NOTICE OF PRIVACY PRACTICES

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED OR DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION.  PLEASE REVIEW IT CAREFULLY.

At CCS Medical, we are committed to using your health information responsibly and in compliance with the law. This Notice of Privacy Practices, which is required by federal, is intended to help you understand how we collect, use and disclose your health information.

WHO MUST ABIDE BY THE NOTICE
CCS Medical, Inc. and its related entities, their employees, staff and other personnel (collectively “CCS Medical”), including:

UNDERSTANDING YOUR PROTECTED HEALTH INFORMATION
Your health information includes information on your diagnosis, treatment, medical supplies needed, prescriptions and future plan of treatment.  These records are used to plan your care and to communicate with other healthcare providers about your care.
OUR LEGAL DUTIES

• We are required by law to maintain the privacy of your health information and to provide you a copy of this Notice.
• We are required to abide by the terms of this Notice until we adopt a new one.
• We are required to post our current Notice on our web site: www.ccsmed.com

YOUR RIGHTS
Although your health record is the physical property of CCS Medical, the information belongs to you. By law, you have the following rights:

• You have the right to access your health information in our medical records, subject to certain limitations.  Please make this request in writing to our Privacy Officer.  Your request must be signed and it should specifically list the information you want copied (i.e. “I want copies of my records from June 1, 2003 - October 31, 2003.”).  We may charge a fee for the cost of providing the records.
• You have the right to obtain an accounting of certain disclosures of your information.  This is a list of the times we have given your information to others after April 14, 2003 for purposes other than treatment, payment and healthcare operations or releases pursuant to a signed authorization.  Your request should be in writing and sent to the Privacy Officer.  We may charge a fee for providing more than the first list. The right to receive this information is subject to certain exceptions, restrictions and limitations.
• You have the right to ask us to communicate with you at a special address or by special means. We will not ask for an explanation.  We will agree to reasonable requests which are made request in writing to our Privacy Officer.
• You have the right to ask us, in writing, to restrict how we use or disclose your health information.  We will consider your request, but we are not required to agree to it.
• You have the right to ask us to amend your health information you believe is incorrect or incomplete.  You must make this request in writing to the Privacy Officer and explain the reason you believe the information is not correct or complete.  We may deny your request if we did not create the information, if it is not part of the records we use to make decisions about you, if it is not something you would be permitted to inspect or copy, or if it is complete and accurate.
• We may ask for your written authorization if we plan to use or disclose your health information for reasons not covered in this Notice.  If you authorize us to use or disclose your information, you have the right to revoke the authorization at any time, in writing, unless we have released information prior to receiving your revocation.  For more information about authorizations, please contact our Privacy Officer.
• We may ask for your written authorization if we plan to use or disclose your health information for reasons not covered in this Notice.  If you authorize us to use or disclose your information, you have the right to revoke the authorization at any time, in writing, unless we have released information prior to receiving your revocation.  For more in formation about authorizations, please contact our Privacy Officer.

WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION IN THE FOLLOWING WAYS
CCS Medical is required to inform you of how we may use your health information.  We may use your health information for a number of purposes, including treatment, payment and healthcare operations.  For each purpose, we have written a brief explanation.
Service and Treatment - As it pertains to CCS Medical, treatment means providing you with medications, supplies and durable medical equipment services as ordered by your physician.  Treatment also includes coordination and consultation with your physician and other healthcare providers.
Payment - We will use and disclose your information as necessary to obtain payment for the services and supplies we provide to you.
Friends and Family - We may disclose to a family member, other relative, close personal friend or any other person identified by you, the health information directly relevant to such person's involvement with your care or payment related to your health care.
Healthcare Operations - We may use or disclose your health information for activities that are needed to operate CCS Medical, such as compliance, quality assurance, business planning and management, certain marketing activities and general administrative activities.
Information to Patients - We may use your health information to provide you with information about treatment options or other health-related services.
Required by Law or Law Enforcement - We may disclose your health information to others as required by law.  This may include reporting information to government agencies that monitor the health care system.  This also includes providing information to locate a suspect, fugitive, missing person or in connection with suspected criminal activity. We may also disclose information in response to court orders, subpoenas or other lawful requests.
Public Health and Oversight - We may disclose health information to agencies authorized by law to conduct health oversight activities, including audits, investigations, licensing and similar activities.
To Report Abuse - We may disclose health information when the information relates to a victim of abuse, neglect or domestic violence.
Other Specialized Purposes - We may disclose your health information for a number of other specialized purposes.  We will only disclose as much information as is necessary for the purpose.  Under certain circumstances, we may disclose information to avert a serious threat or harm.
Business Associates - We may disclose health information to attorneys, accountants and other non-employees acting on behalf of CCS Medical.  These individuals or entities are called Business Associates and they are asked to sign written contracts agreeing to safeguard the confidentiality of your information.
CHANGES TO THIS NOTICE
Please be advised that CCS Medical reserves the right to change the terms of its Notice of Privacy Practices and to make those changes applicable to all health information maintained at that time.  Any new or revised Notices are available upon request or by visiting www.ccsmed.com.

FOR MORE INFORMATION, TO REPORT A PROBLEM, OR FILE A COMPLAINT
Please Contact:

CCS Medical
Attn: Privacy Officer
14255 49th St N, Suite 301
Clearwater, FL 33762
Toll Free (866) 885-9087

If you think your privacy has been violated, you may also file a complaint with the Secretary of the Department of Health and Human Services.
We will not retaliate against you for filing a complaint.

CCS Medical
Notice of Privacy Practices
Last revised 02/18/08