US Medical Care Inc (d/b/a: Florida Premier
Health; Florida Premier Med Spa)
NOTICE OF PRIVACY PRACTICES
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.

If you have any questions about this notice, please contact our Privacy Officer at
561-338-3999.
US Medical Care Inc understands your privacy is important. This Privacy Notice
describes how we may use and disclose your protected health information to carry
out treatment, payment or health care operations and for other purposes that are
permitted or required by law. It also describes your rights to control your protected
health information. Protected health information (PHI) is information about you,
including demographic information, that may identify you and that relates to your
past, present or future physical or mental health condition or payment.
Understanding Your Health Record/Information
Each time you visit a hospital, physician, or other healthcare provider, a record of
your visit is made. Typically, this record contains personal demographic
information, your symptoms, examination and test results, diagnoses, treatment,
and a plan for future care or treatment. This information, often referred to as your
health or medical record, serves as a:
 Basis for planning your care and treatment;
 Means of communication among the many health professionals who
contribute to your care;
 Legal document describing the care you received;
 Means by which you or a third party payer can verify that services billed
were actually provided;
 A tool in educating health professionals;
 A source of data for medical research;
 A source of information for public health officials charged with improving
the health of the nation;

 A source of data for facility planning and marketing; and
 A tool with which we can assess and continually work to improve the
care we render and the outcomes we achieve.

Understanding what is in your record and how your health information is used
helps you to:
 Ensure its accuracy;
 Better understand who, what, when, where and why others may access
your health information;
 Make more informed decisions when authorizing disclosure to others.
Your Health Information Rights:
Although your health record is the physical property of the healthcare practitioner
or facility that compiled it, the information belongs to you. You have the right to:
 Request a restriction on certain uses and disclosures of your information
as provided by 45 CFR 164.522. However, we are not required to agree to
the restriction;
 Inspect and copy your health record as provided for in 45 CFR 164.524
and Florida law. Usually this includes medical and billing records, but
does not include psychotherapy notes. If you request a copy of the
information, we may charge a fee for the costs of copying, mailing or
other supplies associated with your request.
 Amend your health record as provided in 45 CFR 164.526. To request an
amendment, your request must be in writing and must provide a reason
that supports your request. We may deny your request if you ask to
amend information that:
 Was not created by us;
 Is not part of the medical information kept by USMC;
 Is not part of the information which you would be permitted
to inspect or copy; or
 Is accurate or complete.

 Obtain an accounting of disclosures of your health information as
provided in 45 CFR 164.528. To request this list or accounting of
disclosures, your request must be in writing and must state the time
period which may not be longer than six years and may not include
dates before April 13, 2003.
 Request communications of your health information by alternative
means or at alternative locations;

 Receive confidential communications of protected health information as
provided in 45CFR 164.522 (b), as applicable;
 Revoke your authorization to use or disclose health information except
to the extent that action has already been taken.
 Restrict the release of protected health information to your health plan if
you are paying out of pocket in full. 45 CFR 164.522(a)(1)(vi).
 Restrict disclosure related to genetic testing for insurance underwriting
purposes.

Copies of the regulations cited above may be requested from the Privacy Officer by
calling 352-567-0188.
Our Responsibilities:
US Medical Care Inc is required to:
 Maintain the privacy of your health information;
 Provide you with a notice as to our legal duties and privacy practices with
respect to information we collect and maintain about you;
 Abide by the terms of this notice;
 Notify you if we are unable to agree to a requested restriction;
 Accommodate reasonable requests you may have to communicate
health information by alternative means or at alternative locations.
 Notify affected individuals following a breach of unsecured protected
health information in writing.

We reserve the right to change our practices and to make the new provisions
effective for all protected health information we maintain. Should our information
change significantly, we will post the new notice in each USMC location as well as on
our Web site: www.flmedhealth.com.
You may also request a copy of our notice at any time.
For More Information or to Report a Problem
If have questions and would like additional information, you may contact the USMC
Privacy Officer at (561) 338-3999.
If you believe your privacy rights have been violated, you can file a complaint by
contacting the USMC Privacy Officer at 561-338-3999 or you may send a written
complaint to the Secretary, U.S. Department of Health and Human Services. The
USMC Privacy Officer can provide you with the appropriate address upon request.
There will be no retaliation for filing a complaint.
Examples of Disclosures for Treatment, Payment and Health Care Operations

