I. Overview of Policies
- Our policies regarding use and disclosure of your PHI
- Your privacy rights and other rights with respect to your PHI
The latter includes your right to file complaints with USPM or with the Secretary of the United States Department of Health and Human Services (the “Secretary”).
2. Frequently Asked Questions on Privacy
The specifics of our use of personal information are best described in the answers to the following frequently asked questions and USPM’s answers.
A. DOES THE PREVENTIVE PLAN ASK FOR PERSONAL INFORMATION FROM PARTICIPANTS?
Yes, we ask for your name, email address, date of birth, and other limited information when you sign up as a participant.
B. HOW DO YOU USE MY PERSONAL INFORMATION?
C. WILL USPM DISCLOSE MY INFORMATION TO THIRD PARTIES?
Information submitted by you online (such as information about your activities, program enrollment, name, address) may be used by USPM to design new activities, information sets, quality review and process improvements, and for assisting you in defining your health goals, your activities to meet those goals, and to improve your experience with the program. Limited information may be shared with third parties under protection of confidentiality agreements to fulfill rewards earned as part of the program, or for program evaluation and/or research purposes. USPM will not, except as may be required by law, share with any other party your password or payment information.
Other circumstances where limited personal information may be disclosed are specifically described when the data is collected, or in the rules of sweepstakes or other promotions.
We do reserve the right to disclose de-identified, aggregated user statistics, such as “45 percent of our participants are interested in lowering their blood pressure” to describe our services to prospective partners, advertisers, and other third parties. Reports, statistics, and other analyses of aggregate de-identified information may be shared within the organization or provided to third parties at the sole discretion of USPM.
Under the protection of confidentiality agreements, we use third parties in some cases to help us provide services and manage our websites and relationships with you. These may include database management and information technology services, credit card processing, removing duplicate information from lists, and providing other customer services. Third-party processors and providers will be given access only to the information needed to perform their support functions, and they are regulated and bound by the same confidentiality and legal requirements as USPM.
Exception: The Preventive Plan program and USPM reserve the right to use all information at its disposal and to share this information with internet service providers (ISPs) and other third parties as necessary to investigate any incident of misuse or abuse of its site, server, or information systems.
D. WILL MY EMPLOYER OR REFERRING ORGANIZATION SEE THE INFORMATION I ENTER IN THIS SYSTEM?
No. All PHI is kept private and safe. USPM is required by law to keep your information private and takes this responsibility very seriously. We meet or exceed all federal and state health care privacy laws.
E. WHAT ABOUT PURCHASES FROM USPM PARTNERS OR OTHER LINKED WEBSITES?
If you navigate away from USPM’s website or its mobile or web products to visit the website of any third party, you may be asked for your credit card or other personal information to purchase or use products and services offered. These companies have their own privacy and data collection practices. We have no responsibility or liability for these independent policies. You should, therefore, review their privacy policies carefully if you have concerns about how your information may be used.
F. WILL YOU USE MY INFORMATION FOR DIRECT MAILINGS?
From time to time, we will send electronic mail or other mail to you, for the purpose of informing you of changes or additions to The Preventive Plan program or to the USPM.com website. If you do not want to receive such mailings, you may opt out at any time by using the unsubscribe link listed in the email.
G. DO YOU USE “IP ADDRESSES” AND/OR “COOKIES” ON USPM.COM?
IP Addresses: We do use your IP address to help diagnose problems with our server and to administer our website. Your IP address is also used to gather broad demographic information, such as the geographic distribution of our participants, and may be used to geolocate our participants to allow us to provide services appropriate to your place of residence.
Cookies: Contrary to popular myth, cookies do not extract private or personal information from your computer’s memory but record only information you volunteer to us upon registering or visiting the website. Cookies are tiny files placed onto the hard drive of your computer when you register at our website that enable our server to recognize who you are each time you return. You can delete or block cookies from your computer if you want to (your browser help function should tell you how to do this), but certain services may not work correctly or at all if you delete and/or block cookies.
3. Use and Disclosure of PHI
Required Uses and Disclosers: USPM must permit you to inspect and copy your PHI (with certain exceptions) upon request. USPM is also required to disclose your PHI upon request to the Secretary in connection with the Secretary’s investigation of USPM’s compliance with federal privacy regulations.
