Privacy Practices
Effective: April 13, 2003

Privacy Notice

Life Supply Corp (LSC) is committed to preserving the privacy of your personal health information. This notice describes our policies and how we treat the information we receive regarding recipients of our services. It also describes how medical information about you may be used and disclosed and how you can access this information.

How we collect Information

LSC may obtain information from our recipients, their family members, social workers, physicians, hospitals, skilled nursing facilities and insurance companies.

How we use Health Information

For Treatment We may use and disclose health information about you so that we are able to provide you with the appropriate equipment and/or services requested by you or on your behalf. We may disclose health information about you to doctors, therapists, office staff and other personnel who are involved in taking care of you and your health.

For Payment We may use and disclose health information about you so that the payment may be collected from you, Medicaid, Medicare, an insurance company or a third party.

For Health Care Organizations We may use and disclose health information about you in order to run the office and make sure that you and our other recipients receive quality care.

To Avert a Serious Threat to Health or Safety We may use and disclose health information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. We may use and disclose health information about you for public health reasons in order to prevent or control disease.

Required By Law We may use and disclose health information about you when required to do so by federal, state or local law.

Health oversight Activities We may use and disclose health information about you to a health oversight agency for audits, investigations, inspections or licensing purposes.

You’re Rights Regarding Health Information About You

You have the following rights regarding health information we maintain about you.

Right to Inspect and Copy You have the right to inspect and copy your health information, such as medical and billing records that LSC maintains regarding you. You must submit a written request to our office in order to inspect and/or copy your health information. If you request a copy of the information, LSC may charge a fee for the cost of the copying, mailing or other associated supplies. We may deny your request to inspect and/or copy your health information in certain limited circumstances. If you are denied access, you may ask that the denial be reviewed. If law requires such a review, we will select a licensed health care professional to review your request and our denial. The person conducting the review will not be the person who denied you request, and we will comply with the outcome of the review.

Right to Amend If you believe hat health information we have about you is incorrect or incomplete; you may ask us to amen the information. You have the right to request an amendment for the duration of time that this office keeps the information. To request an amendment, you must compete and submit a Medical Record Amendment/Correction Form to our office, we may deny your request if it is not in writing and does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that we did not create, is not part of the health information we keep, you would not by law be permitted to inspect or copy, and if the information is accurate and complete.

Right to an Accounting of Disclosures you have the right to an “Accounting of Disclosures”. This is a list of disclosures LSC made of your health information for purposes other than treatment, payment and health care operations, the request must be submitted in writing to our office. It must state a time period, which may not be longer than six years and may not include dates before April 14, 2003. LSC may charge a fee for the cost of the copying, mailing or other associated supplies.

Right to Request Restrictions You have the right to request a restriction or limitation on the health information we use or disclose about you for treatment, payment or health care operations.  The request must be submitted in writing to our office. We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you with emergency treatment.

Right to Request Confidential Communications You have the right to request that we communicate with you regarding medical matters in a certain way. The request must be submitted in writing to our office. LSC will not ask you the reason for your request and will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.

Right to a Paper Copy of this Notice You have the right to a paper copy of this notice at any time. To obtain a copy you may contact our office.
Changes to this Notice LSC reserves the right to change this notice and to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future. We will post a copy of the current notice in our office with its effective date in the top right hand corner.

Complaints If you believe that your privacy rights have been violated, you may file a complaint with our office at the address provided or with the Secretary of The Department of Health and Human Services.