We will use your health information for treatment. For example, information obtained
by a nurse, physician or other member of your healthcare team will be recorded in
your record and used to determine the course of treatment that should work best
for you. Different departments within US Medical Care Inc may share medical
information about you in order to coordinate different services you need, such as
prescriptions, lab work and X-rays. We may also disclose medical information about
you to people outside USMC who may be involved in your medical care, such as
hospitals, long- term care facilities, ambulatory surgery centers or home health
agencies.
We will also provide a referring physician or a subsequent healthcare provider with
copies of various reports that should assist him/her in treating you.
We will use your health information for payment. For example, a bill may be sent to
you or an insurance company (third party payer). The information on or
accompanying the bill may include information that identifies you, as well as your
diagnosis, procedures and supplies used. We may also tell your health plan about a
treatment you are going to receive to obtain prior approval or to determine
whether your plan will cover the treatment.
We will use your health information for regular healthcare operations. For example, in
day-to-day business practices, trained staff may handle your physical medical
record in order to have the record assembled or for filing reports into your record.
Certain data elements are entered into our computer system that processes most
billing, schedules your appointments and for statistical reporting. As part of our
improvement efforts to provide the most effective services, your record may be
reviewed by professional staff to assure accuracy, completeness and organization.
This information may be shared by facsimile transmission.
Other Uses or Disclosures
Business Associates: There are some services provided in our organization through
contacts with business associates. Examples include our using an outside
transcription service to type physicians’ dictated notes or a copy service we may use
when making copies of your health record. When these services are contracted, we
may disclose your health information to our business associates so that they can
perform the job we’ve asked them to do. So that your health information is
protected, however, we require the business associate to agree in writing to
appropriately safeguard your information.
Communication with Family: Health professionals, using their best judgment, may
disclose to a family member, other relative, close personal friend or any other
person you identify, health information relevant to that person’s involvement in
your care or payment related to your care.

Research: We may disclose information to researchers when their research has
been approved by an Institutional Review Board that has reviewed the research
proposal and established protocols to ensure the privacy of your health
information.
Coroners, Medical Examiners and Funeral Directors: We may disclose health
information to a coroner or medical examiner. This may be necessary, for example,
to identify a deceased person or determine the cause of death. We may also
release medical information about patients to funeral directors consistent with
applicable law to carry out their duties.
Organ Procurement Organizations: If you are an organ donor, we may disclose health
information to organ procurement organizations or other entities engaged in the
procurement, banking, or transplantation of organs for the purpose of tissue
donation and transplant.
Marketing: We may contact you to provide appointment reminders or information
about treatment alternatives or other health related benefits and services that may
be of interest to you.
Fundraising: We will not use or disclose PHI for fundraising purposes.
Food and Drug Administration (FDA): We may disclose to the FDA health information
relative to adverse events with respect to food, supplements, product and product
defects or post marketing surveillance information to enable product recalls,
repairs or replacement.
Workers Compensation: We may disclose health information to the extent
authorized by and to the extent necessary to comply with laws relating to workers
compensation or other similar programs established by law. These programs
provide benefits for work-related injuries or illness.
Public Health: As required by law, we may disclose your health information to public
health or legal authorities for public health activities. These activities generally
include the following:
 To prevent or control disease, injury or disability;
 To report births or deaths;
 To report reactions to medications or problems with products;
 To notify people of recalls of products they may be using;
 To notify a person who may have been exposed to a disease or may be
at risk for contracting or spreading a disease or condition;
 To notify the appropriate government authority if we believe a patient
has been the victim of abuse, neglect or domestic violence. We will only
make this disclosure when you agree or when required or authorized by
law.

Correctional Institution: If you are an inmate of a correctional institution or under the
custody of a law enforcement official, we may disclose to the institution or agents
thereof, health information necessary for your health, and the health and safety of
other individuals.
Law Enforcement: We may disclose health information for law enforcement
purposes as required by law:
 In response to a court order, valid subpoena, warrant, summons or
similar process;
 To identify or locate a suspect, fugitive, material witness, or missing
person;
 About the victim of a crime if, under certain limited
circumstances, we are unable to obtain the person’s
agreement;

 About a death we believe may be the result of criminal conduct;
 About criminal conduct at the Clinic; 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.

Disaster Relief: We may disclose your PHI to disaster relief organizations that seek
your PHI to coordinate your care, or notify family or friends of your location or
condition in a disaster. We will provide you with an opportunity to agree or object
to such a disclosure whenever we practically can do so.
Health Oversight Agency: Federal law makes provision for your health information to
be released to an appropriate health oversight agency, public health authority or
attorney, provided that a workforce member or business associate believes in good
faith that we have engaged in unlawful conduct or have otherwise violated
professional or clinical standards and are potentially endangering one or more
patients, workers or the public.
We will not use or disclose your health information without your authorization,
except as described in this notice.
Other Uses and Disclosures of Your Information
by Authorization Only
We are required to receive your authorization to use or disclose your PHI for any
use other than treatment, payment or health care operations, and those specific
circumstances outlined above. We use an Authorization to Use/Disclose form that
specifically states what information will be given to whom, for what purpose, and is

signed by you or your legal representative.  You have the ability to revoke the
signed authorization at any time by a written statement given to us to that effect.
The following uses and disclosures of your Protected Health Information will be
made only with your written authorization:
 Uses and disclosures of PHI for marketing purposes;

 Disclosures that constitute a sale of your Protected Health
 Psychotherapy notes if maintained by the provider

This Notice of Privacy Practices is effective January 1, 2020 and revised July 1, 2022.
Contact Us
To ask questions or comment about this privacy policy and our privacy practices,
contact us at:
George Thomas
gthomas@axiahealthcare.org
(561) 418-2505
 
Revision Dates: 07/01/2022
Review Dates: 01/05/2022

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