A. USES AND DISCLOSURES PERMITTED WITHOUT YOUR CONSENT, AUTHORIZATION, OR OPPORTUNITY TO OBJECT
USPM is permitted to use and disclose your PHI without obtaining your consent or authorization in connection with certain health information review and payment activities and health care operations:
- Payment: Payment includes, but is not limited to, the preparation and submission of invoices and other actions required to secure payment for services provided by USPM (such as billing and collection activities). Use and disclosure of your PHI for payment-related purposes may include disclosure to any person responsible for payment with respect to USPM’s services, including any billing and/or collection companies. USPM will limit disclosure of your PHI to the minimum necessary to secure payment for its services.
- Health Care Operations: Health Care Operations include most of USPM’s business operations involving its services. They include (a) quality review and improvement programs; (b) reviewing qualifications and competence of health care providers; (c) legal services and auditing; (d) business planning and development; and (e) other general business and administrative functions. Subject to applicable state law, USPM may use and disclose your PHI as needed for its Health Care Operations and for certain operations of other health care providers and health plans.
This section above describes how USPM will use or disclose your PHI under such circumstances.USPM may also use or disclose your PHI without your consent or authorization, and without giving you the opportunity to object, in the following limited scenarios:
- When the use or disclosure is required by law.
- When permitted or required for purposes of public health activities, including reports to public health authorities authorized by law to collect or receive information for the purpose of preventing or controlling disease (USPM does not generally collect such information).
- When authorized by law and in a manner consistent with applicable law to report information about abuse, neglect, or domestic violence to public authorities.
- When reported to a public health oversight agency for health oversight activities authorized by law. This includes uses or disclosures in civil, administrative, or criminal investigations; inspections; licensure and disciplinary actions; and other activities necessary for appropriate oversight of the health care system or government benefit programs.
- When in the course of any judicial or administrative proceeding (e.g., in response to a subpoena or discovery request), subject to certain conditions. One of these conditions is that, if the subpoena or discovery request is not accompanied by a court order, written assurances must be given to USPM that (a) the requesting party has made a good faith attempt to provide written notice to you, together with information sufficient to permit you to raise an objection, and (b) you did not object or any objections were resolved in favor of disclosure by the court or tribunal.
- When required for law enforcement purposes, as set forth in federal privacy regulations (e.g., to report certain types of wounds). USPM may also release certain PHI (a) upon request to law enforcement officials for the purpose of identifying or locating a suspect, material witness, or missing person, and (b) about an individual who is or is suspected to be a victim of a crime, if the individual agrees to the disclosure or USPM is unable to obtain the individual’s agreement because of emergency circumstances and certain other conditions are met.
- When needed to disclose to a coroner or medical examiner for the purpose of identifying a deceased person, determining a cause of death, or performing other duties, as authorized by law.
- When consistent with applicable state law, if USPM believes in good faith that the use or disclosure of PHI is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public and the disclosure is to a person reasonably able to prevent or lessen the threat, including the target of the threat.
- When in compliance with workers’ compensation or other similar programs established by law.
The above scenarios do not require your written authorization, notice, consent, or opportunity to object.
B. USES AND DISCLOSURES THAT REQUIRE YOUR WRITTEN AUTHORIZATION
4. Your Rights Regarding PHI
You have certain rights regarding PHI held or maintained by USPM. This section summarizes those rights.
A. RIGHT TO REQUEST RESTRICTIONS ON USE AND DISCLOSURE
B. RIGHT TO RECEIVE CONFIDENTIAL COMMUNICATIONS
You have the right to request that you receive communications of PHI from USPM in a certain way or at a certain location. For example, you may request that USPM communicate with you only at work or by mail. To request confidential communications, please submit your request in writing to USPM at the address set forth at the bottom of this page. You are not required to provide a reason for your request, and USPM will accommodate reasonable requests. Please be sure to specify how or where you wish to be contacted.
