Health Insurance Portability and Accountability Act of 1996 (HIPAA)/Notice of Privacy Practices:
Mobility Angels Corporation is required by the privacy regulations issued under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to maintain the privacy practices with respect to your individually identifiable health information. The Privacy Rule protects all “individually identifiable health information” held or transmitted by Mobility Angels Corporation or our business associate (also referred to as “we” in this document), in any form or media, whether electronic, paper, or oral. The Privacy Rule calls this information “protected health information (PHI).” The term ‘individually identifiable health information’ means any information, whether oral or recorded in any form or medium, that–is created or received by a health care provider, health plan, public health authority, employer, life insurer, school or university, or health care clearinghouse; and relates to the past, present, or future physical or mental health or condition of an individual, the provision of health care to an individual, or the past, present, or future payment for the provision of health care to an individual. For example, the medical and demographic information that we obtain from you and maintain that specifically identifies you (parent or legal guardian) and our candidate’s (your child’s) health status and demographic information.
How we may use or disclose individually identifiable health information WITHOUT your written authorization:
Mobility Angels Corporation or our business associate may disclose protected health information to the individual who is the subject of the information.
We may use and disclose your health information for the coordination or management of health care related services for a candidate by one or more health care providers, including consultation between providers regarding a candidate and referral of a candidate by one provider to another. We may use and disclose your health information for activities of a health plan to obtain eligibility and benefits, determine or fulfill responsibilities for coverage and provision of benefits.
We may use and disclose your health information for operations of our candidacy and eligibility process for a wheelchair accessible vehicle (WAV) or other service. These uses and disclosures are necessary to run our eligibility process and make sure that all of the candidate’s receive quality services and accommodations. We may use health information to review our services and to evaluate the performance of our staff and programs. We may also use and disclose your health information for legal services and insurance eligibility. We may also combine health information about many of our candidates to decide what additional services we should offer, what services are not needed, whether certain services are effective, or to compare how we are doing with others and to see where we can make improvements. We may remove information that identifies a candidate from this set of health information so others may use it to study service delivery without learning who our specific candidates are.
We may disclose your health information when required to do so by federal, state, or local law. We may also disclose your health information to a government oversight agency conducting audits, investigations, or civil and criminal proceedings. We may disclose your health information when to investigate or determine our compliance with federal regulation.
We may use and disclose health information about our clients when necessary to prevent a serious threat to their 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 the threat.
We may use and disclose your health information for public health activities. These activities generally include the following: to prevent or control disease, injury, or disability; to report births and deaths; to report child abuse or neglect; to notify the Food and Drug Administration if necessary to report adverse events, to report reactions to medications or problems with products; to participate in product recalls; to report communicable diseases or death; or for reporting abuse, neglect or domestic violence.
If you become enrolled or are a member of the armed forces or separated/discharged from military services, we may release health information required by military command authorities or the Department of Veterans Affairs as may be applicable. We may also release health information about foreign military personnel to the appropriate foreign military authorities We may use and disclose your health information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws. (A health oversight agency is as organization authorized by the government to oversee eligibility and compliance and to enforce civil rights laws).
We may release health information to a coroner or health examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release health information about recipients to funeral directors as necessary to carry out their duties.
We may release health information about our clients to authorized federal officials for intelligence, counterintelligence, and other national security activities authorizes by law. We may disclose your health information to authorized federal officials so they may provide protection to the President, other authorized persons, or foreign heads of state, or conduct special investigations.
If you are involved in a lawsuit or a dispute, we may disclose health information about you as a result of Judicial or Administrative proceedings, for example responding to a court order or subpoena.
We may release your health information if asked to do so by a law enforcement official. We may release your health information to comply with law enforcement situations, for example, to report certain types of wounds or other physical injuries; to identify or locate a suspect, fugitive, material witness, or missing person; in response to a court order subpoena, warrant, summons, or similar process; to report about the victim of a crime(if the victim agrees to disclosure or under certain limited circumstances, we are unable to obtain the person’s agreement); to report about a death we believe may be the result of criminal conduct; about criminal conduct at out facility; and in emergency circumstances to report a crime; the location of the crime or victims; or the identity, description, or location of the person who committed the crime.
If you (or your child) become an inmate of a correctional institution or are under the custody of a law enforcement official, we may release your health information about you to the correctional institution or law enforcement official. This release would be necessary (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) for the safety and security of the correctional institution.
How we may use or disclose individually identifiable health information YOU MAY OBJECT TO:
Our Site may use cookie and tracking technology depending on the features offered. Cookie and tracking technology are useful for gathering information such as browser type and operating system, tracking the number of visitors to our site, and understanding how visitors use our site. Cookies can help us customize our site for visitors. Personal information can NOT be collected via cookies and other tracking technology. However, if you previously provided personally identifiable information, cookies may be tied to such information. Aggregate cookies and tracking information may be shared with third parties.
Distribution of Information:
If you do not want us to use your identifiable health information for the following, please contact us at: 1-844-902-6435 or email at firstname.lastname@example.org (Please note that communication by unencrypted email presents a risk that personally identifiable information contained in such an email, may be intercepted by unauthorized third parties). We may use or disclose your health information for the following purposes, unless you ask us not to. For example:
- INFORMING FAMILY AND FRIENDS: We may disclose your health information to a family member, other relative, your close personal friend, or any other person you may identify who are involved in your care. In these circumstances, we would not disclose any medical information which is not directly relevant to that person’s involvement with you or your child’s care.
