medical Supply, Inc. may use and disclose PHI about you for research purposes with a valid waiver of authorization approved by an institutional review board or a privacy board. Otherwise, JTJ Medical Supply, Inc. will request a signed authorization by the individual for all other research purposes.
  • Uses and disclosures to avert a serious threat to health or safety: JTJ Medical Supply, Inc. may use or disclose PHI about you, if it believed in good faith, and is consistent with any applicable law and standards of ethical conduct, to avert a serious threat to health or safety.
  • Uses and disclosures for specialized government functions: JTJ Medical Supply, Inc. may use or disclose PHI about you for specialized government functions including; military and veteran’s activities, national security and intelligence, protective services, department of state functions, and correctional institutions and law enforcement custodial situations.
  • Disclosure for workers’ compensation: JTJ Medical Supply, Inc. may disclose PHI about you as authorized by and to the extent necessary to comply with workers’ compensation laws or programs established by law.
  • Disclosures for disaster relief purposes: JTJ Medical Supply, Inc. may disclose PHI about you as authorized by law to a public or private entity to assist in disaster relief efforts.
  • Disclosures to business associates: JTJ Medical Supply, Inc. may disclose PHI about you to JTJ Medical Supply, Inc.’s business associates for services that they may provide to or for JTJ Medical Supply, Inc. to assist JTJ Medical Supply, Inc. to provide quality health care. To ensure the privacy of your PHI, we require all business associates to apply appropriate safeguards to any PHI they receive or create.

 

 

 

 

 

OTHER USES AND DISCLOSURES

 

JTJ Medical Supply, Inc. may contact you for the following purposes:

 

  • Information about treatment alternatives: JTJ Medical Supply, Inc. may contact you to notify you of alternative treatments and/or products.
  • Health related benefits or services: JTJ Medical Supply, Inc. may use your PHI to notify you of benefits and services JTJ Medical Supply, Inc. provides.
  • Fundraising: If JTJ Medical Supply, Inc. participates in a fundraising activity, JTJ Medical Supply, Inc. may use demographic PHI to send you a fundraising packet, or JTJ Medical Supply, Inc. may disclose demographic PHI about you to its business associate or an institutionally related foundation to send you a fundraising packet. No further disclosure will be allowed by the business associates or an institutionally related foundation without your written authorization.

 

 

 

 

 

 

 

FOR ALL OTHER USES AND DISCLOSURES

JTJ Medical Supply, Inc. will obtain a written authorization from you for all other uses and disclosures of PHI, and JTJ Medical Supply, Inc. will only use or disclose pursuant to such an authorization. In addition, you may revoke such an authorization in writing at any time. To revoke a previously authorized use or disclosure, please contact our Privacy Officer to obtain a Request for Restriction of Uses and Disclosures.

 

 

 

 

 

YOUR HEALTH INFORMATION RIGHTS

 

The following are a list of your rights in respect to your PHI.  Please contact the our Privacy Officer for more information about the below.

 

The Right to request restrictions on certain uses and disclosures of your PHI: You have the right to request additional restrictions of JTJ Medical Supply, Inc.’s uses and disclosures of your PHI; however, we are not required to agree to your request, and we may say “no” if it would affect your care. The right to choose to pay for a prescription or service in full out of pocket and restrict disclosure of PHI to a health plan for payment. We will say “yes” unless the law requires us to share the information.

 

The right to have your PHI communicated to you by alternate means or locations: You have the right to request that JTJ Medical Supply, Inc. communicate confidentially with you using an address or phone number other than your residence. However, state and federal laws require JTJ Medical Supply, Inc. to have an accurate address and home phone number in case of emergencies. JTJ Medical Supply, Inc. will consider all reasonable requests.

 

The right to inspect and/or obtain a copy your PHI: You have the right to request access and/or obtain a copy of your PHI that is contained in JTJ Medical Supply, Inc. for the duration JTJ Medical Supply, Inc. maintains PHI about you. There may be a reasonable cost-based charge for photocopying documents. You will be notified in advance of incurring such charges, if any.

 

The right to amend your PHI: You have the right to request an amendment of the PHI JTJ Medical Supply, Inc. maintains about you, if you feel that the PHI JTJ Medical Supply, Inc. has maintained about you is incorrect or otherwise incomplete. Under certain circumstances we may deny your request for amendment. If we do deny the request, you will have the right to have the denial reviewed by someone we designate who was not involved in the initial review. You may also ask the Secretary, United States Department of Health and Human Services (“HHS”), or their appropriate designee, to review such a denial.

 

The right to receive an accounting of disclosures of your PHI: You have the right to receive an accounting of certain disclosures of your PHI made by JTJ Medical Supply, Inc.

 

The right to receive additional copies of JTJ Medical Supply, Inc.’s Notice of Privacy Practices: You have the right to receive additional paper copies of this Notice, upon request, even if you initially agreed to receive the Notice electronically.

 

 

 

 

 

 

 

FLORIDA STATE SPECIFIC PROVISIONS

Disclosure – Pharmacy Records

We will not disclose your pharmacy records without your written authorization, except to:

        a. you;

        b. your legal representative;

        c. the Department of Health pursuant to existing law;

        d. in the event that you are incapacitated or unable to request your records yourself;

        e. in any civil or criminal proceeding, upon the issuance of a subpoena from a court of competent jurisdiction and proper

        notice to you or your legal representative, by the party seeking the records, and

        f. as otherwise authorized by state law.

 

 

 

 

 

 

CONTACT INFORMATION

If you have any questions on JTJ Medical Supply, Inc.’s privacy practices or for clarification on anything contained within the Notice, please contact:

 

JTJ Medical Supply, Inc

DBA Mail-Meds Clinical Pharmacy and Bliss Rx

ATT: Privacy Officer

2692 Oak Ridge Court

Fort Myers, FL 33901

(800) 939-2022

 

 

REVISIONS TO THE NOTICE OF PRIVACY PRACTICES

 

JTJ Medical Supply, Inc. reserves the right to change and/or revise this Notice and make the new revised version applicable to all PHI received prior to its effective date. JTJ Medical Supply, Inc. will also post the revised version of the Notice in JTJ Medical Supply, Inc.

 

 

 

 

 

COMPLAINTS

 

If you believe your privacy rights have been violated, you may file a complaint with JTJ Medical Supply, Inc. and/or to the Secretary of HHS, or his designee. If you wish to file a complaint with JTJ Medical Supply, Inc., please contact our Privacy Officer, Privacy Officer. If you wish to file a complaint with the Secretary, please write to:

 



 

 

 

 

 

 

Region IV ‐ Atlanta

(Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee)

Roosevelt Freeman, Regional Manager

Office for Civil Rights

U.S. Department of Health and Human Services

Sam Nunn Atlanta Federal Center, Suite 16T70

61 Forsyth Street, S.W.

Atlanta, GA 30303‐8909

Voice Phone (800) 368‐1019

FAX (404) 562‐7881

TDD (800) 537‐7697

JTJ Medical Supply, Inc. will not take any adverse action against you as a result of your filing of a complaint.

 

 

 

 

 

 

Effective 07/12/2013

Revised 03/04/2014

Revised 09/20/2016

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