C. RIGHT TO INSPECT AND COPY MEDICAL INFORMATION
Subject to certain limitations, you have the right to inspect and obtain a copy of your PHI. This includes most PHI maintained by USPM, except for information compiled by USPM in anticipation of legal proceedings. If you wish to inspect and copy your PHI, you must submit a written request to USPM at the address set forth at the bottom of this page. USPM may charge a fee to cover the cost of providing you with a copy of your PHI. USPM is also permitted to deny your request to inspect and copy PHI under certain limited circumstances. If we deny your request, you may (under most circumstances) request that the denial be reviewed by a licensed health care professional selected by USPM. We will thereafter comply with the decision of the reviewing official. USPM will respond to all requests for access to PHI under this paragraph within 30 days of receipt of written notice by (1) providing the requested access and/or copies of the requested information; (2) notifying you in writing of our denial of your request and the reasons for our denial; or (3) notifying you in writing that we are not able to respond within 30 days and of the date on which you may expect a response.
D. RIGHT TO AMEND PHI
You have the right to request that USPM amend PHI if you believe that such information is inaccurate or incomplete. Your request must be in writing and directed to USPM at the address set forth at the bottom of this page. Your request must contain your reason for believing that such information is inaccurate or incomplete. USPM may deny your request for amendment if it determines that the information at issue is accurate and complete or that it: (1) was not created by USPM, unless you submit evidence providing a reasonable basis to believe that the originator of the PHI is not available to make the amendment; (2) is not part of the medical information maintained by USPM; or (3) is not part of the PHI that you have the right to inspect and copy.
USPM will respond to all requests under this paragraph within 60 days of receipt of written notice by either (1) agreeing to make the requested amendment(s); (2) notifying you in writing of the denial of your request and the reasons for denial; or (3) notifying you in writing that we are not able to respond within 60 days and of the date on which you may expect a response. If USPM denies your request, you have (a) the right to submit a written statement disagreeing with our denial, which will become part of your PHI and (b) certain additional rights. Your additional rights and the manner in which a statement of disagreement should be submitted will be described in greater detail in USPM’s denial of your request.
E. RIGHT TO AN ACCOUNTING OF USPM’S USE AND DISCLOSURE OF YOUR PHI
We are not required to list disclosures occurring more than six years prior to the date of your request. USPM will respond to all requests under this paragraph within 60 days of receipt of written notice by either (a) providing you with the requested accounting or (b) notifying you in writing of our inability to respond within 60 days and of the date on which you may expect a response. If you request more than one accounting within a 12-month period, we will impose a fee to cover our costs in providing the requested information.
G. RIGHT TO OPT OUT OF OR CEASE COMMUNICATIONS
As a participant in The Preventive Plan program, you have the right to disenroll and terminate any future correspondence from USPM at any time. Disenrolled members will not receive communications from USPM, except as required by law. To disenroll and opt out of future communications, call 904-265-1058 during normal business hours, and someone from our Member Care team would be happy to assist you.
5. Minimum Necessary Standard
When using or disclosing PHI or when requesting PHI from another covered entity, USPM is required to make reasonable efforts not to use, disclose, or request more than the minimum amount of PHI necessary to accomplish its intended purpose, taking into account practical and technological limitations. However, the minimum necessary standard described in this paragraph does not apply to: (1) disclosures by USPM for Health Information Review purposes; (2) disclosures to or requests by a health care provider for treatment purposes; (3) disclosures made to or authorized by you; (4) disclosures to the U.S. Department of Health and Human Services; or (5) uses or disclosures that are required by law or for USPM to comply with the law.
6. Personal Representatives
You may generally exercise your rights through a personal representative, who will be required to produce evidence of his/her authority to act on your behalf before being given access to your PHI or allowed to take any action for you. Proof of such authority may take one of the following forms: (1) a power of attorney for health care purposes, notarized by a notary public; (2) a court order appointing the person as your conservator or guardian; (3) an individual who is the parent of a minor child; or (4) any other form permitted by applicable state law.
USPM retains the discretion to deny access to PHI to a personal representative to protect any person who depends on others to exercise his or her rights and who may be subject to abuse or neglect.
7. De-Identified Information
III. Complaints and Contact Info
You have the right to file a complaint with USPM or with the Secretary if you believe your privacy rights have been violated. If you wish to file a complaint with USPM, please contact USPM in writing:
If you wish to provide feedback, make requests, ask questions, or file complaints regarding the policies described on this page, you may do so in writing.
US PREVENTIVE MEDICINE, INC.
ATTN: Member Care
13245 Atlantic Boulevard, Suite 4-392
Jacksonville, FL 32225
All complaints must be submitted in writing. USPM will not penalize or discriminate against you in any manner if you choose to file a complaint.