- ASSISTANCE IN DISASTER RELIEF EFFORTS: We may disclose limited health information to a public or private entity that is authorized to assist in disaster relief efforts in order for that entity to locate a family member or other persons that may be involved in some aspect of caring for you.
- CONFIRMING APPOINTMENT VISITS: We may disclose your health information to a family member, other relative, your close personal friend, or any other person you may identify in order to confirm our appointments.
- INFORMING YOU ABOUT TREATMENT ALTERNATIVES: We may disclose your health information to a family member, other relative, your close personal friend, or any other person you may identify in order to inform about treatment alternatives or other health-related benefits and services that may be of interest to you.
How we may use or disclose individually identifiable health information that REQUIRES YOUR WRITTEN AUTHORIZATION:
Your written authorization is required to use and disclose identifiable health information not covered by this notice or the law that applies to us. You may revoke that permission, in writing, at any time. If you revoke that permission, we will no longer use or disclose your health information for the reasons covered by your written authorization. Herein, we are unable to take back any disclosures we have already made with your permission and we are required to retain your health information in our records in reference to the services we provided. You must directly contact us for this authorization or change at 1-844-902-6435 or email at email@example.com (Please note that communication by unencrypted email presents a risk that personally identifiable information contained in such an email, may be intercepted by unauthorized third parties).
Health Information Privacy Rights
RIGHT TO INSPECT AND COPY: You have the right to inspect and copy your health information. Please send a written request at firstname.lastname@example.org. The preferred method of requests is via email to participate in our efforts to protect our environment and reduce costs. If you request a copy of the information, we will fulfill this request without cost to you by requesting and sending the information electronically via email to email address provided. Please note that communication by unencrypted email presents a risk that personally identifiable information contained in such an email, may be intercepted by unauthorized third parties. If you wish us to mail you documents, we will charge a $20.00 fee plus the costs of copying, mailing, or other supplies and services associated with your request. Cost per page is $1.00.
We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to health information, you may request that the denial be reviewed. We will internally review the request and denial. We will comply with the outcome of the review.
RIGHT TO AMEND: If you feel that your health information is incorrect or incomplete, you may ask us to correct the information. You have the right to request an amendment for as long as we keep the information. To request an amendment, your request must be made in writing to us via email at email@example.com, and you must provide a reason that supports your request for an amendment. Please note that communication by unencrypted email presents a risk that personally identifiable information contained in such an email, may be intercepted by unauthorized third parties.
We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information: that was not created by us, unless the person or entity that created the information is no longer available to make the amendment; that is not part of the health information kept by or for our organization; that is not part of the information which you would be permitted to inspect and copy; or that is accurate and complete.
Any amendment we make to your health information will be disclosed to those with whom we disclose information as previously specified.
RIGHT TO REQUEST AN ACCOUNTING OF DISCLOSURES OF YOUR HEALTH INFORMATION: You have the right to request who has seen your health information. We will make every attempt to honor your request. We are not required to provide and accounting for disclosures before April 21, 2021 or for more than 7 years prior to the date of your request. You must submit your request in writing to us.
The first list you request within a 12 month period will be free. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred. We will email you a list of disclosures within 60 days of your request, or notify you if we are unable to supply the list within that time period and by what date we can supply the list; but this date will not exceed a total of 90 days from the date you made the request.
RIGHT TO REQUEST RESTRICTIONS: You have the right to request a restriction or limitation on the health information we use or disclose about you including restricting who has access. You must notify us of your request for a restriction in writing. Your request must describe in detail the restriction you are requesting and to whom you want the limits to apply. You also have the right to terminate any agreed-to restriction by contacting us in writing.
We are not required to agree to your request for restrictions if it is not feasible for us to ensure our compliance or believe it will negatively impact the services we may provide you.
If you believe your privacy rights have been violated, you may file a complaint with us or with the United States Secretary of the Department of Health and Human Services.
Visit United States Secretary of the Department of Health and Human Services’ website to download the Health Information Privacy Complaint Form Package at https://www.hhs.gov/hipaa/filing-a-complaint/complaint-process/index.html Then, either Print and Mail OR Print and Email the completed complaint and consent forms to:
Centralized Case Management Operations U.S. Department of Health and Human Services 200 Independence Avenue, S.W. Room 509F HHH Bldg. Washington, D.C. 20201
OCRComplaint@hhs.gov (Please note that communication by unencrypted email presents a risk that personally identifiable information contained in such an email, may be intercepted by unauthorized third parties.)
You may file your complaint with our company by contacting LOURDES M. PALMER, Co-President/Founder of Mobility Angels Corporation at:
Mobility Angels Corporation Phone: 1-844-902-6435 Email: firstname.lastname@example.org
Mobility Angels Corporation Phone: 1-844-902-6435 Email: email@example.com
Please note that communication by unencrypted email presents a risk that personally identifiable information contained in such an email, may be intercepted by unauthorized third parties.